{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T10:00:26Z","timestamp":1790589626012,"version":"4.1.0"},"reference-count":37,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Global Spine Journal"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Study Design<\/jats:title>\n                    <jats:p>Retrospective Single-center propensity score\u2013matched cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Adjacent segment disease remains a major cause of revision surgery after multilevel lumbosacral fusion, and muscle-preserving approaches may help reduce this risk. This study compared clinical and radiographic outcomes between a muscle-preserving fusion combining standalone anterior plus lateral lumbar interbody fusion (A + LLIF) vs circumferential lateral plus posterior lumbar interbody fusion (L + PLIF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients who underwent multilevel lumbosacral fusion (2016-2023) with either A + LLIF or L + PLIF were included. L + PLIF patients with contraindications to standalone A + LLIF were excluded. Propensity score matching, based on age, BMI, PI\u2013LL mismatch and stenosis severity, yielded 90 1:1-matched patients. The primary outcome was revision surgery. Secondary outcomes included spinopelvic alignment, cage subsidence, and perioperative metrics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline characteristics were comparable between groups (mean age 57 \u00b1 10 years; median fusion levels: 2 [range 2-4]). The 5-year cumulative incidence of revision surgery was significantly lower with A + LLIF (1\/45 events; 2.2%) than with L + PLIF (14\/45 events; 31.1%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001), with superior perioperative outcomes and comparable radiographic alignment.Operative time, blood loss, and length of stay were significantly lower in the A + LLIF group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001 for all). Spinopelvic parameters were largely equivalent, except for improved distal lordosis and LPA\u2013PI mismatch in the A + LLIF group (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .003 and\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = .019, respectively). Cage subsidence rates were low and similar between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In carefully selected patients, combined standalone anterior and lateral interbody fusion offers a paraspinal muscle-preserving alternative to circumferential fusion, with significantly lower revision rates, favorable perioperative outcomes, and comparable radiographic alignment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21925682261432978","type":"journal-article","created":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T18:47:12Z","timestamp":1773254832000},"page":"3305-3315","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Multilevel Standalone Anterior Plus Lateral Lumbar Interbody Fusion: A Propensity-Matched Comparison to Circumferential Lumbosacral Fusion"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1501-1952","authenticated-orcid":false,"given":"Marco D.","family":"Burkhard","sequence":"first","affiliation":[{"name":"Weill Cornell Medicine"},{"name":"Center for Musculoskeletal Surgery, Charit\u00e9 - University Medicine Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4381-775X","authenticated-orcid":false,"given":"Torben","family":"Stepan","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine"},{"name":"Center for Musculoskeletal Surgery, Charit\u00e9 - University Medicine Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna-Maria","family":"Mielke","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine"},{"name":"Center for Musculoskeletal Surgery, Charit\u00e9 - University Medicine Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-7663-9043","authenticated-orcid":false,"given":"Ali E.","family":"Guven","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine"},{"name":"Center for Musculoskeletal Surgery, Charit\u00e9 - University Medicine Berlin, Berlin, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Verna","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8395-4817","authenticated-orcid":false,"given":"Giuseppe","family":"Loggia","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Shue","sequence":"additional","affiliation":[{"name":"Weill Cornell Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Federico 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