PMC5742434_01
(a) Preoperative sagittal T2-weighted magnetic resonance image of the cervicothoracic spine shows vertebral osteomyelitis and intervertebral disk abscess of T2/3. (b) Preoperative sagittal CT shows bone destructions of the endplates of T2/3.
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Magnetic resonance imaging (MRI) showed no abscess in the lumbar spine, but it showed an abscess of T2/3 (Figure 1). CT demonstrated bone destructions of the endplates of T2/3 (Figure 1).
Schema of position and skin incisions. (a) At surgery, the patient's arm is positioned at 80  of abduction and neutral flexion, extension, and rotation due to make a 4 cm long skin incision as a utility port along the mid-axillary line between the fifth and sixth costal spaces in the axillary region ( ), which was directly located on the T5/6 disc level. One additional incision was made along the anterioraxillary line between the fourth and fifth costal spaces in the axillary region (#). (b) Left lateral decubitus position.
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Anterior debridement and interbody fusion at T2/3 were performed using a lateral VATS approach with left lateral decubitus position (Figures 2 and 2).
Anterior debridement and interbody fusion at T2/3 were performed using a video-assisted operating technique.
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An autologous iliac strut and chipped bone were implanted into the evacuated space (Figure 3).
Sagittal CT of the cervicothoracic spine six months after operation shows bony fusion at T2/3.
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CRP was 0.01 mg/dl. CT showed bony fusion at T2/3 (Figure 4).