PMC10172676_01
Imaging evolution of the clinical case in lateral view radiography images and sagittal CT sections: Rad-Li:initial radiograph in lateral view, showing T12 and L1 vertebral body flatenning and extensive bone destruction at T12 (arrow); Sag-I:initial median sagittal view of computed tomography, showing acute T12 fracture and old L1 fracture. Note the extensive bone trabeculae destruction at anterior half of the vertebral body; Sag-P:Median sagittal view of tomography, showing T12 vertebral body pseudarthrosis with a large anterior intravertebral cleft and marked posterior wall retropulsion; Sag-Fm:Median sagittal view of CT at 1 year after surgery, showing T12 vertebral body pseudarthrosis filled with stent and signs of T12 laminectomy; Sag-Fr:Right parasagittal view of CT at 1 year after surgery, showing the right stent filled with bone graft and the right pedicular screws, note the pseudarthrosis healing; Sag-Fl:Left parasagittal view of CT at 1 year after surgery, showing the left stent filled with bone graft and the right pedicular screws. Note the pseudarthrosis healing; Rad-Lf:Final radiograph in lateral view at 2 years after surgery, showing T12 stents, adjacent pedicle screws, rods and crosslink.
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F1
A CT scan was performed in the context of the current episode and a pseudarthrosis of T12 vertebral body was identified, with almost total somatic collapse, the presence of a large anterior intrasomatic cleft and marked retropulsion of the posterior wall (Figure 1 Sag-P and Figure 2:Color-P, Ax-P). Average Hounsfield units at T11 and L1 and L2 vertebral body on this CT was 180, so patient demonstrated normal bone mineral density. We present the final radiographic control at 2 years postoperatively, which demonstrates maintenance of the integrity of the vertebral body and implants (Figure 1 Rad-Lf and Figure 2 Rad-APf).
Imaging evolution of the clinical case in anteroposterior view radiography and coronal and axial CT sections: Rad-APi:initial radiograph in anteroposterior view, showing T12 and L1 vertebral body flattening and extensive bone destruction (arrow) at T12; Cor-I:initial coronal view of CT, showing acute T12 fracture and old L1 fracture. Note the extensive bone trabeculae destruction across the entire width of the vertebral body; Cor-P:Coronal view of CT, showing T12 vertebral body pseudarthrosis with a large intravertebral cleft across the entire width and height of the vertebral body; Cor-F:Coronal view of CT at 1 year after surgery, showing T12 vertebral body pseudarthrosis cleft filled with stents with bone graft inside, which demonstrates signs of bone healing and osteointegration. Also note the development of lateral osteophytes that help to stabilize the vertebral body to the adjacent ones; Rad-APf:Final radiograph in anteroposterior view at 2 years after surgery, showing T12 stents, adjacent pedicle screws, rods and crosslink; Ax-I:Initial axial view of CT, showing acute T12 fracture. Note the extensive bone trabeculae destruction across the entire width of the anterior half of the vertebral body; Ax-P:Axial view of CT, showing T12 vertebral body pseudarthrosis with a large intravertebral cleft across the entire width of the anterior half of the vertebral body; Ax-F:Axial view of CT at 1 year after surgery, showing T12 vertebral body pseudarthrosis cleft filled with two stents with bone graft inside, which demonstrates signs of bone healing and osteointegration. Also note T12 laminectomy procedure, the crosslink applied at that level and the remodeling of posterior wall retropulsion with reabsorption of intracanalar bone.
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F2
A CT scan was performed in the context of the current episode and a pseudarthrosis of T12 vertebral body was identified, with almost total somatic collapse, the presence of a large anterior intrasomatic cleft and marked retropulsion of the posterior wall (Figure 1 Sag-P and Figure 2:Color-P, Ax-P). Average Hounsfield units at T11 and L1 and L2 vertebral body on this CT was 180, so patient demonstrated normal bone mineral density. We present the final radiographic control at 2 years postoperatively, which demonstrates maintenance of the integrity of the vertebral body and implants (Figure 1 Rad-Lf and Figure 2 Rad-APf).
Armed kyphoplasty with VBS  in treatment of posttraumatic vertebral necrosis with mobile vertebrae non-plana and plana. The present clinical case was a mobile vertebra plana; however, the treatment of armed kyphoplasty is similar to the one of plana or non-plana mobile necrotic vertebrae, as is illustrated in this figure. After removal of pseudarthrosis region (the same as the intravertebral cleft) and proper intravertebral cleaning, the implants are expanded and then filled with bone cement or graft (in this clinical case, we chose bone graft).
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F3
In Figure 3 we show an illustration of the armed kyphoplasty with VBS  stents.