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A 71-year-old man had been treated with hemodialysis for 34 years. The patient complained of painful dysesthesia in the right lower extremity, and 7 years ago underwent decompressive right partial laminectomy at the L4/L5 level. Painful dysesthesia in the bilateral lower extremities occurred four years ago, following a fracture in the right inferior articular process of the 4 vertebral body. Consequently, decompressive left partial laminectomy at the L4/L5 level was performed. The painful dysesthesia relapsed in the right lower extremity following a fracture in the left inferior articular process of the 4 vertebral body, and he was treated with posterior lumbar interbody fusion(PLIF)3 years ago. The painful dysesthesia in the bilateral lower extremities, lumbago, and intermittent claudication recurred, and an X-ray showed instability between the L4 and L5 levels. Computed tomography at the L4/L5 level showed that both the spacer and iliac bone graft were protruding into the spinal canal. Magnetic resonance imaging revealed spondylolisthesis and compression of the dural sac at the L4/L5 level. Transforaminal lumbar interbody fusion(TLIF)was performed at the L4/L5 level using a boomerang-type intervertebral spacer. The symptoms improved markedly after the operation. Percentage slip(the percentage of vertebral slippage)and angle of slippage improved after TLIF with the recovery of segmental sagittal lordosis. No protrusion of the spacer has occurred 10 months after the surgery. TLIF is a viable option for salvage surgery after a failed PLIF operation. (Received:September 18, 2010;accepted:March 29, 2011)

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Transforaminal Lumbar Interbody Fusion (TLIF) using a Boomerang-type Interbody Spacer in a Hemodialysis Patient : Salvage Surgery after a Failed PLIF Operation