28151882 Visualization

A 65 Age - year Age - old Age woman Sex reported persistent Detailed_description back Biological_structure pain Sign_symptom for almost Duration 3 Duration months Duration .
The symptoms Coreference would be severe Severity after walking Activity or changing Activity positions Activity and would be slightly relieve Sign_symptom after taking painkillers Medication .
The patient described no pain Sign_symptom or numbness Sign_symptom in her legs Biological_structure .
She also described no bowel Biological_structure or bladder Biological_structure voiding Sign_symptom difficulties Sign_symptom .
The patient reported past medical history of hypertension, History coronary History heart History disease, History cerebral History infarction, History and History asthma, History all History of History which History were History well History controlled History .
Physical Diagnostic_procedure exam Diagnostic_procedure demonstrated kyphosis Disease_disorder of the thoracic Biological_structure spine Biological_structure in Detailed_description standing Detailed_description position Detailed_description and lumbar Detailed_description vertebra Detailed_description bend Detailed_description forward Detailed_description and Detailed_description backward Detailed_description straight activities were limited.
There is obvious rap Detailed_description pain Sign_symptom in back Biological_structure about T12 Biological_structure level.
The patient's general Diagnostic_procedure medical Diagnostic_procedure examination Diagnostic_procedure was unremarkable Lab_value in upper Biological_structure and Biological_structure lower Biological_structure extremity Biological_structure motor Biological_structure , stretch Detailed_description reflex Detailed_description , and sensory Biological_structure examinations Diagnostic_procedure .
X Diagnostic_procedure - ray Diagnostic_procedure , computed Diagnostic_procedure tomography Diagnostic_procedure ( CT Diagnostic_procedure ), and magnetic Diagnostic_procedure resonance Diagnostic_procedure imaging Diagnostic_procedure ( MRI Diagnostic_procedure ) exams were performed after the patient in hospital Nonbiological_location (Fig.1).
The lateral Detailed_description X Diagnostic_procedure - ray Diagnostic_procedure showed T12 Biological_structure fracture Disease_disorder with 40° Lab_value kyphotic Lab_value cobb Diagnostic_procedure angle Diagnostic_procedure .
CT Diagnostic_procedure showed an intravertebral Sign_symptom vacuum Sign_symptom sign Sign_symptom .
Sagittal Detailed_description T1 Detailed_description - weighted Detailed_description MRI Diagnostic_procedure showed a decreased Detailed_description signal Detailed_description intravertebral Sign_symptom vacuum Sign_symptom cleft Sign_symptom and posterior Biological_structure cortex Biological_structure breakage Disease_disorder with cord Sign_symptom compression Sign_symptom in T12 Biological_structure .
Sagittal Detailed_description T2 Detailed_description - weighted Detailed_description MRI Diagnostic_procedure showed an increased Detailed_description signal Detailed_description in the intravertebral Sign_symptom vacuum Sign_symptom cleft Sign_symptom .
The patient was diagnosed with Kümmell Disease_disorder disease Disease_disorder ( Stage Lab_value III).[9]
The operation Therapeutic_procedure was performed under general Medication anesthesia Medication and prone Detailed_description position Detailed_description .
A standard Detailed_description posterior Therapeutic_procedure exposure Therapeutic_procedure of the spine Biological_structure was given, pedicle Therapeutic_procedure screws Therapeutic_procedure were inserted in target vertebrae Biological_structure T10 Biological_structure , T11 Biological_structure , L1 Biological_structure , and L2 Biological_structure under C Detailed_description - arm Detailed_description guidance.[10] The screws were connected Detailed_description on Detailed_description the Detailed_description left Detailed_description side Detailed_description with Detailed_description a Detailed_description temporary Detailed_description stabilizing Detailed_description rod Detailed_description .
