PMC9899152_01
Imaging findings before and after surgery. (A) Computed tomography scan after emergency transport; a narrow canal between C4 and C5 (11 mm), ossification of the posterior longitudinal ligament of the segmental type on the posterior walls of C4 and C5, and no fractures. (B) T2-weighted magnetic resonance imaging scan after emergency transport. The spinal cord compression rate was 21%. (C) T2-weighted magnetic resonance imaging scan at eight months after injury. Edema was reduced, and the spinal cord compression rate was 16%. (D) X-ray findings after decompression surgery. The spinal canal enlargement rate was 173%.
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FIG1
CSCIw. Computed tomography scan after emergency transport revealed no fractures, but a narrow canal between C4 and C5 (11 mm) and ossification of the posterior longitudinal ligament of the segmental type on the posterior walls of C4 and C5 (Figure 1A). T2-hyperintense signal changes in the cord on C3-4 (Figure 1B). T2-weighted MRI at eight months after the injury revealed myelomalacia on C3/4, and disc protrusion at C3-6 (Figure 1C). He underwent C4-6 open-door laminoplasty eight months after the injury (Figure 1D).
Short-term progress of the standing posture. (A) Postoperative day two: Standing posture indicated hip and knee joint flexion; however, foot-flat was not observed (heel-off; plantar-flexed position of the ankle joint). (B) Postoperative day six. (c) Postoperative day 10: The patient was able to attain foot-flat and stand positions in the midline position.
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FIG2
On postoperative day 10, the muscle tone of the hip and knee flexors, including ankle plantar flexors, decreased (each muscle: MAS-1), and he was able to attain foot-flat and stand positions in the midline position (Figure 2).