PMC3350213_01
Case 1: 79-year-old man with metastatic leiomyosarcoma to the T11 vertebral body, s/p vertebrectomy, and reconstruction. (a, b, c). Axial, coronal, and sagittal MDCT. The position of the expandable titanium cage and anterior thoracic fusion plate is demonstrated. (d, e, f). Co-registration of sequential MDCT studies. The original study is in white color and the more recent study is in black color; a similar position of the surgical instrumentation between the two sequential studies is demonstrated. Green line denotes corresponding position of the other two orthogonal planes.
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fig1
T11 level was performed with an expandable titanium cage, and the spine was stabilized anteriorly from T10-T12 using a thoracic plate. The construct was stable on followup imaging between the immediate postsurgical imaging and at followup 6 months later (Figure 1).
PMC3350213_02
Case 2: 39-year-old man with renal cell carcinoma metastatic to the T2 through T4 vertebral bodies, s/p vertebrectomy with placement of Steinmann pin and methyl methacrylate graft. (a, b). Sequential sagittal noncontrast MDCT studies 3 months apart demonstrate subtle posterior migration of the Steinmann pin and methyl methacrylate graft. Arrow in (b) points to initial position of the graft. (c, d). Sagittal co-registered MDCT studies (windowed to view methyl methacrylate). Posterior migration of the methyl methacrylate graft; initial position (black arrow) and position on followup, (white arrow). (e) Sagittal coregistered MDCT studies (windowed to view instrumentation). Posterior migration of the Steinmann pin; initial position (black arrow) and position on followup (white arrow). (f). MIP (maximal intensity projection). Posterior migration of the Steinmann pin; original position: black color, followup: red color.
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fig2
On followup imaging, obtained 3 months after surgery, the inferior aspect of the Steinmann pin and the methyl methacrylate graft, which were positioned on the superior T5 endplate, had migrated posteriorly (Figure 2).