PMC4887591_01
Preoperative MRI scans of the lumbar spine demonstrating the right-sided paramedian herniation of the L5-S1 intervertebral disc: a - sagittal view, b - axial view.
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According to the grading system proposed by Pfirrmann, intervertebral disc degeneration corresponded to Grade III; spondylarthrosis corresponded to Grade 1-2 according to the Grogan classification; the intervertebral disc height in the dorsal portion was 6 mm; neither anomalies of the lumbosacral joint nor signs of segmental instability were detected (Fig. 1a, b).
Postoperative X-rays of the lumbar spine: a - anteroposterior view, b - lateral view. The Barricaid annular closure device is visualized at the L5-S1 level of the functional spinal unit; its anchor is impacted into the S1 vertebral body, while the mesh tightly contacts the hyaline cartilage endplate of the L5 vertebral body.
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Postoperative control X-rays (Fig. 2a, b) demonstrated the implant shadow located directly in the L5-S1 intervertebral space.
MRI (a, b) and MSCT (c, d) scans of the lumbar spine 1.5 months after surgery. The scans show bone resorption around the implant anchor (in the S1 vertebral body) and the mesh (in the L5 vertebral body) and inflammatory changes in the adjacent tissues.
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MRI and MSCT scans of the lumbar spine were recorded (Fig. 3a-d).
X-rays of the lumbar spine in the anteroposterior (a) and lateral (b) views after the Barricaid annular closure device was removed and 360  spinal fusion was achieved at the L5-S1 level of the functional spinal unit.
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A decision was made to remove the implant and perform transpedicular and interbody fixation of the functional spinal unit (Fig. 4a, b).