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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_6040_Библиотеки_им_академика_М_И_Перельмана.pdf
170 F. Caranci et al.
Postoperative Follow-Up After 6 Months
Fig. 2 a–g. STIR sagittal
(a–c), TSE T2 axial
sections (d–g). Slight
reduction of flogosis with
inhomogeneous signal
especially in the right
retrovertebral space
Case 51 - Degenerative Lumbar Instability. Rigid Posterior Stabilization 171
Fig. 3 a–p. CT soft (a–d) and bone window (e–h) sections, MPR sagittal (i–l), coronal sections (m–p). Clod-like
calcification in right retrovertebral muscles surrounding superior part of device (arrow) and extending along the
lamina
172 F. Caranci et al.
Postoperative Follow-Up After 9 Months
Fig. 4 a–k. TSE T2 sagittal (a–c), axial (d–g), CE fat sat T1 axial (h–k) sections. Reduction of flogosis in
retrovertebral muscles (a–c), with massive calcification of right retrovertebral tissues (arrow, f, k). Bilateral
retrovertebral and right foraminal CE (arrowhead)
Case 51 - Degenerative Lumbar Instability. Rigid Posterior Stabilization 173
Fig. 4 (continued)
174 F. Caranci et al.
Fig. 5 a–l. CT axial (a–d), MPR sagittal (e–h), coronal (i–l) sections. Large calcification of retrovertebral right
muscles. Removal of device (arrow)
Degenerative Lumbar Instability Dynamic Stabilization
Irregular Positioning of Screws and
Repositioning
Tommaso Scarabino, Michele Maiorano, Tullia Garribba,
Giuseppe Diaferia and Raniero Mignini
• Patient with low back pain invertebral instability treated by L4–L5
dynamic stabilization through transpeduncular screws (Dynesys) and
L4 left screw repositioning
• XR/CT early postoperative follow-up
Early Postoperative Follow-Up
Fig. 1 a–b. XR anteroposterior (a), lateral (b),
CT axial (c–d), L4–L5 device. a–b Radio-opaque
screws and radiolucent lateral bars. b Screws
(especially left) inside positioned with respect to
peduncles
Case
52
T. Scarabino M. Maiorano T. Garribba
Department of Radiology—Neuroradiology, ‘‘Lorenzo Bonomo’’ Hospital, Andria, Italy
G. Diaferia R. Mignini (&)
Department of Neurosurgery, ‘‘Lorenzo Bonomo’’ Hospital, Andria, Italy
e-mail: ranieromignini@libero.it
T. Scarabino and S. Pollice (eds.), Imaging Spine After Treatment,
DOI: 10.1007/978-88-470-5391-5_57, Springer-Verlag Italia 2014
175
176 T. Scarabino et al.
Fig. 1 (continued)
Postoperative Follow-Up
Fig. 2 a–d. CT axial:
screws repositioning
Case
Degenerative Cervical Instability
Stabilization–Posterior Decompression
Screw Rupture
Alessandro Stecco, Francesco Fabbiano, Silvio Ciolfi,
Christian Cossandi, Marco Pelle, Gabriele Panzarasa
and Alessandro Carriero
• Patient with vertebral instability in grade II C1–C2 degenerative
listhesis treated by stabilization through screws positioned in C1
lateral process and in C2 isthmus. C0–C1 posterior decompression
(laminectomy and foramen opening)
• CT/MR early preoperative imaging and late postoperative follow-up
53
Fig. 1 a–c. CT MPR parasagittal (a), sagittal (b), MR FSE T2 sagittal (c). Anterior C1–C2 grade II listesis (a–b) and
atlas-odontoid arthrosis; restriction of foramen magnum and of bulb-medullary district that shows T2 hyperintensity
for compressive alteration (c). Multiple disk protrusions in C3–C7, interapophyseal arthrosis with yellow ligaments
hypertrophy: these alterations cause obliteration of epidural space anterior and posterior
A. Stecco (&) F. Fabbiano S. Ciolfi M. Pelle A. Carriero
Department of Radiology, ‘‘Maggiore della Carità University Hospital’’, Novara, Italy
e-mail: a.stecco@libero.it
A. Carriero
e-mail: profcarriero@vigilio.it
C. Cossandi G. Panzarasa
Department of Neurosurgery, ‘‘Maggiore della Carità University Hospital’’, Novara, Italy
T. Scarabino and S. Pollice (eds.), Imaging Spine After Treatment,
DOI: 10.1007/978-88-470-5391-5_58, Springer-Verlag Italia 2014
177
178 A. Stecco et al.
Preoperative Imaging
Fig. 2 a–c. FSE T2 (a), CT axial (b–c). Regular C1–C2 alignment. No signs of cord compression and/or myelopathy
(c)
Postoperative Follow-Up After 1 Year
Fig. 3 a–b. CT MPR sagittal. Left C1 screw rupture. Further surgery is not necessary thanks to clinical stability
Traumatic Lumbar Dislocation Percutaneous Stabilization
Regular Findings
Chiara Potente, Roberto Trignani, Tommaso Scarabino
and Gabriele Polonara
• Patient with traumatic L2–L3 dislocation treated by percutaneous
• CT/MR early preoperative imaging and postoperative follow-up
Preoperative Imaging
Fig. 1 a–b. CT thorax-
abdomen a, MPR sagittal
b. L2–L3 irregular
alignment
Case
54
stabilization through transpeduncular screws and rigid bars in L2–L3
(1 month later)
G. Polonara (&) C. Potente
Department of Neuroradiology, University Hospital, Ancona, Italy
e-mail: g.polonara@univpm.it
R. Trignani
Department of Neurosurgery, University Hospital, Ancona, Italy
T. Scarabino
Department of Radiology–Neuroradiology, Lorenzo Bonomo Hospital, Andria, Italy
T. Scarabino and S. Pollice (eds.), Imaging Spine After Treatment,
DOI: 10.1007/978-88-470-5391-5_59, Springer-Verlag Italia 2014
179