case_images: PMC8326106_01
case_images: Preoperative imaging showing L4-L5, L5-S1 spinal canal stenosis with degenerative scoliosis, with L5 transitional vertebral body.
case_images: SNI-12-360-g001.jpg
case_images: PMC8326106_01_SNI-12-360-g001.jpg
case_images: F1
case_images: An 80-year-old female underwent a two-level TLIF (L4-L5, L5-S1) for spinal canal stenosis with degenerative scoliosis [Figure 1].
case_images: Intraoperative fluoroscopy view after cage insertion showing both the cages has crossed the anterior vertebral body margin.
case_images: SNI-12-360-g002.jpg
case_images: PMC8326106_01_SNI-12-360-g002.jpg
case_images: F2
case_images: 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).
case_images: Successful repositioning of L4-L5 cage.
case_images: SNI-12-360-g003.jpg
case_images: PMC8326106_01_SNI-12-360-g003.jpg
case_images: F3
case_images: Although the L4-L5 cage was successfully repositioned intraoperatively, the L5-S1 cage migrated further anteriorly [Figures 3 and 4].
case_images: Anterior migration of the cage at L5-S1 while attaching a cage holder.
case_images: SNI-12-360-g004.jpg
case_images: PMC8326106_01_SNI-12-360-g004.jpg
case_images: F4
case_images: Although the L4-L5 cage was successfully repositioned intraoperatively, the L5-S1 cage migrated further anteriorly [Figures 3 and 4].
case_images: Three months postoperative X-ray showed inferior migration of cage in the pouch of Douglas.
case_images: SNI-12-360-g005.jpg
case_images: PMC8326106_01_SNI-12-360-g005.jpg
case_images: F5
case_images: Three months later, however, the X-ray showed further inferior migration of the cage into the pouch of Douglas [Figure 5].