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Fig. 3 | Journal of Orthopaedic Surgery and Research

Fig. 3

From: Relationship between postoperative lordosis distribution index and adjacent segment disease following L4-S1 posterior lumbar interbody fusion

Fig. 3

Imaging studies of ASD associated with high postoperative LDI. a A 47-year-old female patient underwent L4-S1 PLIF with the postoperative LL of 41.79° and LLL of 39.94°. The ultimate LDI equals to 95.57%. b Preoperative sagittal T2-weighted MRI scans at the L3–4 showing no or mild spinal stenosis (Imagama’s classification II) and disc degeneration of Pfirrmann classification III. c Postoperative neutral lateral X-ray obtained 69 months after surgery revealing retrolisthesis of L3 vertebra. d The final follow-up MRI scans demonstrating severe spinal stenosis (Imagama’s classification IV) and disc degeneration of Pfirrmann classification IV

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