PMC8088530_01
Plain radiographs anteroposterior (a), lateral in flexion (b) and extension (c) showing decreased joint space and focal kyphosis at L4-L5 segment. Sagittal (d) and axial T2-weighted MR images showing L4-5 segmental kyphosis with decreased disk space and lumbar canal stenosis (e) and prolapsed intervertebral disk at L5-S1 (f).
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F1
X-rays revealed degenerative changes in the lower lumbar spine with evidence of instability at L4-5 on dynamic imaging [Figure 1]. The MR revealed lumbar canal stenosis at L4-L5, a left L5-S1 HNP with inferior migration, and a left sided facet cyst [Figure 1].
Immediate postoperative anteroposterior (a) and lateral (b) radiographs showing transforaminal lumbar interbody fusion with restoration of focal lordosis and increase in disk height at L4-5, and discectomy at L5-S1.
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F2
The patient underwent a L4-L5 minimally invasive transforaminal lumbar interbody fusion (TLIF) with L5-S1 micro-discectomy [Figure 2].
MR T2 sagittal (a) and T2 TIRM sagittal (b) and axial (c) images showing increased signal intensity at L5-S1 disk space revealing probable infective process with collection under the posterior longitudinal ligament.
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F3
The MR was suggestive of spondylodiscitis at the L5-S1, and he underwent a TLIF L5-S1 with insertion of Titanium Cage [Figures 3 and 4].
Immediate postoperative images anteroposterior (a) and lateral (b) showing extension of instrumentation to S1 with debridement followed by interbody fusion at L5-S1 using Titanium cage and removal of right L5 screw due to medial pedicle breach.
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F4
The MR was suggestive of spondylodiscitis at the L5-S1, and he underwent a TLIF L5-S1 with insertion of Titanium Cage [Figures 3 and 4].