PMC6744757_01
Sagittal (a) computed tomography without contrast, axial T1 magnetic resonance imaging w/contrast (b) and sagittal T1 magnetic resonance imaging without (c) and with (d) contrast demonstrate an enhancing erosive lesion involving the C6 and C7 vertebral bodies with peripherally enhancing fluid collection within the intervertebral disc space and a large fluid collection along the posterior aspect of the vertebral bodies with compression of the ventral spinal cord at C6-C7. There is also extensive prevertebral swelling with anterior and posterior epidural enhancement extending from C4 to T1.
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F1
The computed tomography (CT) scan demonstrated severe bony erosion of the C6-C7 vertebral bodies with kyphosis and retropulsion of bone into the central canal, resulting in marked cord/root compression [Figure 1a]. The magnetic resonance imaging (MRI) demonstrated extensive prevertebral swelling, while contrast enhancement showed erosive lesions involving the C6 and C7 vertebral bodies with epidural phlegmon extending from C4 to C7-T1 [Figure 1b-d].
Postoperative cervical X-rays anterior-posterior (a) and lateral (b) show placement of C6-C7 expandable cervical cage and C5 to T1 anterior discectomy with instrumentation and fusion, as well as posterior C4 to T2 instrumentation and fusion with C6 and C7 laminectomy. There is restoration of normal anatomic height with interval improvement in alignment of the cervical spine and reduction of the preoperative kyphotic deformity.
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F2
T1. Three days later, a C6-C7 laminectomy with C4-T2 posterior instrumented fusion was performed [Figure 2].