International Journal of Spine Surgery最新文献

{"title":"Prone Lateral Transpsoas Approach to the Spine: A Technical Guide for Mastery.","authors":"Juan P Giraldo, Winward Choy, Juan S Uribe","doi":"10.14444/8712","DOIUrl":"https://doi.org/10.14444/8712","url":null,"abstract":"<p><strong>Background: </strong>The single-position prone transpsoas (PTP) lateral interbody fusion represents an alternative approach to the traditional lateral lumbar interbody fusion (LLIF) typically performed with the patient in the lateral decubitus position. Advantages of PTP surgery include improved segmental lordosis, single-position surgery, and ease of performing posterior techniques as needed. However, the learning curve of PTP is distinct from that of traditional LLIF surgery performed with the patient in the lateral decubitus position. Here, we highlight the senior author's approach to PTP surgery. The authors review key strategies of the preoperative workup, patient selection, operative techniques, and intraoperative pearls. This technical guide aims to shorten the learning curve for new adopters, optimize workflow for the surgeon, and maximize patient safety.</p><p><strong>Methods: </strong>A detailed analysis of the PTP approach was conducted, incorporating preoperative imaging and planning strategies and technical adjustments in patient positioning to accommodate access following the senior author's technical pearls. The workflow was structured to streamline transitions between levels, minimize time requirements, and reduce physical strain on the surgical team.</p><p><strong>Results: </strong>The application of PTP has demonstrated successful segmental lordosis correction and stable fusion across lumbar levels without requiring patient repositioning. The integrated workflow enabled sequential access and mastery of the PTP technique. These technical pearls have improved the efficiency of the PTP approach, according to the surgeon's expertise.</p><p><strong>Conclusion: </strong>The PTP technical strategies offer a viable and effective alternative to traditional LLIF. Surgeons can enhance the safety and efficiency of the PTP approach, maximize procedural benefits, and minimize potential risks using these technical strategies for preoperative planning, patient positioning, and intraoperative monitoring.</p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013511","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Short- and Mid-Term Outcomes Following ALIF and TLIF in L5-S1 Isthmic Spondylolisthesis Patients.","authors":"Jialun Chi, Kate S Woods, Ved A Vengsarkar, Zhiwen Xu, Hanzhi Yang, Abhishek Kumar, Yi Zhang, Zhichang Zhang, Jesse Wang, Lawal Labaran, Li Jin, Xudong Li","doi":"10.14444/8696","DOIUrl":"https://doi.org/10.14444/8696","url":null,"abstract":"<p><strong>Background: </strong>A limited number of studies have compared the outcomes of anterior lumbar interbody fusion (ALIF) to transforaminal lumbar interbody fusion (TLIF) for the treatment of isthmic spondylolisthesis. This study aims to compare postoperative complications between these two surgical approaches.</p><p><strong>Methods: </strong>A retrospective review was performed using a large national database. The study population included all patients older than 18 years who underwent single-level ALIF or TLIF with a diagnosis of L5 to S1 isthmic spondylolisthesis. A 1:2 propensity score was used to match ALIF and TLIF cohorts for age, sex, and relevant comorbidities, including smoking status. Multivariate logistic regression was used to compare 3-month and 2-year medical and surgical complications, including 5-year reoperation rates.</p><p><strong>Results: </strong>Five hundred and seventy-eight ALIF patients were paired with 1,156 TLIF patients following the match. The analysis revealed a higher 3-month ileus rate in ALIF patients (<i>P</i> = 0.009) and a lower, though not significant difference in, reoperation rate for ALIF within 2 years at 7.1% compared with TLIF at 7.7% (<i>P</i> = 0.696). Five-year reoperation rates were comparable (9.5% vs 10.8%; <i>P</i> = 0.612).</p><p><strong>Conclusions: </strong>Aside from the increased rate of ileus in the ALIF group, there was no significant difference in both short- and mid-term complications, including overall reoperation rate, between the 2 techniques. Spine surgeons should select the optimal technique for a given patient.</p><p><strong>Clinical relevance: </strong>ALIF and TLIF offer comparable mid-term postoperative outcomes for treating 1-level L5/S1 isthmic spondylolisthesis.