SpineUniverse Case Study Library
Superior Articular Facet Interbody Reconstruction (SAFIR)
A novel posterior lumbar interbody fusion approach
History
The patient is a 74-year-old female who presents with 9 months of back and right greater than left leg pain. Four years ago, she underwent anterior lumbar interbody fusion (ALIF) with pedicle screws at L4-S1. Her Oswestry Disability Index (ODI) is 20.
Her past medical history includes borderline diabetes, obesity, and hypertension. She is a nonsmoker.
Examination
- Positive right femoral stretch
- Trace right quadriceps weakness
- Diminished right knee reflex
Preoperative Imaging
Lateral herniated nucleus pulposus (HNP) at L3-L4 with disc space collapse; prior L4-S1 ALIF. (Figures 1-4 below)