PMC9062908_01
Anteroposterior radiograph of the patient depicting collapse of lumbar vertebrae and a coronal shift of around 4 cm to the left side.
SNI-13-136-g001.jpg
PMC9062908_01_SNI-13-136-g001.jpg
F1
X-rays revealed a lumbar spine deformity characterized by L2-L4 vertebral lysis [Figures 1 and 2].
Plain lateral radiograph of the patient depicting gross lumbar kyphosis. There is a loss of multiple lumbar vertebrae architecture evident in the radiographs. The overall lumbar lordosis is around 30  but there is gross instability due to loss of multiple lumbar vertebral bodies. The sagittal vertebral axis is shifted around "-3 cm."
SNI-13-136-g002.jpg
PMC9062908_01_SNI-13-136-g002.jpg
F2
X-rays revealed a lumbar spine deformity characterized by L2-L4 vertebral lysis [Figures 1 and 2].
A magnetic resonance imaging T2-weighted sagittal image showing hyperintense signals in the lumbar vertebrae in both anterior and posterior elements of the vertebrae. It justifies and correlates with the chylous fluid found peroperative.
SNI-13-136-g003.jpg
PMC9062908_01_SNI-13-136-g003.jpg
F3
In addition, the CT/myelo-CT demonstrated dilated cysts within the L2-L4 posterior elements [Figures 3-6].
Sagittal reconstruction of computed tomographic scan of the patient showing multiple lytic defects in the body of the lumbar vertebra and the lumbar kyphosis.
SNI-13-136-g004.jpg
PMC9062908_01_SNI-13-136-g004.jpg
F4
In addition, the CT/myelo-CT demonstrated dilated cysts within the L2-L4 posterior elements [Figures 3-6].
Coronal magnetic resonance myelogram showing a partial myelo-block along with fluid intensity in the anterior and posterior elements of the vertebra.
SNI-13-136-g005.jpg
PMC9062908_01_SNI-13-136-g005.jpg
F5
In addition, the CT/myelo-CT demonstrated dilated cysts within the L2-L4 posterior elements [Figures 3-6].
Sagittal MR myelogram suggestive of a partial myelogram block at the kyphotic apex at L2-L3.
SNI-13-136-g006.jpg
PMC9062908_01_SNI-13-136-g006.jpg
F6
In addition, the CT/myelo-CT demonstrated dilated cysts within the L2-L4 posterior elements [Figures 3-6].
Intraoperative photograph of the patient showing the four-rod construct with domino connectors and placement of copious quantities of bone grafts.
SNI-13-136-g007.jpg
PMC9062908_01_SNI-13-136-g007.jpg
F7
A spinopelvic fusion was performed from T5 to T12 through the L5/S2 levels using anchors to the pelvis and S2 alar/iliac screws (i.e., supplemented with a four-rod cobalt chrome construct and cross-links) [Figures 7-9].
Postoperative anteroposterior radiograph demonstrating that coronal tilt is well corrected to within 1 cm of the midline after posterior stabilization with multiple point anchors and multirod construct.
SNI-13-136-g008.jpg
PMC9062908_01_SNI-13-136-g008.jpg
F8
A spinopelvic fusion was performed from T5 to T12 through the L5/S2 levels using anchors to the pelvis and S2 alar/iliac screws (i.e., supplemented with a four-rod cobalt chrome construct and cross-links) [Figures 7-9].
Postoperative lateral radiographs showing good correction of lumbar kyphosis. The sagittal vertebral axis is corrected to "+2 cm."
SNI-13-136-g009.jpg
PMC9062908_01_SNI-13-136-g009.jpg
F9
A spinopelvic fusion was performed from T5 to T12 through the L5/S2 levels using anchors to the pelvis and S2 alar/iliac screws (i.e., supplemented with a four-rod cobalt chrome construct and cross-links) [Figures 7-9].
Follow-up anteroposterior radiograph at 4 years depicting maintained correction and no implant failure. There is no further progression of disease to other segments.
SNI-13-136-g010.jpg
PMC9062908_01_SNI-13-136-g010.jpg
F10
Both the CT and MR studies continue to confirm remission of GSD; the CT scan shows bony bridging/ fusion/stability, while the MRI demonstrates no new vertebral bony reformation [Figures 10-12].
Follow-up lateral radiograph showing maintained alignment.
SNI-13-136-g011.jpg
PMC9062908_01_SNI-13-136-g011.jpg
F11
Both the CT and MR studies continue to confirm remission of GSD; the CT scan shows bony bridging/ fusion/stability, while the MRI demonstrates no new vertebral bony reformation [Figures 10-12].
3-D computed tomographic reconstruction showing good posterior and posterolateral bony fusion along the reconstruction.
SNI-13-136-g012.jpg
PMC9062908_01_SNI-13-136-g012.jpg
F12
Both the CT and MR studies continue to confirm remission of GSD; the CT scan shows bony bridging/ fusion/stability, while the MRI demonstrates no new vertebral bony reformation [Figures 10-12].