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142979801","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Segmental Interbody, Muscle-Preserving, Ligamentotaxis-Enabled Reduction: \"SIMPLER\" Technique for cMIS Correction of ASD.","authors":"Jerry Robinson, David Gendelberg, Andrew Chung, Jose H Jimenez-Almonte, Babak Khandehroo, Neel Anand","doi":"10.14444/8714","DOIUrl":"https://doi.org/10.14444/8714","url":null,"abstract":"<p><strong>Background: </strong>Correction of adult spinal deformity (ASD) through minimally invasive techniques is a challenging endeavor and has typically been reserved for experienced surgeons. This publication aims to be the first high-resolution technique guide to demonstrate a reproducible technique for ASD correction utilizing circumferential minimally invasive surgery (cMIS) without an osteotomy. The Segmental Interbody, Muscle-Preserving, Ligamentotaxis-Enabled Reduction (SIMPLER) technique is a novel ligamentotaxis-based scoliosis surgery that represents a paradigm shift from traditional osteotomies toward patient-specific correction.</p><p><strong>Methods: </strong>The senior author's (N.A.) cMIS technique for ASD correction without an osteotomy is described using high-resolution photographs, computer-generated imagery (CGI), and a case example. Step-by-step intraoperative photographs document a novel muscle-preserving posterior spinal exposure, spinal robotic safety protocol for instrumentation, dedicated deformity instrumentation system, rod reduction sequence, and minimally invasive fusion technique. CGI assists to reinforce technical considerations described by intraoperative photographs.</p><p><strong>Results: </strong>The SIMPLER technique is documented from incision to closure with high-resolution pictures including CGI to highlight concepts documented in photographs. Technical considerations were detailed for all aspects involved in the planning and execution of an osteotomy-free deformity correction.</p><p><strong>Conclusion: </strong>This represents the first in-depth technical description of ligamentotaxis-based, osteotomy-free, ASD scoliosis correction. The SIMPLER approach is reproducible and minimally invasive and can be done routinely for appropriately selected deformity candidates. This technique serves as a foundation to externally validate previously described cMIS ASD deformity correction outcomes.</p><p><strong>Clinical relevance: </strong>Circumferential minimally invasive spinal deformity correction is reproducible and can be achieved reliably through the use of the SIMPLER technique, without the use of an osteotomy.</p><p><strong>Level of evidence: 5: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142967229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stem Cells Therapy as a Treatment for Discogenic Low Back Pain: A Systematic Review.","authors":"Randy Randy, Khandar Yosua, Aswin Guntara, Nicko P Hardiansyah","doi":"10.14444/86717","DOIUrl":"https://doi.org/10.14444/86717","url":null,"abstract":"<p><strong>Background: </strong>Low back pain (LBP) is 1 of the most common problems that present in 80% of people. LBP can be caused by some pathologies, with discogenic pain being 1 source. Pain from LBP can become chronic and also cause disability. Treatment options for LBP varied from conservative to operative, and a novel treatment nowadays is using stem cells therapy to treat with pain from LBP.</p><p><strong>Methods: </strong>Database searches from Pubmed and ScienceDirect from inception to 13 September 2023. A total of 283 discogenic LBP cases from 8 articles. This study measured clinical outcomes using a visual analog scale (VAS) and Oswestry Disability Index (ODI) obtained from each study.</p><p><strong>Results: </strong>Functional outcomes in patients treated with stem cell therapy showed significant improvement ODI and VAS (<i>P</i> < 0.00001). Improvement also showed in Pfirrmann grade before and after treatment with stem cells (<i>P</i> = 0.005). Subgroup analyses using bone marrow aspirate concentrate also showed significant differences in both ODI and VAS (<i>P</i> < 0.00001).</p><p><strong>Conclusion: </strong>Stem cells therapy could be beneficial as an option of treatment for discogenic LBP in improving pain and activity of daily living.</p><p><strong>Clinical relevance: </strong>Intradiscal stem cell therapy is a promising alternative for managing discogenic low back pain, offering improvements in pain and function.