case_images: PMC8337157_01
case_images: Imaging findings. (a) Lumbar magnetic resonance imaging (MRI) demonstrating severe lumbar spine stenosis at L1-5 and spondylolisthesis at L4/5. (b), (c) No percutaneous pedicle screw deviation or compression observed in the spinal canal. (d) Cervical MRI revealing spinal canal stenosis extending to C4-6 and disc herniation at the C3/4 level. (e) Lumbar MRI showing bilateral foraminal narrowing at the L4/5 level after laminectomy for L4 anterior spondylolysis, but no apparent implant deviation.
case_images: CRIM2021-6283076.001.jpg
case_images: PMC8337157_01_CRIM2021-6283076.001.jpg
case_images: fig1
case_images: Magnetic resonance imaging (MRI) showed severe lumbar spinal stenosis at L1-5 and spondylolisthesis at L4/5 (Figure 1(a)). Spinal computed tomography showed no evidence of spinal cord compression (Figures 1(b) and 1(c)). MRI showed no abnormalities. MRI of the whole spine showed moderate disc herniation at the C3/4 level without significant cord or nerve root compression or an epidural hematoma or abscess (Figures 1(d) and 1(e)).
case_images: Nerve conduction study results. At 21 days after surgery, the median and tibial motor nerves showed findings of demyelination, such as prolonged terminal latencies, reduction in the compound muscle action potential, a slowed conduction velocity, and temporal dispersion. The ulnar motor nerve showed a decrease in amplitude. The sensory examination showed an abnormal median and normal sural sensory response. The F wave was absent in the bilateral median, ulnar, and tibial motor nerves (data not shown). At 38 days after surgery, the median and ulnar motor nerve compound muscle action potentials had residual prolonged terminal latencies but improved amplitudes. The tibial nerve showed temporal dispersion on both day 21 and day 28 with no improvement. The median and ulnar sensory nerves abnormalities were exacerbated, but the sural nerve remained normal.
case_images: CRIM2021-6283076.002.jpg
case_images: PMC8337157_01_CRIM2021-6283076.002.jpg
case_images: fig2
case_images: Table 1 and Figure 2 show the results of the NCS. The median and ulnar sensory nerve abnormalities were exacerbated, but the sural nerve remained normal (Table 1, Figure 2).