{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T17:46:19Z","timestamp":1790012779723,"version":"4.0.1"},"reference-count":41,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,5,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>Short-segment fusion (SSF) is an effective surgical option for appropriately selected patients with de novo degenerative lumbar scoliosis (DNDLS). Considering that DNDLS is frequently accompanied by multisegment degeneration and potential instability across the entire lumbar segments, it is inevitable that unhealthy segments remain after SSF, thereby increasing the potential risk of adjacent-segment disease (ASD) occurrence. Therefore, the authors aimed to identify the risk factors for ASD in patients with DNDLS who underwent SSF.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>This retrospective study included 80 patients with DNDLS (Cobb angle &gt; 10\u00b0) who underwent SSF (1 or 2 levels) between December 2010 and July 2018 with a minimum follow-up duration of 5 years. The participants were divided into two groups: ASD and non-ASD. ASD was defined as clinical ASD rather than radiographic ASD. Various patient and operative variables were compared between the groups. Global and regional radiographic parameters (preoperatively and postoperatively) were also compared between the two groups using plain radiography and MRI. Consequently, univariate and multivariate analyses were conducted to identify the risk factors for ASD occurrence. The receiver operating characteristic (ROC) curve was used to calculate the cutoff values.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>The mean \u00b1 SD age was 67.7 \u00b1 7.2 years at the time of SSF, and there were 62 women (77.5%) enrolled in the study. Thirty patients (37.5%) were in the ASD group and 50 patients (62.5%) were in the non-ASD group. The mean time from the surgery to ASD diagnosis was 34.9 \u00b1 28.2 months in ASD group. Thirteen patients required revision surgery at a mean time of 8.8 \u00b1 7.0 months after ASD occurrence. Multivariate logistic regression analysis demonstrated that preoperative disc wedging angle (OR 1.806, 95% CI 1.255\u20132.598, p = 0.001), presence of facet tropism (defined as \u2265 10\u00b0 difference between the facet joint angles of the right and left sides) (OR 5.534, 95% CI 1.528\u201320.040, p = 0.009), and foraminal stenosis \u2265 grade 2 (OR 5.935, 95% CI 1.253\u201328.117, p = 0.025) were significant risk factors for ASD development. The cutoff value of the preoperative disc wedging angle was calculated to be 2.5\u00b0 using the ROC curve.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>Preoperative disc wedging angle \u2265 2.5\u00b0, presence of facet tropism, and foraminal stenosis \u2265 grade 2 were identified as significant risk factors for ASD development after SSF in patients with DNDLS.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2023.12.spine23999","type":"journal-article","created":{"date-parts":[[2024,2,10]],"date-time":"2024-02-10T01:47:17Z","timestamp":1707529637000},"page":"570-579","source":"Crossref","is-referenced-by-count":3,"title":["Risk factors of adjacent-segment disease after short-segment fusion in patients with de novo degenerative lumbar scoliosis"],"prefix":"10.3171","volume":"40","author":[{"given":"Hyun-Jun","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Spine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Se-Jun","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Spine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin-Sung","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Spine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Choong-Won","family":"Jung","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Spine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong-Shin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Spine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Han-Seok","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Spine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chong-Suh","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Haeundae Bumin Hospital, Busan, South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"10","key":"b1","series-title":"Eur Spine J","first-page":"925","article-title":"The adult scoliosis","volume":"14","author":"Aebi M","year":"2005","unstructured":"Aebi M. The adult scoliosis. Eur Spine J. 2005;14(10):925\u2013948."