case_images: PMC3835208_01
case_images: (a) Length in the standing position and lateral image in the standing position. (b) CT-MPR of the total length of the spine. The lateral X-ray image in the standing position showed no L2-L3 intervertebral space, but CT-multiplanar reconstruction images in the dorsal position showed a clearly opened L2-L3 intervertebral space.
case_images: CRIM.ORTHOPEDICS2013-497458.001.jpg
case_images: PMC3835208_01_CRIM.ORTHOPEDICS2013-497458.001.jpg
case_images: fig1
case_images: Radiographs of the thoracic and lumbar spine showed flowing ossification along the anterior and lateral aspects of the Th2-L5 vertebral bodies, with disruption of ossific ridging and marked destructive changes at the L2-L3 intervertebral disc level (Figure 1).
case_images: (a) Flexion and (b) extension images of the spine, showing instability at the L2-L3 intervertebral space and a stenosis of spinal canal is observed in the extension position.
case_images: CRIM.ORTHOPEDICS2013-497458.002.jpg
case_images: PMC3835208_01_CRIM.ORTHOPEDICS2013-497458.002.jpg
case_images: fig2
case_images: Myelography showed stenosis at the L2-L3 intervertebral space and flexion-extension radiograph indicated instability at this position (Figure 2).
case_images: Lateral plain X-ray image obtained after the first surgery. In addition to posterior fusion at the L1-L5 intervertebral space, posterior lumbar interbody fusion at the L2-L3 intervertebral space was performed using a PEEK cage and local bone.
case_images: CRIM.ORTHOPEDICS2013-497458.003.jpg
case_images: PMC3835208_01_CRIM.ORTHOPEDICS2013-497458.003.jpg
case_images: fig3
case_images: We performed posterior fusion from the L1 to L5 levels with spinal instrumentation, in addition to posterior lumbar interbody fusion at the L2-L3 intervertebral space (Figure 3).
case_images: Lateral plain X-ray image obtained 10 weeks after the first surgery, showing loosening and back-out of the pedicle screw at L1-L2.
case_images: CRIM.ORTHOPEDICS2013-497458.004.jpg
case_images: PMC3835208_01_CRIM.ORTHOPEDICS2013-497458.004.jpg
case_images: fig4
case_images: Thus, a second surgery was performed 12 weeks after the initial surgery (Figure 4).
case_images: (a) Frontal and (b) lateral images obtained at 18 months after the second surgery, showing no loosening of pedicle screws and favorable bone adhesion in PLIF and PLF.
case_images: CRIM.ORTHOPEDICS2013-497458.005.jpg
case_images: PMC3835208_01_CRIM.ORTHOPEDICS2013-497458.005.jpg
case_images: fig5
case_images: Plain radiographs taken 1.5 years after surgery showed rigid bony union at the L2-L3 intervertebral space (Figure 5).