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When this patient first presented with left leg pain from L5-S1 nerve compression, we recommended a foraminotomy as the right surgery for her at that time, knowing the underlying segment could later require fusion. Two years later, her spondylolisthesis had progressed, and we performed a minimally invasive transforaminal lumbar interbody fusion (TLIF) to address the underlying instability and restore lumbar lordosis. A second spine surgery doesn't mean the first one failed — it often means each
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