PMC5461573_01
Axial (a) and midsagittal reconstruction (b) of the cervical spine CT at the C5-6 level demonstrating complete spondyloptosis, with the body of the C5 vertebra placed in front of that of the C6 vertebra
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F1
Computed tomography (CT) of the cervical spine demonstrated C5-6 spondyloptosis, superior and inferior lamina fractures on the right at the C3-4 level, and widened facet joint on the right at C6-7 [Figure 1].
Postoperative lateral (a) and anterior-posterior (b) radiograph shows reduction and C5-6-7 anterior cervical disc fusion
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F2
The patient was treated with anterior C5-6 and C6-7 discectomy with fusion (Puros S2 allograft bone grafts; Zimmer Spine, Minneapolis, MN, USA) and a 40-mm Invizia (Zimmer Spine; plates C5-C7); no posterior stabilization was used [Figure 2].
CT angiography taken on postoperative day 2 revealed 100% occlusion of the left vertebral artery within the left transverse foramen. The dissection extends from the origin at the subclavian to the C4-5 level. The contralateral vertebral artery of the patient
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F3
Postoperative CT angiography showed dissection and occlusion of the left vertebral artery originating at the C4-5 level with distal reconstitution via muscular collaterals [Figures 3 and 4].
The left vertebral artery distal to the occlusion shows reconstitution from the muscular collaterals and is contiguous with the patient contralateral vertebral artery
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F4
Postoperative CT angiography showed dissection and occlusion of the left vertebral artery originating at the C4-5 level with distal reconstitution via muscular collaterals [Figures 3 and 4].
Lateral plain radiograph obtained 1.5 months postoperatively reveals satisfactory alignment surrounding the instrumentation
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F5
The patient was discharged to a rehabilitation hospital on postoperative day 5; her condition remained unchanged 6 months later [Figure 5].