PMC5725151_01
Radiographs showing marked destruction of L2 and L3 vertebrae with paravertebral hypertrophic ossification and kypho-scoliotic deformity.
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F1
Radiographs showed gross destruction of L2 and L3 vertebral bodies leading to kypho-scoliosis at the upper lumbar region with a Cobb angle of 70 degrees in the sagittal plane, paravertebral hypertrophic ossification involving an area from T12 to L3, with destruction of posterior elements, and lateral translation of L2 over L3 (Figure 1).
CT scan at presentation showing bony destruction and para-vertebral new bone formation.
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F2
A CT scan confirmed partial resorption of upper lumbar vertebral bodies and gross para-spinal ossification and deformity (Figure 2).
Pre-operative MRI in supine position showing large fluid filled cavitary lesion between L2 and L3 vertebrae extending to the posterior elements and associated bony resorption.
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F3
A minor syrinx was also seen at T10/T11 following previous spinal cord injury (Figure 3).
Intra-operative fluoroscopy image showing final fixation with four rod construct and immediate post operative radiograph showing good 3D correction of the deformity with stable fixation.
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F4
A four rod construct was used for the fixation to prevent future risk of rod breakage (Figure 4).
1 year follow up radiograph shows good consolidation at the pseudoarthrosis site and correction of the deformity.
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F5
At the latest follow up 1 year post-operatively, the patient remained symptom-free and independent doing his routine daily activities (Figure 5).