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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)

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