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. 2023 May 15;13(7):4475–4492. doi: 10.21037/qims-22-1394

Figure 7.

Figure 7

An illustrative case. A 70-year-old female with degenerative lumbar scoliosis and kyphosis was admitted to the hospital due to low back pain, leg pain, and intermittent claudication. She underwent long-instrumented spinal fusion from T10-L5, and she began antiosteoporosis therapy after discharge from the hospital. Two years after surgery, this patient complained of recurrent severe low back pain. The lumbar spine CT scan showed pedicle screw loosening at the LIV. The preoperative lumbar spine MRI showed low muscularity of the paraspinal muscle. The rFCSA for the PSE was 137.40. The preoperative lumbar spine CT scan showed low bone mass of the vertebra. The HU values of the lumbosacral region and LIV were 96.23 and 90.01, respectively. (A-D) Preoperative and two-year postoperative standing full-length spine radiographs; (E-I) two-year postoperative lumbar spine CT scan of the LIV; (J-M) measurement of the paraspinal muscle using preoperative lumbar spinal MRI at L4 and L5; (N-S) measurement of the HU values of the lumbosacral region and LIV using preoperative lumbar spine CT scans at L4, L5, and S1. The orange circles indicate the region of interest. CT, computed tomography; LIV, lower instrumented vertebra; MRI, magnetic resonance imaging; rFCSA, relative functional cross-sectional area; PSE, paraspinal extensor muscle; HU, Hounsfield unit.