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Images illustrate the case of a 51-year-old man who underwent anterior lumbar interbody fusion at L4–L5 and experienced radiographic adjacent segment degeneration at followup. (A) A preoperative lateral radiograph shows isthmic spondylolisthesis at L4–L5 and retrolisthesis of the cranial segment progressing after (B) 5 and (C) 10 years.
