PMC5458703_01
Sagittal T2 magnetic resonance imaging from the first hospitalization, with increased signal of T12 vertebrae.
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F1
A 57-year-old obese (body mass index = 39) afebrile male patient, with breathing, constrained disturbances, resident of the province with domestic animals was transferred to our clinic from another hospital, where he was treated with bed rest for 2 weeks for spine fracture (Fig. 1) due to misdiagnosis.
Sitting position chest X-ray with significant pleural effusion of the left side.
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F2
His left osteoarthritic knee was swollen, while chest roentgenogram showed pleural effusion on the left side (Fig. 2).
Lateral radiogram of thoracolumbar spine with significant deterioration and osteolytic lesions of T12.
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F3
Lateral plain roentgenogram (Fig. 3) and computed tomography (CT)-scan (Fig. 4) of the spine revealed destruction of the T12-vertebral body and intervertebral discs T11-T12 and T12-L1 associated with paravertebral abscess formation (Fig. 5).
Transverse computed tomography scan image of T12, shows the destruction of the vertebrae.
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F5
Lateral plain roentgenogram (Fig. 3) and computed tomography (CT)-scan (Fig. 4) of the spine revealed destruction of the T12-vertebral body and intervertebral discs T11-T12 and T12-L1 associated with paravertebral abscess formation (Fig. 5).
Lateral post-operative radiogram, shows the anterior (cage) and posterior instrumentation.
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F6
An expandable titanium mesh cage (TMC) filled with resected rib bone graft was inserted, and the spine was stabilized through a minimally invasive posterior instrumentation (Fig. 6).
Sagittal computed tomography scan image of 6-month follow-up, shows the fusion and the incorporation of the mesh cage.
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F7
Radiograms and CT scan showed a good result of fusion in both sites (Fig. 7 and 8).
Anteroposterior radiogram of fused knee of 6-month follow-up. The Illizarov device has been removed, and two screws for patella fixation are shown.
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F8
Radiograms and CT scan showed a good result of fusion in both sites (Fig. 7 and 8).
Brain computed tomography scan image with drainage tube due to severe hydrocephalus.
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F9
Brain CT scan revealed edema and hydrocephalus that required drainage tube installation (Fig. 9).