PMC9852623_01
(A) Preoperative T2. (B) Preoperative chest CT. (C) Two months postoperative T2. (D) Two months postoperative fat reduction image.
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F1
C3/4 was herniated to the left from the median, and the spinal cord was obviously compressed (Figures 1A, 2A,C). Chest CT showed an old foci of pulmonary TB in the upper lobe of the left lung (Figure 1B). TB infection such as low-grade fever, night sweats, occasional fatigue, insomnia, and no obvious abnormality in limb movement and sensation. The cervical spine MRI imaging 2 months after surgery (Figures 1C,D, 4C) showed bone erosion at the C4/5 vertebral body edge with swelling of the paravertebral soft tissue, and inflammatory manifestations of the C4/5 intervertebral disc and vertebral body. The patient's pain was not relieved after 48 h of empiric antibiotic (ceftriaxone) treatment.
(A) Preoperative C3/4 MRI cross-section. (B) Postoperative C3/4 MRI cross-section. (C) Preoperative C4/5 MRI cross-section. (D) Postoperative C4/5 MRI cross-section.
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F2
C3/4 was herniated to the left from the median, and the spinal cord was obviously compressed (Figures 1A, 2A,C). Chest CT showed an old foci of pulmonary TB in the upper lobe of the left lung (Figure 1B). Postoperative MR of the patient's C3/4 and C4/5 segments showed good postoperative decompression and no vertebral body infection (Figures 2B,D).
(A) Preoperative sagittal enhancement MRI of the cervical spine. (B) Preoperative C3/4 cross-sectional enhanced MRI. (C) Fat suppression of preoperative sagittal enhancement MRI. (D) Preoperative C4/5 cross-sectional enhanced MRI.
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F3
A preoperative enhanced MRI ruled out the possibility of a tumour in the patient's cervical spine (Figures 3A-D).
(A) X-ray before operation. (B) X-ray 2 days after the operation. (C) X-ray 2 months after the operation. (D) X-ray 12 months after the operation.
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F4
Thus, the patients were considered to be cervical spondylotic myelopathy (Figure 4A). On the second day postoperatively, an x-ray examination (Figure 4B) confirmed the decompression of the spinal cord, and the implant structure was stable and the position was correct. TB infection such as low-grade fever, night sweats, occasional fatigue, insomnia, and no obvious abnormality in limb movement and sensation. The cervical spine MRI imaging 2 months after surgery (Figures 1C,D, 4C) showed bone erosion at the C4/5 vertebral body edge with swelling of the paravertebral soft tissue, and inflammatory manifestations of the C4/5 intervertebral disc and vertebral body. The patient's pain was not relieved after 48 h of empiric antibiotic (ceftriaxone) treatment. On June 16, 2022, the patient underwent a cervical spine x-ray examination and the results showed (Figure 4D) that the C3/4 and C4/5 segments were fused, and the paravertebral soft tissue swelling disappeared.
(A) Preoperative C3/4 CT sagittal plane. (B) Preoperative C3/4 CT cross-section. (C) Postoperative C3/4 CT sagittal plane. (D) Postoperative C3/4 CT cross-section.
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F5
The preoperative CT showed no infection in the cervical vertebrae (Figures 5A,B). The postoperative cervical spine CT showed successful surgical decompression, stable endophytes and no signs of infection in the vertebral body (Figures 5C,D).