case_images: PMC8053453_01
case_images: Thoracic spine MRI, (a) axial T2-weighted image show left-sided isointense mass compatible with a sequestrated disc (black arrow), (b and c) sagittal T1- and T2-weighted MRI demonstrated the disc fragment migrated up, note the edema of the corresponding end plated. (d) MR myelogram showing complete block at the affected level and hyperintense endplates edema.
case_images: SNI-12-108-g001.jpg
case_images: PMC8053453_01_SNI-12-108-g001.jpg
case_images: F1
case_images: T2-weighted axial MR images showed an isointense left-sided large anterolateral thoracic disc herniation at the T10-T11 level with superior migration resulting in an image equivalent to a "complete block" herniation [Figure 1a]. The adjacent vertebral endplates were edematous due to the antecedent trauma. T10/ T11 disc space [Figures 1b-d]. The CT scan confirmed these traumatic findings [Figure 2a and b].
case_images: Thoracic spine reconstructed C.T. scan, (a) in sagittal view, the intervertebral disc space is hypodense indicating release of nitrogen gas through the porous holes of the corresponding end plates into the disc space subsequent to expulsion of the nucleus and occurrence of negative pressure, designated as vacuum phenomenon (white arrow head) (b). Coronal images show breakage of the lateral syndesmophytes in the absence of vertebral body fracture which is indicative of acute traumatic event.
case_images: SNI-12-108-g002.jpg
case_images: PMC8053453_01_SNI-12-108-g002.jpg
case_images: F2
case_images: T10/ T11 disc space [Figures 1b-d]. The CT scan confirmed these traumatic findings [Figure 2a and b].
case_images: Intraoperative fluoroscopy (a) there is narrow dissector inside the disc, note that the disc space is hypodense (intradiscal gas: black arrow), (b) after placement of a cage.
case_images: SNI-12-108-g003.jpg
case_images: PMC8053453_01_SNI-12-108-g003.jpg
case_images: F3
case_images: Postoperative lateral radiograph showing the construct.
case_images: SNI-12-108-g004.jpg
case_images: PMC8053453_01_SNI-12-108-g004.jpg
case_images: F4
case_images: However, the thoracic plain radiographs showed that the fusion construct was intact [Figure 4].
case_images: (a and b) Photograph of the patient at 6-month follow-up, showing normal walking.
case_images: SNI-12-108-g005.jpg
case_images: PMC8053453_01_SNI-12-108-g005.jpg
case_images: F5
case_images: We await further neurological follow-up [Figure 5].