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posttraumatic Spinal Cord Tethering and Syringomyelia: A Retrospective Investigation of Patients With Progressive Disease and Surgical Revisions.","authors":"Crescenzo Capone, Denis Bratelj, Susanne Stalder, Phillip Jaszczuk, Marcel Rudnick, Rajeev K Verma, Tobias Pötzel, Michael Fiechter","doi":"10.14444/8716","DOIUrl":"https://doi.org/10.14444/8716","url":null,"abstract":"<p><strong>Background: </strong>Spinal cord tethering and syringomyelia after trauma are well-known pathologies in patients suffering from spinal cord injury (SCI). In symptomatic cases, various surgical options are available, but untethering and expansion duraplasty is the currently preferred treatment strategy. However, patient outcomes are usually limited by rather high rates of surgical revisions. The aim of the present study was to identify risk factors in SCI patients who underwent multiple surgeries for symptomatic spinal cord tethering and syringomyelia.</p><p><strong>Methods: </strong>We retrospectively investigated 25 patients who received at least 2 untethering surgeries of the spinal cord. All patients were treated by untethering and expansion duraplasty and/or clinically followed between 2012 and 2022 at the Swiss Paraplegic Center.</p><p><strong>Results: </strong>A higher location of SCI correlates with a more rapid development of symptomatic spinal cord retethering in need of surgical revision (<i>r</i> = 0.406 and <i>P</i> = 0.044). Interestingly, the extent of spinal cord tethering is lower in those patients who underwent an early surgical intervention (<i>r</i> = 0.462 and <i>P</i> = 0.030), which points toward an increased vulnerability of the spinal cord at higher levels. Ninety-two percent of the patients displayed a potentially chronic inflammatory condition with a mean level of C-reactive protein of 28.4 ± 4.1 mg/L, while the white blood cell count was identified as an independent predictor for surgical interventions in symptomatic cases.</p><p><strong>Conclusions: </strong>Revision surgery in posttraumatic spinal cord tethering and syringomyelia patients is associated with the location of SCI and the extent of spinal cord tethering. It appears that chronic inflammatory conditions might play an important role in promoting spinal cord retethering and thus warrant further investigation.</p><p><strong>Clinical relevance: </strong>SCI patients with chronic inflammatory conditions and SCI at upper levels should be clinically monitored more carefully as they appear to be more susceptible to progressive forms of posttraumatic spinal cord tethering and syringomyelia.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lateral Transpsoas Interbody Fusion.","authors":"T Barrett Sullivan, Angel Ordaz, Frank M Phillips","doi":"10.14444/8711","DOIUrl":"https://doi.org/10.14444/8711","url":null,"abstract":"<p><p>The lateral transpsoas approach to lumbar interbody fusion has gained widespread adoption for a variety of indications. This approach to the interbody space allows for a favorable fusion environment, disc and neuroforaminal height restoration, and powerful alignment correction. Despite its minimally invasive nature, this procedure carries unique risks, the most severe of which include bowel injury, major vascular injury, and lumbosacral plexopathy. This poses a marked learning curve and requires rigorous attention to detail in technique. In this review, we provide a detailed description of our approach to preoperative imaging, patient positioning, and surgical technique, with an emphasis on patient safety and evidence-based decision-making. A brief description of intraoperative neuromonitoring techniques follows. The lateral transpsoas approach to interbody fusion has demonstrated reliable outcomes in regard to fusion rates, pain and function, and deformity correction, all across a widespread variety of lumbar spine pathologies. Here, we depict techniques, pearls, and pitfalls that are critical for any surgeon considering whether to add this technique to their practice.</p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nuances of the Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Technical Review.","authors":"Daivik B Vyas, Brian J Park, Michael Y Wang","doi":"10.14444/8713","DOIUrl":"https://doi.org/10.14444/8713","url":null,"abstract":"<p><strong>Background: </strong>Transforaminal lumbar interbody fusion (TLIF) achieves anterior and posterior spinal arthrodesis through a single approach. Minimally invasive surgery (MIS) methods reduce surgical morbidity while achieving positive outcomes.</p><p><strong>Methods: </strong>The major MIS-TLIF techniques, from tubular to endoscopic approaches, are reviewed with a discussion on the incorporation of new technologies and a comparative review of their outcomes.</p><p><strong>Results: </strong>MIS-TLIF approaches span a spectrum of visualization methods, with technical nuances related to patient and surgeon-specific factors determining optimal fit. To date, the superiority of 1 technique has yet to be definitively determined. Existing techniques may be integrated in a personalized manner to optimize surgical utility.