},{"issue":"6","key":"b2","series-title":"Spine (Phila Pa 1976)","first-page":"542","article-title":"Symptomatic lumbar scoliosis with degenerative changes in the elderly","volume":"4","author":"Epstein JA","year":"1979","unstructured":"Epstein JA, Epstein BS, Jones MD. Symptomatic lumbar scoliosis with degenerative changes in the elderly. Spine (Phila Pa 1976). 1979;4(6):542\u2013547."},{"issue":"Suppl 7","key":"b3","series-title":"Eur Spine J","first-page":"887","article-title":"Long vs. short fusions for adult lumbar degenerative scoliosis: does balance matters","volume":"24","author":"Faldini C","year":"2015","unstructured":"Faldini C, Di Martino A, Borghi R, Perna F, Toscano A, Traina F. Long vs. short fusions for adult lumbar degenerative scoliosis: does balance matters? Eur Spine J. 2015;24(Suppl 7):887-892."},{"issue":"2","key":"b4","series-title":"Options for surgical management. Orthop Clin North Am","first-page":"269","article-title":"Degenerative scoliosis","volume":"34","author":"Gupta MC","year":"2003","unstructured":"Gupta MC. Degenerative scoliosis. Options for surgical management. Orthop Clin North Am. 2003;34(2):269\u2013279."},{"issue":"8","key":"b5","series-title":"Eur Spine J","first-page":"2649","article-title":"Adult degenerative scoliosis: comparison of patient-rated outcome after three different surgical treatments","volume":"25","author":"Kleinstueck FS","year":"2016","unstructured":"Kleinstueck FS, Fekete TF, Jeszenszky D, Haschtmann D, Mannion AF. Adult degenerative scoliosis: comparison of patient-rated outcome after three different surgical treatments. Eur Spine J. 2016;25(8):2649\u20132656."},{"issue":"3","key":"b6","series-title":"Global Spine J","first-page":"861","article-title":"Decompression alone in the setting of adult degenerative lumbar scoliosis and stenosis: a systematic review and meta-analysis","volume":"13","author":"Echt M","year":"2023","unstructured":"Echt M, De la Garza Ramos R, Geng E,  Decompression alone in the setting of adult degenerative lumbar scoliosis and stenosis: a systematic review and meta-analysis. Global Spine J. 2023;13(3):861\u2013872."},{"issue":"2","key":"b7","series-title":"Asian Spine J","first-page":"431","article-title":"Deformity correction with interbody fusion using lateral versus posterior approach in adult degenerative scoliosis: a systematic review and observational meta-analysis","volume":"17","author":"Mittal S","year":"2023","unstructured":"Mittal S, Sudhakar PV, Ahuja K,  Deformity correction with interbody fusion using lateral versus posterior approach in adult degenerative scoliosis: a systematic review and observational meta-analysis. Asian Spine J. 2023;17(2):431\u2013451."},{"issue":"20","key":"b8","series-title":"Spine (Phila Pa 1976)","first-page":"1872","article-title":"Surgical outcomes of decompression, decompression with limited fusion, and decompression with full curve fusion for degenerative scoliosis with radiculopathy","volume":"35","author":"Transfeldt EE","year":"2010","unstructured":"Transfeldt EE, Topp R, Mehbod AA, Winter RB. Surgical outcomes of decompression, decompression with limited fusion, and decompression with full curve fusion for degenerative scoliosis with radiculopathy. Spine (Phila Pa 1976). 2010;35(20):1872\u20131875."},{"issue":"9","key":"b9","series-title":"Orthopade","first-page":"744","article-title":"Surgical treatment of de-novo scoliosis. Article in German","volume":"45","author":"Putzier M","year":"2016","unstructured":"Putzier M, Pumberger M, Halm H, Zahn RK, Franke J. Surgical treatment of de-novo scoliosis. Article in German. Orthopade. 2016;45(9):744\u2013754."},{"issue":"19","key":"b10","series-title":"Spine (Phila Pa 1976)","first-page":"E1126","article-title":"Short limited fusion versus long fusion with deformity correction for spinal stenosis with balanced de novo degenerative lumbar scoliosis: a meta-analysis of direct comparative studies","volume":"42","author":"Lee CH","year":"2017","unstructured":"Lee CH, Chung CK, Sohn MJ, Kim CH. Short limited fusion versus long fusion with deformity correction for spinal stenosis with balanced de novo degenerative lumbar scoliosis: a meta-analysis of direct comparative studies. Spine (Phila Pa 1976). 