A 57 year old female with history of diabetes mellitus, diabetic peripheral neuropathy and scoliosis with four previous spinal fusions (T4 to pelvis) presented with worsening ambulating for the past one month. She was previously at baseline ambulating with a walker. Her physical exam demonstrated normal cranial nerve functions. Motor exam revealed full strength in bilateral upper extremities, 3+/5 MRC strength in bilateral hip flexors, 5-/5 MRC in bilateral hip abductors, adductors, knee

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... /extensors, and ankle dorsiflexors/plantar flexors, with increased muscle tone in the lower extremities. Sensory exam revealed decreased sensation to pinprick below T6 level. Deep tendon reflexes were 2+ symmetric in upper extremities as well as at the knees and 4+ at ankles with non-sustained clonus. A positive Babinski's sign was elicited bilaterally. A CT thoracic spine revealed the pedicle screws traversing the disc space at the T3-4 level, with the deformity associated with moderate to severe central stenosis (Figure 1 ). Due to the severe spinal cord compression at the T3 to T4 level, she underwent another surgery -T4 to T12 segmental spinal instrumentation removal, a T4 vertebral column resection and a T3 1A 1B Figure 1: CT thoracic spine (coronal view figure 1a and axial view figure 1b) revealing pedicle screws traversing the disc space at the T3-4 level. Figure 1b reveals the surgical screw causing moderate to severe central stenosis. 2A 2B Figure 2: Three month follow up CT thoracic spine (coronal view figure 2a and axial view figure 2b) revealing resolving of moderate to severe central stenosis at the T3-4 level.