</p><p><strong>Conclusions: </strong>Selection of an MIS-TLIF modality relies on a calculus between patient characteristics and surgeon faculty; proper selection can offer significant benefits to patients with spine disease.</p><p><strong>Clinical relevance: </strong>Emerging technologies for MIS-TLIF comprise a major source of development and clinical translation, while the safe and effective use of these techniques promises greater patient benefit in the right populations.</p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fully Navigated Single-Position Prone Lateral Lumbar Interbody Fusion: A Detailed Technical Report and Description of 15 Cases.","authors":"David E Bauer, Nicolas Lauper, Dennis E Dominguez","doi":"10.14444/8697","DOIUrl":"https://doi.org/10.14444/8697","url":null,"abstract":"<p><strong>Background: </strong>Navigation increases the precision and safety of pedicle screw placement and has been used to place interbody cages for lateral lumbar interbody fusion. Single-position surgery shortens its duration and that of anesthesia. The aim of this study was the feasibility of simultaneous cage and screw placement in a single prone position using intraoperative navigation without the need for additional fluoroscopy and a detailed technical description of this procedure.</p><p><strong>Methods: </strong>We retrospectively analyzed 15 patients who underwent simultaneous navigated lateral lumbar interbody fusion and posterior instrumentation in a single prone position. A detailed technical description of the procedure is provided. Surgery duration, blood loss, complications, and radiographic parameters were recorded.</p><p><strong>Results: </strong>A total of 24 cages were placed in 15 patients. The mean time taken for cage placement was 21 ± 6.70 minutes, and there were no major complications. Mean surgery duration and blood loss per case, including posterior instrumentation, were 263 ± 94 minutes and 315 ± 143 mL, respectively. There were significant improvements in pre- to postoperative Oswestry Disability Index scores (51.38 ± 15.93 vs 32.81 ± 17.18, <i>P</i> < 0.001) and segmental lordosis (3.26° ± 8.97° vs 13.09° ± 15.25°, <i>P</i> < 0.001).</p><p><strong>Conclusion: </strong>The present study's results showed the feasibility of lateral lumbar interbody fusion using simultaneous posterior pedicle screw instrumentation and intraoperative navigation in a single prone position.</p><p><strong>Clinical relevance: </strong>Navigated lateral lumbar interbody fusion and posterior instrumentation in a single prone position possibly reduces operating time and blood loss and reduces exposure of operation room personnel to radiation.</p><p><strong>Level of evidence: 4: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142898838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Pain and Functional Outcomes Among Geriatric and Nongeriatric Adults Following Full Endoscopic Spine Surgery for Degenerative Lumbar Pathology.","authors":"Alexander A Chernysh, Jannik Leyendecker, Owen P Leary, Rahul A Sastry, Ziya L Gokaslan, Jared S Fridley, Peter Derman, Osama Kashlan, Sanjay Konakondla, John Ogunlade, Christoph P Hofstetter, Albert E Telfeian","doi":"10.14444/8693","DOIUrl":"https://doi.org/10.14444/8693","url":null,"abstract":"<p><strong>Background: </strong>Full endoscopic spine surgery (FESS) champions a rapid recovery and a low rate of overall complications. However, its efficacy in geriatric patients that might yield additional benefits from minimized invasiveness remains underexplored.</p><p><strong>Methods: </strong>A multi-institutional prospective cohort study was conducted involving patients undergoing elective lumbar FESS. Participants were categorized into nongeriatric (18-69 years old) and geriatric (≥70 years old) groups. Studied variables included demographics, medical comorbidities, operative details, visual analog scale (VAS) for back and leg pain, and Oswestry Disability Index (ODI). A mobile application was leveraged to collect real-time data pre- and postoperatively.</p><p><strong>Results: </strong>One hundred and sixty-four patients were included and divided into nongeriatric (<i>N</i> = 125) and geriatric (<i>N</i> = 39) cohorts. No group differences were observed between sex (<i>P</i> = 0.404), body mass index (<i>P</i> = 0.372), procedure duration (<i>P</i> = 0.350), or blood loss (<i>P</i> = 0.384). Nongeriatric patients received discectomy more frequently (<i>P</i> < 0.001), while older patients underwent more decompressive procedures (<i>P</i> < 0.001). Characterization of pain and functional outcome revealed that nongeriatric and geriatric patients follow a similar recovery trajectory and both appreciate significant improvements from baseline to 3 months postoperatively (<i>P</i> < 0.001 for VAS back, VAS leg, and ODI). There were no differences in the rate of improvement between age groups at any time point (<i>P</i> > 0.05 for VAS back, VAS leg, and ODI).