PMC5860911_01
Anteroposterior (AP) X-ray of the right knee
. AP X-ray of the right knee demonstrating long-standing joint contractures and joint disease leading to a fused and nonfunctional knee joint.
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 The patient had a long-standing history of arthrogryposis and underwent several lower extremity reconstructive surgeries from birth until 5 years of age. ( Fig. 1 ) Previous surgical history also included a T3 to L5 thoracolumbar fusion for scoliosis treatment as an adolescent.
Preoperative cervical magnetic resonance imaging (MRI)
. Preoperative cervical MRI demonstrating moderate-to-severe spinal stenosis from C3 to C5, and evidence of intramedullary spinal cord signal change at C3 to C4 level, which was thought to represent cord contusion or edema.
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 Magnetic resonance imaging (MRI) of the cervical spine revealed moderate-to-severe spinal stenosis from the C3 to C5 levels. ( Fig. 2 ) There was evidence of intramedullary spinal cord signal change at the C3 to C4 level, which was thought to represent cord contusion or edema.
Anteroposterior (AP) and lateral postoperative cervical X-rays
. AP and lateral postoperative cervical X-rays demonstrating a posterior cervical instrumented fusion with good instrumentation placement.
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A posterior cervical instrumented fusion from levels C3 to C6 was performed with a bilateral posterior cervical laminectomy from C3 to C5. ( Fig. 3 ) Local laminectomy bone was utilized as morselized autograft with the addition of demineralized bone matrix to aid with fusion. 
Pre- and postoperative cervical magnetic resonance imaging (MRI)
. (Left) Preoperative cervical MRI demonstrating multilevel cervical stenosis with cord signal change. (Right) Postoperative cervical MRI demonstrating optimal cervical decompression and alignment.
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 Postoperative MRI demonstrated proper alignment and decompression. ( Fig. 4 ) The patient experienced mild neck pain post-surgery; otherwise, the post-operative course was uneventful.