PMC9831644_01
(A) Lumbar spine X-ray, anteroposterior view showed the collapse of the L1-2 intervertebral space. (B) Lumbar spine X-ray and lateral view showed L2 superior endplate erosion.
rjac635f1.jpg
PMC9831644_01_rjac635f1.jpg
f1
X-ray films showed the collapse of the L1, L2 vertebrae, and L1-2 intervertebral space (Fig. 1).
Sagittal T2-weighted MRI shows severe disco vertebral destruction, the formation of epidural abscess and compression of the spinal cord at the L1-2 level.
rjac635f2.jpg
PMC9831644_01_rjac635f2.jpg
f2
An abscess was observed at the L1-L2 vertebral level in lumbar magnetic resonance imaging (MRI) (Fig. 2).
Lumbar T1 and T2 consistent with an abscess at the L1-2 vertebral level. (A) and (B) showed that the height of the L1 and L2 vertebral bodies was markedly reduced and the dural sac and spinal cord were severely compressed by an abscess posterior to the vertebral body. (C and D) Axial T1 shows a well-defined paraspinal abscess. The anterior epidural abscess compresses the spinal cord.
rjac635f3.jpg
PMC9831644_01_rjac635f3.jpg
f3
The patient was treated with anti-TB treatment (Isoniazid, Rifampicin, Ethambutol, Pyrazinamide) due to spinal TB findings on MRI (Fig. 3). MRI confirmed these abnormalities and showed typical findings such as vertebral endplate destruction, bone marrow and disk signal abnormalities, and paravertebral or epidural abscesses (Fig. 3). Due to clinical manifestations and MRI spinal TB findings (Fig. 3), the patient underwent surgical debridement, interbody fusion and internal fixation with fibular autografting and supplemental posterior spinal stabilisation using a posterior-only approach.
(A, B) Post-operation, anteroposterior and lateral view showing fibular autograft implantation followed by supplemental posterior instrumentation.
rjac635f4.jpg
PMC9831644_01_rjac635f4.jpg
f4
Radiologically 2, 6 and 12 months, 14 years' post-operation, the patient had achieved full bony graft spinal fusion (Figs 4-6).
(A, B) 2, 4 months after single-stage posterior extensive debridement and fibular autograft implantation followed by supplemental posterior instrumentation performed to treat the spinal infection.
rjac635f5.jpg
PMC9831644_01_rjac635f5.jpg
f5
Radiologically 2, 6 and 12 months, 14 years' post-operation, the patient had achieved full bony graft spinal fusion (Figs 4-6).
(A, B) Complete bony incorporation between the implanted fibular autograft and host vertebral body was noted on the lateral radiograph 1, and 14 years later.
rjac635f6.jpg
PMC9831644_01_rjac635f6.jpg
f6
Radiologically 2, 6 and 12 months, 14 years' post-operation, the patient had achieved full bony graft spinal fusion (Figs 4-6).