{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T16:42:00Z","timestamp":1790959320744,"version":"4.1.0"},"reference-count":53,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:00:00Z","timestamp":1777593600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Sel\u00e7uk University Scientific Research Projects"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Orthop Surg (Hong Kong)"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Adjacent segment disease (ASD) is a recognized complication following lumbar fusion, characterized by new symptomatic and radiological degeneration at levels adjacent to the fused segment. While revision decompression with extended fusion has traditionally been performed, minimally invasive fusion-sparing strategies such as unilateral biportal endoscopic (UBE) decompression have gained attention. High-level evidence regarding their effectiveness in carefully selected stable ASD remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included 17 consecutive patients with clinically and radiologically confirmed ASD treated with isolated UBE posterior decompression between 2022 and 2025. Patients with radiographic instability requiring fusion were excluded. Clinical outcomes included Visual Analog Scale (VAS) scores for back and leg pain, Oswestry Disability Index (ODI), and walking capacity assessed by the self-paced walking test (SPWT). Radiological evaluation included MRI-based canal measurements and standing lateral radiographs assessing segmental kyphosis and sagittal alignment. Pre\u2013post comparisons were performed using paired statistical analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Median age was 66\u00a0years (IQR 64\u201370). Significant postoperative improvements were observed in SPWT distance and duration (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001), VAS-back and VAS-leg scores (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001), and ODI (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001). MRI demonstrated significant enlargement of canal dimensions at the ASD level (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      &lt; 0.001). Segmental kyphosis improved modestly without deterioration of global sagittal balance. Two perioperative complications (one dural tear, one epidural hematoma) were managed successfully without permanent neurological deficit.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In carefully selected patients with stable ASD, UBE posterior decompression provides meaningful pain relief, functional improvement, and effective neural decompression while preserving sagittal alignment. This tissue-sparing approach may be considered a treatment option in selected high-risk or elderly patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of evidence<\/jats:title>\n                    <jats:p>IV.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10225536261456331","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T12:38:33Z","timestamp":1780576713000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":1,"title":["Unilateral biportal endoscopic decompression for stable adjacent segment disease after lumbar fusion: Clinical and radiological outcomes"],"prefix":"10.1177","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3110-0261","authenticated-orcid":false,"given":"Ali","family":"Gulec","sequence":"first","affiliation":[{"name":"Selcuk University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2940-604X","authenticated-orcid":false,"given":"Ebubekir","family":"Eravsar","sequence":"additional","affiliation":[{"name":"Selcuk University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-0351-547X","authenticated-orcid":false,"given":"Abdullah","family":"Balc\u0131","sequence":"additional","affiliation":[{"name":"Selcuk University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayse","family":"Gulec","sequence":"additional","affiliation":[{"name":"Beyhekim State Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bahattin Kerem","family":"Aydin","sequence":"additional","affiliation":[{"name":"Selcuk University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3249-3420","authenticated-orcid":false,"given":"Sadettin","family":"Ciftci","sequence":"additional","affiliation":[{"name":"Selcuk University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.20.00408"},{"issue":"2","key":"e_1_3_6_3_2","first-page":"134","article-title":"Analysis of the effect of lumbar spine fusion on the superior adjacent intervertebral disk in the presence of disk degeneration, using the three-dimensional finite element method","volume":"17","author":"Chosa E","year":"2004","unstructured":"Chosa E, Goto K, Totoribe K, et al. Analysis of the effect of lumbar spine fusion on the superior adjacent intervertebral disk in the presence of disk degeneration, using the three-dimensional finite element method. Clini Spine Surg 2004; 17(2): 134\u2013139. https:\/\/doi.org\/10.1097\/00024720-200404000-00010","journal-title":"Clini Spine