Fig. 3

A 63-year-old female underwent L4–5 transforaminal lumbar interbody fusion surgery in 2016 for lumbar spondylolisthesis and lumbar spinal stenosis and underwent L3–4 revision surgery for adjacent segment disease 4 years later. A shows the lumbar lateral plain radiograph before the first surgery. B suggests significant fatty infiltration of the multifidus muscle at the L4–5 segment before the first surgery. C shows the lumbar lateral plain radiograph after the first surgery. D and E are pre- and postoperative radiographs of the revision surgery, respectively