Spondylolysis causes chronic low back pain that is resistant to therapy and results in poor overall spinal alignment.

When ALIF surgery is not feasible due to vascular anatomical variations or patient comorbidities, restoration of segmental lordosis and achieving a solid fusion from a posterior approach remain essential.
Here, we present a 35-year-old patient with chronic recurrent and recently therapy-resistant, immobilizing low back pain associated with poor global spinal alignment caused by bilateral L5 spondylolysis without listhesis and advanced disc degeneration L5/S1.
Fortunately, the availability of large-footprint TLIF cages 40 mm length, 15 mm anterior height, and 10° lordosis in this case allowed restoration of segmental lordosis at L5/S1.
I have always been a great admirer of the DEVEX cage from DePuy Spine, which unfortunately is no longer available. However, the implanted Roccia cage from Silony represents an excellent alternative.
Dr Basil Al Sharef | German Spine Surgeon Dubai | Pioneer of Complex Spine Surgery | German and Swiss Board Certified
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