PMC8411640_01
Magnetic resonance image with gadolinium, T2 sagittal view. Bone marrow edema at T3-T4.
Large epidural abscess at T3-T4-T5 complicated with severe spinal canal stenosis.
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Gadolinium enhanced magnetic resonance imaging (MRI) of the thoracic spine demonstrated evidence of T3-T4-T5 osteomyelitis with epidural abscess and bony destruction of the T4 and T5 vertebral bodies, resulting in severe spinal canal stenosis and spinal cord compression (Figures 1 and 2).
Magnetic resonance image with gadolinium, T2 axial view. Bone marrow edema and abnormal
enhancement at the T3-T4 level with large epidural abscess and severe spinal cord
compression. There is preservation of the anterior meningovertebral ligament; a finding
suggestive of tuberculosis spondylodiscitis.
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Gadolinium enhanced magnetic resonance imaging (MRI) of the thoracic spine demonstrated evidence of T3-T4-T5 osteomyelitis with epidural abscess and bony destruction of the T4 and T5 vertebral bodies, resulting in severe spinal canal stenosis and spinal cord compression (Figures 1 and 2).
Sagittal view computed tomography thoracic spine showing post-operative interval
placement of corpectomy device with removal of T4 and the majority of T5. Posterior
fusion rods extending T2-T7.
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The patient underwent emergency decompression of the epidural abscess with multi-level pedicle screw instrumentation for thoracic vertebral stabilization and interbody cage placement (Figure 3).
Epidural abscess, hematoxylin-eosin. 10x. Well-formed granulomas (*) with giant
cells.
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Epidural tissue biopsies showed caseating and non-caseating granulomas (Figure 4).