PMC6826297_01
(a) Lateral plain radiograph shows refracture of cemented L1, note that the posterior compartment is pushed back associated with canal compromise and kyphosis, (b) anteroposterior lumbar X-ray demonstrates two cemented lumps.
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F1
Although the height of the anterior compartment was preserved with the PKP, the wedge-shaped posterior compartment was now significantly kyphotic and had migrated dorsally into the spinal canal resulting in significant conus/cauda equina compression [Figure 1].
(a) The bone cement is demonstrated at the beginning of spondylectomy, (b) trying to remove cemented lump, (c) is almost removed.
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F2
Next, an L1 corpectomy was performed to reset the previously cemented L1 vertebra followed by reconstruction of the anterior column utilizing a tibial shaft allograft [Figures 2-4].
Intraoperative fluoroscopy (a) shows complete spondylectomy, (b) the anterior column is reconstructed with a tibial shaft allograft.
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F3
Next, an L1 corpectomy was performed to reset the previously cemented L1 vertebra followed by reconstruction of the anterior column utilizing a tibial shaft allograft [Figures 2-4].
Intraoperative photograph, (a) the lump is removed, (b) spondylectomy done, (c) replacement of the site with allograft.
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F4
Next, an L1 corpectomy was performed to reset the previously cemented L1 vertebra followed by reconstruction of the anterior column utilizing a tibial shaft allograft [Figures 2-4].
Postoperative lumbar X-ray, (a) anteroposterior radiograph shows proper placement of the allograft, note good coronal alignment, (b) lateral radiographs show correction of kyphosis and good sagittal alignment, note pedicle screws cement augmentation.
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F5
Postoperatively, the plain thoracolumbar X-ray demonstrated adequate alignment [Figure 5].