</p><p><strong>Conclusions: </strong>FESS significantly improves pain and function in both geriatric and nongeriatric adults with degenerative lumbar conditions, with no difference in the degree of improvement between groups.</p><p><strong>Clinical relevance: </strong>These findings underscore the efficacy of FESS as a minimally invasive surgical option for elderly patients. Mobile application technology is useful for collecting patient-reported data in spine surgery clinical research.</p><p><strong>Level of evidence: 3: </strong></p>","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142847905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Clinical Efficacy in the Treatment of Lumbar Degenerative Disease: Posterior Lumbar Interbody Fusion, Posterior Lumbar Fusion, and Hybrid Surgery.","authors":"Zhenbiao Zhu, Anwu Xuan, Cheng Xu, Chaofeng Wang, Qing He, Liang Tang, Dike Ruan","doi":"10.14444/8659","DOIUrl":"10.14444/8659","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Numerous studies have confirmed that both posterior lumbar interbody fusion (PLIF) and posterior lumbar fusion (PLF), have their advantages and disadvantages. However, the inconsistent results of these studies make it difficult to reach a consensus on which fusion method is superior.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;To compare the clinical outcomes of PLIF, PLF, and hybrid surgery combining PLIF and PLF in the treatment of lumbar degenerative disease.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective review was conducted, collecting clinical records and radiological data of patients with lumbar degenerative disease from 2014 to 2022. Patients were divided into 3 groups based on surgical strategy: PLIF group, PLF group, and hybrid group. Clinical data included patient-reported outcomes such as the Japanese Orthopedic Association score, Oswestry Disability Index score, visual analog scale score, 36-item Short Form Health Survey score, and the occurrence of complications. Radiological data included Cobb angle, fusion rate, adjacent segment degeneration (ASDeg), adjacent segment disease (ASDis), and cage subsidence.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;A total of 378 patients were divided into 3 groups: PLIF group (&lt;i&gt;n&lt;/i&gt; = 122), PLF group (&lt;i&gt;n&lt;/i&gt; = 126), and hybrid group (&lt;i&gt;n&lt;/i&gt; = 130). The baseline characteristics were balanced among the 3 groups. As the follow-up time increased, visual analog scale scores showed varying degrees of improvement (all &lt;i&gt;P&lt;/i&gt; &lt;sub&gt;measure time&lt;/sub&gt; &lt; 0.001), but there were no significant differences observed between the groups (all &lt;i&gt;P&lt;/i&gt; &lt;sub&gt;measure time * group&lt;/sub&gt; &gt; 0.05). Oswestry Disability Index scores improved over time (&lt;i&gt;F&lt;/i&gt; &lt;sub&gt;measure time&lt;/sub&gt; = 939, &lt;i&gt;P&lt;/i&gt; &lt;sub&gt;measure time&lt;/sub&gt; &lt; 0.001), with the hybrid group showing more significant improvement (&lt;i&gt;F&lt;/i&gt; &lt;sub&gt;measure time * group&lt;/sub&gt; = 2.826, &lt;i&gt;P&lt;/i&gt; &lt;sub&gt;measure time * group&lt;/sub&gt; = 0.006). The 36-item Short Form Health Survey scores and Cobb angles also improved significantly during the follow-up period, with no significant differences observed among the groups. The overall fusion rates for the hybrid group and PLIF group were 93% and 91%, significantly higher than the fusion rate of the PLF group (84%; &lt;i&gt;P&lt;/i&gt; = 0.031). The postoperative complication rate was significantly higher in the PLIF group (24.4%) compared with the PLF group (16.4%) and the hybrid group (12.5%; &lt;i&gt;P&lt;/i&gt; = 0.022). There was no significant difference in the overall 5-year ASDeg occurrence rate (38% vs 36%) and ASDis occurrence rate (11.3% vs 8.3%) between the PLIF group and PLF group for single-level fusion (&lt;i&gt;P&lt;/i&gt; &gt; 0.05). The occurrence rate of ASDeg for multilevel fusion in the hybrid group was 29%, significantly lower than that in the PLIF group (42%) and PLF group (37%; &lt;i&gt;P&lt;/i&gt; = 0.044). The overall 5-year ASDis occurrence rates for multilevel fusion were 12.3%, 9.9%, and 7.6% for the PLIF group, PLF group, and hybrid g","PeriodicalId":38486,"journal":{"name":"International Journal of Spine Surgery","volume":" ","pages":""},"PeriodicalIF":1.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11687063/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}