PMC9112984_01
Preoperative plain radiograph of lumbar spine in (a) anteroposterior and (b) lateral views revealing compression fracture of L3 vertebral body with loss of height.
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F1
The plain lumbosacral radiographs showed a L3 compression fracture (50% loss of height) [Figure 1].
Magnetic resonance imaging scan showing (a) screening of whole spine, (b) sagittal, and (c) axial cut sections revealing retropulsed segment of L3 vertebral body causing spinal cord compression.
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F2
The magnetic resonance imaging (MRI) documented marrow signal changes involving multiple lumbar vertebral bodies, pedicles, and spinous processes along with L3 body retropulsion, and an epidural soft-tissue mass compressing the cauda equina at the L3 level [Figure 2].
Fluoro-2-deoxy D-glucose positron emission-computerized tomography scan showing (a) primary lesion in the lungs, (b) and (c) multiple lytic lesions in the lumbar spine and pelvis.
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F3
The fluoro-2-deoxy D-glucose (FDG) positron emission-computerized tomography (PET- CT) confirmed multiple FDG avid lytic lumbar lesions [Figure 3].
Postoperative radiograph revealing posterior instrumented stabilization with pedicle screws and rods with mesh cage at L3 level after performing corpectomy in (a) anteroposterior and (b) lateral views.
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F4
On removing the L2-L4 lamina, a grayish-white mass was observed compressing the spinal cord [Figure 4].
Histological study slide as seen under light microscopy (a) showing characteristic tumor cells with small size, scanty cytoplasm and (b) round to fusiform shape and absent or inconspicuous nucleoli representing small cell neuroendocrine tumor.
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F5
They were positive for cytokeratin, CD56, and synaptophysin markers with MIB-1 proliferation index of 70%, all consistent with metastatic carcinoid disease [Figure 5].
A sequential sagittal (a) computed tomography scan imaging study at 3 months after surgery revealing implants and cage in situ with no retropulsion. A three-dimensional image (b) confirming the same findings.
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F6
The 3-month postoperative CT scan confirmed adequate anterior/posterior lumbar fusion [Figure 6].