A patient with prior fusion instrumentation from L2 to the sacrum who underwent 2-level transforaminal lumbar intervertebral fusion at L3–L4 and L4–L5.

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Presentation transcript:

A patient with prior fusion instrumentation from L2 to the sacrum who underwent 2-level transforaminal lumbar intervertebral fusion at L3–L4 and L4–L5. A patient with prior fusion instrumentation from L2 to the sacrum who underwent 2-level transforaminal lumbar intervertebral fusion at L3–L4 and L4–L5. There was inadvertent intraoperative anterior longitudinal ligament disruption at L5–S1. This essentially resulted in an anterior opening osteotomy effect along with a Smith-Petersen osteotomy posterior closing osteotomy (ie, X-osteotomy). There is an unintentional anteriorly extruded intervertebral disc graft at this level (arrow). T. Takahashi et al. AJNR Am J Neuroradiol 2018;39:606-611 ©2018 by American Society of Neuroradiology