PMC9062921_01
(a) Preoperative sagittal MRI T2 scan showing fusion of the L2 and L3 vertebrae, hemivertebrae of L4 and L5, unfused spinous process L2, an interspinosal lipoma at the level of L3, and a tethered cord. (b) Preoperative axial MRI T2 scan L4-L5. The midline muscular abnormality causes spinal cord compression. Furthermore, a left foraminal stenosis is seen. (c) Preoperative axial MRI T2 scan L1 showing diastematomyelia of the spinal cord.
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F1
MRI of the lumbar spine revealed OSD in combination with spondylotic changes [Figure 1].
Intraoperative photo. Exposure of the muscular abnormality (arrow).
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F2
The spinal canal was approached from the left side through a L4/L5 hemi-laminectomy [Figure 2].
Intraoperative microscopic photo. After extraction of the muscular abnormality, the dura is exposed. The internal fascia sheet (arrow) is detached from the dura.
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F3
The fascia of the midline muscle (i.e., attached to the dura) had to be carefully dissected away from the underlying dura [Figure 3].
Histological aspect of excised tissue with hematoxylin and eosin (HE) stain. (a) Muscle tissue HE x200. (b) Muscle tissue with nerve fibers HE x100.
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F4
The pathology report confirmed that the tissue removed was normal muscle tissue [Figure 4].
(a) Postoperative sagittal MRI T2 scan. (b) Postoperative axial MRI T2 scan L4-L5. The midline muscular abnormality is removed, showing adequate decompression of the spinal canal.
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F5
Postoperative MRI at 3 months revealed adequate decompression of the spinal canal [Figure 5].