case_images: PMC5822833_01
case_images: Case 1: coronal (a) and sagittal (b) CT scans showed erosion of endplates at the L2-3 level (arrowhead).
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case_images: PMC5822833_01_CRIOR2018-4645906.001.jpg
case_images: fig1
case_images: Radiographs and computed tomography (CT) scans showed decreased disc height at the L2-3 level, with erosion of endplates (Figure 1), and magnetic resonance imaging (MRI) showed features of spondylodiscitis, with an abscess at the same level.
case_images: Case 1: plain sagittal T2-weighted (a) and gadolinium-enhanced T1-weighted (b) MRI showed the presence of an abscess at the L2-3 level after removal of the implant.
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case_images: PMC5822833_01_CRIOR2018-4645906.002.jpg
case_images: fig2
case_images: Intravenous vancomycin (Vancomycin, Mylan, PA) was initiated; however, epidural abscesses remained, and progressive motor weakness of the iliopsoas and quadricep muscles was detected in the left lower limb (Figure 2).
case_images: Case 1: coronal (a) and sagittal (b) CT images showed bone union at the L2-3 level 13 months after initial ASF.
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case_images: PMC5822833_01_CRIOR2018-4645906.003.jpg
case_images: fig3
case_images: Anterior spinal fusion (ASF) with iliac crest autograft at the L2-3 disc space was then performed (Figure 3).
case_images: PMC5822833_02
case_images: Case 2: plain lateral radiograph (a) and sagittal T2-weighted MRI (b) showed decreased disc height and the presence of an abscess in the disc and extradural space (arrowhead) at the L1-2 level.
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case_images: PMC5822833_02_CRIOR2018-4645906.004.jpg
case_images: fig4
case_images: Radiographs showed decreased disc height at the L1-2 level with erosion of endplates, and MRI showed features of spondylodiscitis with an abscess at the same level and in the extradural space (Figure 4).
case_images: Case 2: plain anteroposterior (a) and lateral (b) radiographs showed progressive vertebral destruction at the L1-2 level after partial removal of the implant.
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case_images: PMC5822833_02_CRIOR2018-4645906.005.jpg
case_images: fig5
case_images: Even after irrigation and debridement, vertebral destruction progressed, resulting in severe instability at the L1-2 level (Figure 5).
case_images: Case 2: plain anteroposterior (a) and lateral (b) radiographs following the final surgery with a spinous process plate and iliac crest bone graft.
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case_images: PMC5822833_02_CRIOR2018-4645906.006.jpg
case_images: fig6
case_images: Thirteen months after the final surgery, he was asymptomatic, and the plain radiographs showed bony fusion at the L1-2 level (Figure 6).
case_images: PMC5822833_03
case_images: Case 3: sagittal T2-weighted MRI before (a) and after (b) administration of antibiotics. An abscess was observed in (a) and was not detectable in (b).
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case_images: PMC5822833_03_CRIOR2018-4645906.007.jpg
case_images: fig7
case_images: Radiographs showed decreased disc height at the T11-12 level with erosion of endplates, and MRI showed features of spondylodiscitis with an abscess at the same level and in the extradural space (Figure 7). Osaka), since MRSE is sensitive to this antibiotic. One month after antibiotic administration, the abscess could not be detected by MRI (Figure 7), and a hematological investigation showed a normal CRP level and total WBC count.
case_images: Case 3: sagittal (a) and axial (b) CT scans revealed facet joint union at the T11-12 level (arrowheads).
case_images: CRIOR2018-4645906.008.jpg
case_images: PMC5822833_03_CRIOR2018-4645906.008.jpg
case_images: fig8
case_images: The CT scans revealed bone union at the T11-12 level (Figure 8).