Mark Hornyak, MD

This is a 53 year old man presented with mid-lower back pain radiating to the left side of the lower chest and flank. He described the pain as severe after a minor fall 2 weeks prior but had mild back pain for about 4 months prior. He has no significant prior medical history.

• All
• Pre-Op
• Intra-op
• Post-op

Sagital (left and axial (right) images from T2 MRI showing abnormally bright signal and expansion of the T12 vertebral body (arrow). The expansion is causing spinal cord compression (the spinal cord is designated by the yellow star(*))

Sagital, coronal, and axial (left to right) images from CT scan showing erosion and collapse of the T12 vertebral body. Note the replacement of bone (which is rather bright white) with tumor (which is dark grey), especially well demonstrated in the axial views (right image).

Images taken from a PET scan. On the left, the PET information is projected over a CT scan. The PET-active tumor is seen as an orange glow in the T12 vertebral body and in the spinal canal (the bright-orange spots to each side of the spine are the kidneys – a normal finding). On the right is a projection of the PET information in an A-P image from the brain (top) to the legs (bottom). PET-active areas are black. An abnormal spot is seen at T12 (arrow) as well as some other areas.

Intraoperative photo taken after laminectomy and corpectomy at T12. It shows the dura that covers the spinal cord and the exiting nerve roots. Note the deep cavity beneath the spinal canal that has been created by removal of bone and tumor (yellow star(*)).

Intraoperative video showing the tumor resection cavity. The instrument moving is a suction tube used to remove blood and fluid from the operative field.

: Intraoperative fluoroscopic (x-ray) image showing the placement of the intervertebral cage into the T12 resection cavity in the lateral (left) and A-P (right) planes, spanning from T11 above to L1 below. The cage is attached to an insertion device. Once expended, the device will bear the weight of the patient.

Intraoperative image showing placement of the cage demonstrated in Figure 7. The cage itself is blue in color and can be seen in the resection cavity demonstrated in Figures 5 and 6. The insertion device is seen at the top of the imageand a suction tube is at the bottom.

Image captured from the intraoperative navigation system. It virtually demonstrates the placement of a screw into the left pedicle of T9.

Postop x-ray in the A-P (left) and lateral (right) planes. It shows the intervertebral cage in the T12 corpectomy site as well as the posterior instrumentation – the screws and rods.

Postop CT scan in the sagittal, coronal, and axial planes (left-to-right) also demonstrating the surgical instrumentation.