2017;42(19):E1126\u2013E1132."},{"key":"b11","series-title":"World Neurosurg","first-page":"e611","article-title":"Short-segment versus long-segment spinal fusion constructs for the treatment of adult degenerative scoliosis: a comparison of clinical outcomes","volume":"171","author":"Ledesma JA","year":"2023","unstructured":"Ledesma JA, Tran K, Lambrechts MJ,  Short-segment versus long-segment spinal fusion constructs for the treatment of adult degenerative scoliosis: a comparison of clinical outcomes. World Neurosurg. 2023;171:e611\u2013e619."},{"issue":"4","key":"b12","series-title":"Asian Spine J","first-page":"570","article-title":"Radiologic and clinical courses of degenerative lumbar scoliosis (10\u00b0-25\u00b0) after a short-segment fusion","volume":"11","author":"Lee KY","year":"2017","unstructured":"Lee KY, Kim MW, Im CS, Jung YH. Radiologic and clinical courses of degenerative lumbar scoliosis (10\u00b0-25\u00b0) after a short-segment fusion. Asian Spine J. 2017;11(4):570\u2013579."},{"issue":"47","key":"b13","series-title":"Medicine (Baltimore)","first-page":"e1824","article-title":"Evaluation of degenerative lumbar scoliosis after short segment decompression and fusion","volume":"94","author":"Wang N","year":"2015","unstructured":"Wang N, Wang D, Wang F, Tan B, Yuan Z. Evaluation of degenerative lumbar scoliosis after short segment decompression and fusion. Medicine (Baltimore). 2015;94(47):e1824."},{"issue":"4","key":"b14","series-title":"J Neurosurg Spine","first-page":"321","article-title":"Curve progression after decompression surgery in patients with mild degenerative scoliosis","volume":"18","author":"Hosogane N","year":"2013","unstructured":"Hosogane N, Watanabe K, Kono H, Saito M, Toyama Y, Matsumoto M. Curve progression after decompression surgery in patients with mild degenerative scoliosis. J Neurosurg Spine. 2013;18(4):321\u2013326."},{"issue":"5","key":"b15","series-title":"J Neurosurg Spine","first-page":"558","article-title":"Risk of progression of degenerative lumbar scoliosis","volume":"15","author":"Seo JY","year":"2011","unstructured":"Seo JY, Ha KY, Hwang TH, Kim KW, Kim YH. Risk of progression of degenerative lumbar scoliosis. J Neurosurg Spine. 2011;15(5):558\u2013566."},{"issue":"4","key":"b16","series-title":"J Neurosurg Spine","first-page":"557","article-title":"Radiologic prognostic factors of curve progression in early degenerative lumbar scoliosis","volume":"34","author":"Park JS","year":"2021","unstructured":"Park JS, Park SJ, Lee CS, Yum TH, Kim BT. Radiologic prognostic factors of curve progression in early degenerative lumbar scoliosis. J Neurosurg Spine. 2021;34(4):557\u2013563."},{"key":"b17","series-title":"World Neurosurg","first-page":"510","article-title":"Progression of coronal Cobb angle after short-segment lumbar interbody fusion in patients with degenerative lumbar stenosis","volume":"89","author":"Lee N","year":"2016","unstructured":"Lee N, Yi S, Shin DA, Kim KN, Yoon H, Ha Y. Progression of coronal Cobb angle after short-segment lumbar interbody fusion in patients with degenerative lumbar stenosis. World Neurosurg. 2016;89:510\u2013516."},{"issue":"1","key":"b18","series-title":"Eur Spine J","first-page":"85","article-title":"Curve progression in de novo degenerative lumbar scoliosis combined with degenerative segment disease after short-segment fusion","volume":"29","author":"Wang Y","year":"2020","unstructured":"Wang Y, Gao A, Hudabardiy E, Yu M. Curve progression in de novo degenerative lumbar scoliosis combined with degenerative segment disease after short-segment fusion. Eur Spine J. 2020;29(1):85\u201392."},{"issue":"9596","key":"b19","series-title":"Lancet","first-page":"1453","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"370","author":"von Elm E","year":"2007","unstructured":"von Elm E, Altman DG, Egger M, Pocock SJ, G\u00f8tzsche PC, Vandenbroucke JP. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370(9596):1453\u20131457."},{"issue":"1","key":"b20","series-title":"Int Orthop","first-page":"40","article-title":"Orientation and tropism of lumbar facet joints in degenerative spondylolisthesis","volume":"25","author":"Dai LY","year":"2001","unstructured":"Dai LY. Orientation and tropism of lumbar facet joints in degenerative spondylolisthesis. Int Orthop. 