PMC7471824_01
Imaging findings at the initial visit. (a) MRI sagittal imaging. T1 low and T2 iso-to-low extradural mass formation and severe compression to the spinal cord were observed. (b) CT sagittal reconstruction and axial imaging at T6. Osteolytic destruction of T6 and T7 vertebrae was observed. (c) X-ray just after the primary surgery.
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T6-7 was demonstrated by computed tomography (CT) and magnetic resonance imaging (MRI) (Figures 1(a) and 1(b)). There were no fevers, and the laboratory data showed no elevation in the white blood cell count (WBC; 5450/mul) or CRP (0.23 mg/dl). The patient accepted emergency surgery for the progressive paraplegia. A T4-9 posterior decompression and fusion with a T6-7 laminectomy were performed (Figure 1(c)).
Imaging findings 9 months after surgery. (a) MRI sagittal imaging. (b) CT sagittal and coronal reconstruction. All the pedicle screws were loosened with the progression of the T6-7-8 vertebrae. (c) Chest CT. Arrowhead shows the coin lesion.
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T5-6-7 vertebrae with loosening of all pedicle screws was noted on MRI and CT (Figures 2(a) and 2(b)). The laboratory data showed elevation of CRP (11.64 mg/dl) without elevation of WBC (6470/mul). Furthermore, a coin lesion in the right lung was observed (Figure 2(c)).
Imaging findings at the final follow-up. (a) X-ray. T1-12 posterior fusion and T6-7-8 corpectomy and anterior reconstruction with an expandable case were performed. (b) CT sagittal and coronal reconstruction. Complete bony fusion was observed inside the cage.
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In the second stage, a T6-7-8 corpectomy, anterior drainage, and reconstruction with an expandable cage were performed (Figure 3(a)). At the final follow-up 1 year after surgery, she could walk with a crutch, the laboratory data had returned to a normal level (CRP: 0.07 mg/dl), and complete fusion of T5-9 was observed on CT that showed healing of the spinal tuberculosis (Figure 3(b)).