PMC9393415_01
(A) Computed tomography images of the thoracic vertebrae indicate marked osteolysis within the T10/T11 vertebrae (arrows); (B) Osteolysis within the T10; (C) Osteolysis within the T11; (D) High-signal intensity was observed on the T1-weighted image within the T10/11 vertebrae (arrows); (E) High-signal intensity was observed on the T2-weighted image within the T10/11 vertebrae (arrows); (F) spinal cord compression was observed on the T2-weighted image within the T10 level (arrows); (G) spinal cord compression was observed on the T2-weighted image within the T11 level (arrows).
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F1
Three-dimensional whole-spine computed tomography (CT) showed a low-density shadow on the T10/11 vertebral body and pedicle, involving the left 8-11 ribs, indicating the possibility of a benign bone tumour (Figure 1). Magnetic resonance imaging (MRI) also demonstrated hyperintense signals on both T1WI and T2WI of the T10/11 vertebral body (Figure 1).
PMC9393415_02
Surgical field of the spine, which revealed thin cortical bone, sparse cancellous bone, and porous cancellous surface that appeared highly soft and spongy.
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F2
During the surgery, lightly hooking the lamina with a nerve peeler destroyed the lamina bone, showing osteoporosis, thin cortical bone, sparse cancellous bone, and a porous cancellous surface, which appeared very soft and spongy (Figure 2).
A 13-year-old male with progressive kyphosis and massive osteolysis in the thoracic vertebrae. (A) patient's preoperative appearance; (B) preoperative standing whole-spine radiograph demonstrated a thoracic kyphosis curve of 122 ; (C) patient's halo-pelvic traction appearance; (D) standing whole-spine radiograph after halo-pelvic traction; (E) patient's postoperative appearance; (F) postoperative standing whole-spine radiograph demonstrated the thoracic kyphosis was reduced to 48 , with a correction rate of 60.8%.
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F3
Post-surgery, the patient experienced neurological improvement, regaining normal muscular strength in the lower extremities (ASIA E) (Figure 3).
The proliferating fibrous tissues and numerous thin-walled blood vessels in the bone cavity are visible in histological pictures of the removed thoracic vertebrae, but there is no sign of cellular atypia or osteogenesis reactions.
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F4
T10-T11 vertebral body and lamina revealed broken mature bone and cartilage, a trabecular bone section that was sparse and thin, along with proliferation of lymph and blood vessels between the trabeculae (Figure 4). The diagnosis of GSS was made based on radiographic, clinical, and pathological findings.
PMC9393415_03