PMC8326106_01
Preoperative imaging showing L4-L5, L5-S1 spinal canal stenosis with degenerative scoliosis, with L5 transitional vertebral body.
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F1
An 80-year-old female underwent a two-level TLIF (L4-L5, L5-S1) for spinal canal stenosis with degenerative scoliosis [Figure 1].
Intraoperative fluoroscopy view after cage insertion showing both the cages has crossed the anterior vertebral body margin.
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F2
Intraoperative fluoroscopy revealed that both cages on impaction crossed the anterior margin of their respective vertebral bodies (potentially risking major organ/vessel injury, deep vein thrombosis, and/or nerve injury, Figure 2).
Successful repositioning of L4-L5 cage.
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F3
Although the L4-L5 cage was successfully repositioned intraoperatively, the L5-S1 cage migrated further anteriorly [Figures 3 and 4].
Anterior migration of the cage at L5-S1 while attaching a cage holder.
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F4
Although the L4-L5 cage was successfully repositioned intraoperatively, the L5-S1 cage migrated further anteriorly [Figures 3 and 4].
Three months postoperative X-ray showed inferior migration of cage in the pouch of Douglas.
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F5
Three months later, however, the X-ray showed further inferior migration of the cage into the pouch of Douglas [Figure 5].