case_images: PMC11729099_01
case_images: PA Fluorographic image taken intraoperatively (during the first surgery) showing the left T8 screw which is non-harmonious with the screws above and below
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case_images: PMC11729099_01_43390_2024_951_Fig1_HTML.jpg
case_images: Fig1
case_images: Patient underwent uneventful T4-L4 posterior spinal instrumentation and fusion; bilateral facetectomies were done at multiple thoracic levels and derotation maneuver was performed under fluoroscopic guidance (Figs. 1, 2).
case_images: A Axial CT without contrast showing the left T8 screw breach into the spinal canal. B Axial CT myelogram at the level of T8 showing compression of thecal sac and cord by the medially misplaced screw
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case_images: PMC11729099_01_43390_2024_951_Fig2_HTML.jpg
case_images: Fig2
case_images: Patient underwent uneventful T4-L4 posterior spinal instrumentation and fusion; bilateral facetectomies were done at multiple thoracic levels and derotation maneuver was performed under fluoroscopic guidance (Figs. 1, 2).
case_images: AP Fluorograph showing the post-operative correction after the first surgery
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case_images: Fig3
case_images: Thoracic spine with myelogram which revealed left T8 pedicle screw passing through the left lateral spinal canal and abutting the thecal sac/spinal cord with block of contrast material at that level (Figs. 3, 4). There was no evidence of pseudoarthrosis, spinal extradural hemorrhage or pedicle fracture.
case_images: Fluorography with myelogram showing the left dura being impacted by the screw
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case_images: PMC11729099_01_43390_2024_951_Fig4_HTML.jpg
case_images: Fig4
case_images: Thoracic spine with myelogram which revealed left T8 pedicle screw passing through the left lateral spinal canal and abutting the thecal sac/spinal cord with block of contrast material at that level (Figs. 3, 4). There was no evidence of pseudoarthrosis, spinal extradural hemorrhage or pedicle fracture.
case_images: PA and lateral fluorograph showing post-operative correction, at 2 years follow-up showing the T6-T9 fixation. The T7 screw was removed for operative convenience
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case_images: PMC11729099_01_43390_2024_951_Fig5_HTML.jpg
case_images: Fig5
case_images: A third rod was used to connect with an open type of lateral connector from T6 to T9 (Fig. 5).