Abstract
INTRODUCTION: Posterior lumbar interbody fusion (PLIF) is effective for lumbar degenerative disorders, but rare complications such as anterior cage migration may occur. Surgical removal is usually performed via open or transperitoneal laparoscopic approaches. CASE PRESENTATION: An 80-year-old woman underwent PLIF, during which a cage migrated anteriorly and was not retrieved intraoperatively. Postoperative CT revealed the cage positioned between the inferior vena cava (IVC) and right renal arteries. Although asymptomatic, she was referred for surgical removal to prevent potential vascular complications. A laparoscopic retroperitoneal approach was performed, allowing direct access to the cage without vascular injury. The procedure was completed safely with minimal blood loss and no complications. CONCLUSION: This is the first reported case of anteriorly migrated cage removal via a retroperitoneal laparoscopic approach. For experienced surgeons, this method offers a minimally invasive and effective alternative to traditional techniques, with potential benefits including reduced surgical morbidity and quicker recovery.