Surg"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-198409000-00007"},{"key":"e_1_3_6_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-199503010-00004"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1227\/NEU.0b013e31828e8ddc"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/BSD.0000000000000328"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2021.07.004"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1097\/BRS.0b013e31816c8b67"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-018-0868-0"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2014.02.015"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2018.03.099"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.3171\/2017.12.SPINE171096"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2020.02.151"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.3171\/2019.6.SPINE19532"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.4103\/2319-4170.112742"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.31616\/asj.2018.0210"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2008-1052034"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/10225536251386150"},{"key":"e_1_3_6_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2019.04.240"},{"key":"e_1_3_6_21_2","doi-asserted-by":"publisher","DOI":"10.3171\/2018.9.SPINE18689"},{"key":"e_1_3_6_22_2","doi-asserted-by":"publisher","DOI":"10.21037\/jss-20-620"},{"key":"e_1_3_6_23_2","doi-asserted-by":"publisher","DOI":"10.3171\/2018.5.SPINE171337"},{"key":"e_1_3_6_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.wneu.2020.06.168"},{"key":"e_1_3_6_25_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-025-06480-x"},{"key":"e_1_3_6_26_2","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-200407000-00020"},{"key":"e_1_3_6_27_2","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-200109010-00011"},{"key":"e_1_3_6_28_2","doi-asserted-by":"publisher","DOI":"10.14245\/ns.1938440.220"},{"key":"e_1_3_6_29_2","doi-asserted-by":"publisher","DOI":"10.3171\/2012.1.SPINE11842"},{"key":"e_1_3_6_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2023.10.011"},{"key":"e_1_3_6_31_2","doi-asserted-by":"publisher","DOI":"10.1177\/2309499020960560"},{"key":"e_1_3_6_32_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00586-015-4269-3"},{"key":"e_1_3_6_33_2","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.N.00313"},{"key":"e_1_3_6_34_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-017-2685-z"},{"key":"e_1_3_6_35_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-024-04621-2"},{"key":"e_1_3_6_36_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-023-04389-x"},{"key":"e_1_3_6_37_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2023.1132698"},{"key":"e_1_3_6_38_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00402-010-1222-0"},{"key":"e_1_3_6_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2004.07.007"},{"key":"e_1_3_6_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2013.03.020"},{"key":"e_1_3_6_41_2","doi-asserted-by":"publisher","DOI":"10.31616\/asj.2025.0394.r2"},{"issue":"2","key":"e_1_3_6_42_2","first-page":"70","article-title":"Risk factors for adjacent segment disease after posterior lumbar interbody fusion and efficacy of simultaneous decompression surgery for symptomatic adjacent segment disease","volume":"27","author":"Hikata T","year":"2014","unstructured":"Hikata T, Kamata M, Furukawa M. Risk factors for adjacent segment disease after posterior lumbar interbody fusion and efficacy of simultaneous decompression surgery for symptomatic adjacent segment disease. Clinical Spine Surgery 2014; 27(2): 70\u201375. https:\/\/doi.org\/10.1097\/BSD.0b013e31824e5292","journal-title":"Clinical Spine Surgery"},{"key":"e_1_3_6_43_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1513721"},{"key":"e_1_3_6_44_2","doi-asserted-by":"publisher","DOI":"10.3171\/spi.2005.3.2.0129"},{"key":"e_1_3_6_45_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-024-05409-0"},{"key":"e_1_3_6_46_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-024-04743-7"},{"key":"e_1_3_6_47_2","doi-asserted-by":"publisher","DOI":"10.2147\/JPR.S559657"},{"key":"e_1_3_6_48_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-025-06034-1"},{"key":"e_1_3_6_49_2","doi-asserted-by":"publisher","DOI":"10.1097\/BSD.0000000000001777"},{"key":"e_1_3_6_50_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2024.11.015"},{"issue":"3","key":"e_1_3_6_51_2","first-page":"CD010036","article-title":"Effectiveness of posterior decompression techniques compared with conventional laminectomy for lumbar stenosis","author":"Overdevest GM","year":"2015","unstructured":"Overdevest GM, Jacobs W, Vleggeert\u2010Lankamp C, et al. Effectiveness of posterior decompression techniques compared with conventional laminectomy for lumbar stenosis. Cochrane Database Syst Rev 2015; (3): CD010036.","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_3_6_52_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.spinee.2023.12.009"},{"key":"e_1_3_6_53_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-025-05699-y"},{"key":"e_1_3_6_54_2","doi-asserted-by":"publisher","DOI":"10.1177\/21925682251358819"}],"container-title":["Journal of Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10225536261456331","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10225536261456331","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10225536261456331","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T13:16:29Z","timestamp":1780751789000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10225536261456331"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":53,"journal-issue":{"issue":"2","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1177\/10225536261456331"],"URL":"https:\/\/doi.org\/10.1177\/10225536261456331","relation":{},"ISSN":["1022-5536","2309-4990"],"issn-type":[{"value":"1022-5536","type":"print"},{"value":"2309-4990","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]},"article-number":"10225536261456331"}}