Tomoyuki Asada, Eric R. Zhao, Adin M. Ehrlich, Adrian Lui, Andrea Pezzi, Sereen Halayqeh, Tarek Harhash, Olivia C. Tuma, Kasra Araghi, Todd J. Albert, James Farmer, Russel C. Huang, Harvinder Sandhu, Han Jo Kim, Francis C. Lovecchio, James E. Dowdell, Sravisht Iyer, Sheeraz A. Qureshi
Neurospine 2025;22(1):3-13. Published online March 31, 2025
Objective While minimally invasive-transforaminal lumbar interbody fusion (MIS-TLIF) has shown superiority in key clinical metrics over the open approach, evidence regarding patient-reported outcomes remains limited. This study compared postoperative recovery trajectories and symptomatic improvement phases between MIS and open TLIF.
Methods This retrospective review included patients who underwent single-level MIS or open TLIF. Oswestry Disability Index (ODI) and Numerical Rating Scale (NRS) for back and leg pain were collected preoperatively and postoperatively. Segmented regression analysis with mixed-effects modeling, allowing for identification of distinct recovery phases, compared symptomatic trends between approaches.
Results Of 324 patients (268 MIS, 56 open), baseline demographics were similar except for greater preoperative leg pain in the MIS group (NRS: 6.0 vs. 5.0, p = 0.027). A segmented regression model identified 4 ODI recovery phases: postoperative disability phase (PDP, day 0 to 13), early improvement phase (day 13 to 28), late improvement phase (day 28 to 110), and plateau phase (later than day 110). The MIS group exhibited significantly lower disability exacerbation during PDP (β = 0.93 vs. 1.42 points per day, p = 0.008). Additionally, the plateau of NRS back occurred significantly earlier in the MIS group than in the open group (MIS, 26.7 ± 2.6 days vs. open, 51.7 ± 6.6 days, p < 0.001).
Conclusion MIS-TLIF resulted in lower postoperative disability during the first 2 weeks compared to the open approach. Furthermore, low back pain achieved an earlier plateau in back pain by about 4 weeks in the MIS approach.
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Modified Integrated Health State Suggests Lower Cumulative Neck Pain–Related Disability After Cervical Disk Replacement Compared With Anterior Cervical Diskectomy and Fusion Tomoyuki Asada, Adin M. Ehrlich, Sereen Halayqeh, Eric R. Zhao, Adrian T. H. Lui, Andrea Pezzi, Austin C. Kaidi, Kasra Araghi, Vishaal Nayagam, Roger Freeman, Olivia C. Tuma, Tarek Harhash, Harvinder S. Sandhu, Todd J. Albert, Han Jo Kim, James C. Farmer, Neurosurgery.2026;[Epub] CrossRef
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Adult cervical spine deformity is associated with decreased health-related quality of life, disability, and myelopathy. A number of radiographic parameters help to characterize cervical deformity and aid in the diagnosis and treatment. There are several etiologies for cervical spine deformity, the most common being iatrogenic. Additionally, spine surgery can accelerate adjacent segment degeneration which may lead to deformity. It is therefore important for all spine surgeons to be aware of the potential to cause iatrogenic cervical deformity. The aim of this review is to highlight concepts and techniques to prevent cervical deformity after spine surgery.
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The Variability of the Cervicothoracic Inflection Point: A Cohort Analysis of the Multi-Ethnic Asymptomatic Normative Study (MEANS) Justin L. Reyes, Roy Miller, Matan Malka, Josephine Coury, Yong Shen, Natalia Czerwonka, Alexandra Dionne, Jean-Charles Le Huec, Stephane Bourret, Kazuhiro Hasegawa, Hee Kit Wong, Gabriel Liu, Hwee Weng Dennis Hey, Hend Riahi, Michael Kelly, Lawrence G. L Global Spine Journal.2025; 15(4): 2409. CrossRef
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Risk factors associated with distal junctional kyphosis and failure after surgical management of adult cervical deformity: a systematic review Davin C. Gong, Anthony N. Baumann, Zhaorui Wang, Omkar S. Anaspure, Muhammad Waheed, Evan J. Beck, Rakesh D. Patel, Ilyas S. Aleem European Spine Journal.2025; 34(8): 3430. CrossRef
Long-term loss of intervertebral disc height after posterior cervical surgery for ossification of the posterior longitudinal ligament: a retrospective study with more than 3 years of follow-up Siyuan Qin, Ruomu Qu, Weili Zhao, Ruixin Yan, Yongye Chen, Feifei Zhou, Ning Lang Journal of Orthopaedic Surgery and Research.2025;[Epub] CrossRef
Jung Kee Mok, Avani S. Vaishnav, Chirag Chaudhary, R. Kiran Alluri, Ryan Lee, Hikari Urakawa, Kosuke Sato, Darren A. Chen, Catherine Himo Gang, Russel Huang, Todd J. Albert, Sheeraz A. Qureshi
Neurospine 2020;17(3):588-602. Published online September 30, 2020
Objective To evaluate outcomes of cervical disc replacement (CDR) in patients with nonlordotic alignment.
Methods Patients who underwent CDR were retrospectively reviewed and divided into 3 cohorts: (1) neutral/lordotic segmental and C2–7 Cobb angle (L), (2) nonlordotic segmental Cobb angle, lordotic C2–7 Cobb angle (NL-S), and (3) nonlordotic segmental and C2–7 Cobb angle (NL-SC). Radiographic and patient-reported outcomes (PROMs) were compared.
Results One-hundred five patients were included (L: 37, NL-S: 30, NL-SC: 38). A significant gain in segmental lordosis was seen in all cohorts at < 6 months (L: -1.90° [p = 0.007]; NL-S: -5.16° [p < 0.0001]; NL-SC: -6.00° [p < 0.0001]) and ≥ 6 months (L: -2.07° [p = 0.031; NL-S: -6.04° [p < 0.0001]; NL-SC: -6.74° [p < 0.0001]), with greater lordosis generated in preoperatively nonlordotic cohorts (p < 0.0001). C2–7 lordosis improved in the preoperatively nonlordotic cohort (NL-SC: 8.04°) at follow-up of < 6 months (-4.15°, p = 0.003) and ≥ 6 months (-6.40°, p = 0.003), but not enough to create lordotic alignment (< 6 months: 3.89°; ≥ 6 months: 4.06°). All cohorts showed improvement in Neck Disability Index, visual analogue scale (VAS) neck, and VAS arm, without significant difference among groups in the amount of improvement ( ≥ 6-month PROMs follow-up = 69%).
Conclusion In patients without major kyphotic deformity, CDR has the potential to generate and maintain lordosis and improve PROMs in the short-term, and can be an effective treatment option for patients with nonlordotic alignment.
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