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Patient in their late 50s presenting with progressive bilateral lower extremity numbness, tingling, weakness, paralumbar pain. Patient had decreased ambulatory capacity. Imaging was performed and revealed severe spinal stenosis from L2 to S1 with bilateral central foraminal compromise with broad based disc herniations and significant lumbopelvic mismatch of greater than 25 degrees with sagittal plane balance deformity. We discussed the risks, benefits and alternatives of an L5-S1 ALIF and L3-5 XLIF and posterior decompression and stabilization and fusion from L2 to the pelvis.
Surgery was performed in under three hours and the patient is recovering well.
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