Laminectomy Therapeutic_procedure was performed to decompress and fully visualize the spinal cord.[10] Careful subperiosteal Therapeutic_procedure dissection Therapeutic_procedure was carried out on the right Detailed_description side Detailed_description to exposure the lateral Biological_structure wall Biological_structure of Biological_structure the Biological_structure T12 Biological_structure vertebral Biological_structure body Biological_structure until the anterior aspect was reached.
The right Biological_structure side Biological_structure pedicle Biological_structure and articular Biological_structure process Biological_structure of the T12 Biological_structure vertebral Biological_structure body Biological_structure were removed Therapeutic_procedure .
T11/T12 Biological_structure and T12/L1 Biological_structure intervertebral Biological_structure disks Biological_structure were also removed Therapeutic_procedure .
Then, the temporary Detailed_description stabilizing Detailed_description rod Therapeutic_procedure was replaced by rod Therapeutic_procedure bended Detailed_description to Detailed_description the Detailed_description desired Detailed_description contour Detailed_description .
Autologous Detailed_description bone Therapeutic_procedure graft Therapeutic_procedure and titanium Therapeutic_procedure mesh Therapeutic_procedure were placed in the intervertebral Biological_structure space Biological_structure .
Another Detailed_description rod Therapeutic_procedure with Detailed_description the Detailed_description desired Detailed_description contour Detailed_description was connected on the right Detailed_description side Detailed_description .
Adequate hemostasis Therapeutic_procedure was ensured and wound Biological_structure was thoroughly irrigated Therapeutic_procedure with Therapeutic_procedure saline Therapeutic_procedure .
Drainage Therapeutic_procedure tube Therapeutic_procedure was inserted and the surgical Biological_structure wound Biological_structure was closed Therapeutic_procedure layer Detailed_description - by Detailed_description -layer.[10] Time from skin incision to completion of wound closure lasted 150 Duration   minutes Duration , and estimated blood Disease_disorder loss Disease_disorder totaled 600 Volume  mL.
Postoperatively, the patient was given preventive antibiotic Medication treatment for 1 Duration day Duration , pain Medication treatment Medication for 3 Duration days Duration , and anticoagulant Medication therapy for 1 Duration week Duration .
The drainage Therapeutic_procedure tube Therapeutic_procedure was removed at 3 Date days Date postoperative when volume Diagnostic_procedure of Diagnostic_procedure drainage Diagnostic_procedure was less Lab_value than Lab_value 50 Lab_value   mL Lab_value per Lab_value 24 Lab_value   hours Lab_value .
Patient was allowed Clinical_event out Clinical_event of bed Nonbiological_location with a custom Detailed_description - made Detailed_description plastic Detailed_description orthosis Therapeutic_procedure at 1 Date week Date after Date operation.
The plastic orthosis Coreference was kept for at Duration least Duration 3 Duration months Duration .
The patient was allowed Clinical_event out Clinical_event of hospital Nonbiological_location at 12 Date days Date after Date operation when surgical Therapeutic_procedure suture Therapeutic_procedure had been removed.
Pain Diagnostic_procedure assessments Diagnostic_procedure were conducted using the visual Diagnostic_procedure analogue Diagnostic_procedure scale Diagnostic_procedure ( VAS Diagnostic_procedure ).
VAS Coreference for preoperative Date , 1 Date week Date after Date operation, and 1 Date year Date after Date operation were 9 Lab_value score Lab_value , 3 Lab_value score Lab_value , and 2 Lab_value score Lab_value , respectively, which demonstrated significant improvement Lab_value .
The patient resumed normal Activity activities Activity and returned Activity to Activity work Activity at 3 Date months Date after Date operation.
Kyphotic Lab_value Cobb Diagnostic_procedure angle Diagnostic_procedure for preoperative Date , 1 Date week Date after Date operation, and 1 Date year Date after Date operation were 40° Lab_value , 8° Lab_value , and 17° Lab_value , respectively, which demonstrated significant improvement Lab_value (Fig.2).