PMC8247685_01
(a) Clinical picture of the patient showing prominent thoracic hump. (b) Lateral and AP view of spine radiograph showing severe thoracic kyphosis.
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F1
On physical examination, bossing of the thoracic cage was observed with short abdomen and both iliac crest almost touching the ribs [Figure 1a]. Radiographic picture of spine showed severe kyphosis of 141  from T1 to T10 thoracic vertebrae on lateral view with diffuse paraspinal calcifications, most likely representing a granulomatous lesion [Figure1b].
Sagittal MRI showing collapsed dorsal spine with gibbous formation.
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F2
Similarly, variable sized paraspinal collections were identified with areas of low-intensity signals/signal void suggested chronic calcified component [Figure 2].
(a) Image of the patient just after the placement of halo-pelvic assembly. (b) Radiograph showing exact position of half pins in pelvic assembly; supra-acetabular half pins (red arrows) half pins in ilium (yellow arrows).
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F3
Both arches were connected with each other through two threaded rods to strengthen the construct [Figure 3].
Both clinical and radiographic images of the patient after a month of distraction. Note the substantial reduction of the kyphosis.
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F4
After 35 days of distraction, rib hump and thoracic knuckle markedly improved and Cobb angle reduced from 141  to 56  [Figure 4] and the patient height increased up to 8 cm.
Radiographic images taken just after corrective surgery showing placement of thoracic cage from T1 to T10.
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F5
A cage was placed from T1 to T10 vertebral body after debridement [Figure 5].