PMC4173207_01
Preoperative T2-weighted sagittal (a) and proton density weighted axial (b-d) MRI images without contrast. The axial images demonstrate the level of spinal canal compromise at the level of the C4-5 disc (b), mid-C5 vertebral body (c) and C5-6 disc (d). An arrow identifies the cervical disc herniation with extrusion on the sagittal MRI
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F1
A large, contiguous C4-5 disc extrusion extending from the postero-inferior corner of C4 to the C5-6 disc space was identified on magnetic resonance imaging (MRI) [Figure 1].
Preoperative sagittal (a) and axial (b-d) CT images. Images b-d correspond to axial MRI images presented in Figure 1. The extent of bony canal compromise secondary to OPLL posterior to the C4-5 disc (b), mid-C5 vertebral body (c) and C5-6 disc (d) is illustrated. Note the double layer sign on the axial CT images
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F2
Sagittal and axial computed tomography (CT) images identified OPLL surrounding the extruded disc [Figure 2].
Axial CT (a) and MRI (b) images at the level of maximal canal compromise posterior to the C5 vertebral body. Measurements of the crosssectional area available for the spinal cord secondary to bony (a) and soft-tissue (b) canal compromise are shown
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F3
Canal compression was measured and computed on axial MR and CT images using imaging software in-house [Figure 3].
Postoperative upright anteroposterior (a) and lateral (b) radiographs following anterior cervical decompression with a C5 corpectomy and cage reconstruction with anterior cervical plate stabilization
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F4
Postoperative upright radiographs indicated good bony alignment and satisfactory instrumentation placement [Figure 4].