case_images: PMC11775952_01
case_images: Preoperative imaging. (a, b) CT scans showing massive calcification at the L3/4 intervertebral disc and (c-f) CT and MRI scans demonstrating massive herniation at L2/3 compressing the dural sac and nerve root. The red and white arrows indicate the "tail sign," a direct channel between the calcified disc and the mass, resembling an umbilical cord or comet's tail.
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case_images: She subsequently visited a local hospital, where a computed tomography (CT) scan revealed calcification at the L3/4 intervertebral disc (Figure 1). At the L2/3 level, a strip of mixed signal was observed in the epidural space with clear boundaries, corresponding to narrowed foramina and compression of the dura mater (Figure 1). We termed this phenomenon the "tail sign" (Figure 1).
case_images: Intraoperative images. (a) A cystic mass is visible within the spinal canal, with the dural hook lifting the cyst wall. (b) A toothpaste-like substance is observed. (c) Hematoxylin-eosin staining and (d) Alizarin red staining showing fibrous tissue with glassy deposits and calcifications.
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case_images: During surgery, a cystic mass was identified within the spinal canal (Figure 2). This material was sent for pathological examination, which revealed fibrous tissue with hyaline degeneration and calcification (Figure 2).
case_images: Postoperative MRI. (a, b) T2-weighted imaging showing recovery of the L3/4 disc.
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case_images: Follow-up MRI at 2 months postoperatively showed complete absorption of the intraspinal calcification, with a small residual low-signal area at the L3/4 intervertebral space on T2-weighted imaging (Figure 3).