case_images: PMC11021091_01
case_images: Magnetic resonance image before and after the surgery. (a) Cervical spinal stenosis was found in the T2-weighted image, sagittal section, and the diagnosis of cervical spondylosis was made; therefore, the patient performed the C3 to C5 laminectomy. (b) Four days after the surgery, the mass occupying the dorsal epidural space (arrowhead) was well demarcated and low-intensity in T1-weighted and (c) homogeneously hyper-intensity in T2-weighted image (arrow).
case_images: SNI-15-87-g001.jpg
case_images: PMC11021091_01_SNI-15-87-g001.jpg
case_images: F1
case_images: Magnetic resonance imaging revealed cervical spinal canal stenosis at the level of C3/4 and C4/5 without ossification of the posterior longitudinal ligament and yellow ligament, and there is no evidence of cervical spinal instability [Figure 1a]; hence, he was performed laminectomy at C3, C4, and C5 level. The mass was well-demarcated, low-intensity in T1-weighted, and homogeneously hyperintensity in T2-weighted image [Figures 1b and c].
case_images: (a) Intraoperative finding. After the laminectomy of C7, a purulent, whitish exudate (arrow) erupted from the thinned cortical bone; Hematoxylin and eosin stain showed the infiltration of neutrophils and the small clusters of weak birefringent, basophilic crystals compatible with calcium pyrophosphate deposition. (b) Low- (x 40), and (c) high-magnification (x 100).
case_images: SNI-15-87-g002.jpg
case_images: PMC11021091_01_SNI-15-87-g002.jpg
case_images: F2
case_images: The surgical findings implied elevated pressure inside the spinal canal because a purulent, whitish exudate erupted from the thinned cortical bone [Figure 2a]. The pathological examination of the exudate showed the infiltration of neutrophils and the small clusters of weak birefringent, basophilic crystals in hematoxylin and eosin stain, suggesting the SEA of CNS with concurrent crystal-induced inflammation of CPP [Figures 2b and c].