Accidental anterior longitudinal ligament rupture during lateral lumbar interbody fusion disclosed after posterior corrective fusion surgery resulting in local hyper-lordosis

April 10, 2021

. 2021 Apr;16(2):111-114.

doi: 10.2185/jrm.2020-057.

Epub 2021 Apr 1.

Affiliations

Item in Clipboard

Yosuke Shibao et al.

J Rural Med.

2021 Apr.

Abstract

Objective: To report a case of anterior longitudinal ligament (ALL) injury that was not noticeable during lateral lumbar interbody fusion and was disclosed after posterior corrective fusion surgery. Case presentation: After performing lateral lumbar interbody fusion followed by posterior corrective fusion surgery, we observed an anterior longitudinal ligament rupture that required additional surgery. Postoperative pain in the left lower limb and muscle weakness due to nerve traction appeared, but this was improved by stabilization between the vertebral bodies. Conclusion: Unidentified anterior longitudinal ligament rupture can result in unexpected local lordosis during posterior surgery, possibly related to lower extremity palsy. Therefore, checking for possible rupture during and after anterior surgery is important. If the ALL damage is disclosed before posterior surgery, the proper surgical strategy for the posterior surgery must be considered.

Keywords:

adult spinal deformity; allograft and fibula; anterior longitudinal ligament.

Figures

**Figure 1**

Preoperative whole-spine radiographs in the anteroposterior (a) and lateral views
(b).

**Figure 2**

Lateral fluoroscopic images obtained after lumbar interbody fusion (a); in the
prone position during surgery (b); and after posterior spinal correction (c).

**Figure 3**

Postoperative whole-spine radiographs in the anteroposterior (a) and lateral views
(b) views. (c) Postoperative sagittal CT images of the fibular graft implanted in
L4/L5.

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