Figure 1:

Preoperative sagittal T2-weighted (a) MRI demonstrates severe angulation and retropulsion of the C5 vertebral body causing marked spinal stenosis with hyperintensity within the spinal cord. Contrast-enhanced T1-weighted image (b) shows abnormal enhancement within the C4–C6 vertebral bodies, lamina, and spinous processes, as well as enhancement in the posterior epidural space with prominent flow voids. Plain sagittal CT obtained on presentation to the emergency department (c) demonstrates severe osteolysis at the levels of C4–C6 and increased retrolisthesis at C5.