2001;25(1):40\u201342."},{"issue":"26 Spec No.","key":"b21","series-title":"Spine (Phila Pa 1976)","first-page":"B45","article-title":"Vertebral rotatory subluxation in degenerative scoliosis: facet joint tropism is related","volume":"39","author":"Bao H","year":"2014","unstructured":"Bao H, Zhu F, Liu Z,  Vertebral rotatory subluxation in degenerative scoliosis: facet joint tropism is related. Spine (Phila Pa 1976). 2014;39(26 Spec No.):B45-B51."},{"issue":"5","key":"b22","series-title":"Eur Spine J","first-page":"1045","article-title":"Association of facet tropism with lumbar disc herniation","volume":"22","author":"Chadha M","year":"2013","unstructured":"Chadha M, Sharma G, Arora SS, Kochar V. Association of facet tropism with lumbar disc herniation. Eur Spine J. 2013;22(5):1045\u20131052."},{"issue":"8","key":"b23","series-title":"Skeletal Radiol","first-page":"1033","article-title":"A new grading system of lumbar central canal stenosis on MRI: an easy and reliable method","volume":"40","author":"Lee GY","year":"2011","unstructured":"Lee GY, Lee JW, Choi HS, Oh KJ, Kang HS. A new grading system of lumbar central canal stenosis on MRI: an easy and reliable method. Skeletal Radiol. 2011;40(8):1033\u20131039."},{"issue":"4","key":"b24","series-title":"AJR Am J Roentgenol","first-page":"1095","article-title":"A practical MRI grading system for lumbar foraminal stenosis","volume":"194","author":"Lee S","year":"2010","unstructured":"Lee S, Lee JW, Yeom JS,  A practical MRI grading system for lumbar foraminal stenosis. AJR Am J Roentgenol. 2010;194(4):1095\u20131098."},{"issue":"24","key":"b25","series-title":"Spine (Phila Pa 1976)","first-page":"E708","article-title":"Modified Pfirrmann grading system for lumbar intervertebral disc degeneration","volume":"32","author":"Griffith JF","year":"2007","unstructured":"Griffith JF, Wang YX, Antonio GE,  Modified Pfirrmann grading system for lumbar intervertebral disc degeneration. Spine (Phila Pa 1976). 2007;32(24):E708\u2013E712."},{"issue":"1","key":"b26","series-title":"Radiology","first-page":"227","article-title":"Osteoarthritis of the facet joints: accuracy of oblique radiographic assessment","volume":"164","author":"Pathria M","year":"1987","unstructured":"Pathria M, Sartoris DJ, Resnick D. Osteoarthritis of the facet joints: accuracy of oblique radiographic assessment. Radiology. 1987;164(1):227\u2013230."},{"issue":"5","key":"b27","series-title":"Asian Spine J","first-page":"776","article-title":"Adult spinal deformity: a comprehensive review of current advances and future directions","volume":"16","author":"Kim HJ","year":"2022","unstructured":"Kim HJ, Yang JH, Chang DG,  Adult spinal deformity: a comprehensive review of current advances and future directions. Asian Spine J. 2022;16(5):776\u2013788."},{"issue":"5","key":"b28","series-title":"Asian Spine J","first-page":"789","article-title":"Lumbar spinal stenosis: review update 2022","volume":"16","author":"Kwon JW","year":"2022","unstructured":"Kwon JW, Moon SH, Park SY,  Lumbar spinal stenosis: review update 2022. Asian Spine J. 2022;16(5):789\u2013798."},{"issue":"3","key":"b29","series-title":"Asian Spine J","first-page":"440","article-title":"Proximal junctional kyphosis in adult spinal deformity: definition, classification, risk factors, and prevention strategies","volume":"16","author":"Kim HJ","year":"2022","unstructured":"Kim HJ, Yang JH, Chang DG,  Proximal junctional kyphosis in adult spinal deformity: definition, classification, risk factors, and prevention strategies. Asian Spine J. 2022;16(3):440\u2013450."},{"issue":"1","key":"b30","series-title":"Asian Spine J","first-page":"109","article-title":"Incidence and characteristics of clinical L5-S1 adjacent segment degeneration after L5 floating lumbar fusion: a multicenter study","volume":"17","author":"Takegami N","year":"2023","unstructured":"Takegami N, Akeda K, Yamada J,  Incidence and characteristics of clinical L5-S1 adjacent segment degeneration after L5 floating lumbar fusion: a multicenter study. Asian Spine J. 2023;17(1):109\u2013117."},{"issue":"22 Suppl","key":"b31","series-title":"Spine (Phila Pa 1976)","first-page":"S1","article-title":"Introduction\/summary statement: adjacent segment pathology","volume":"37","author":"Riew KD","year":"2012","unstructured":"Riew KD, Norvell DC, Chapman JR, Skelly AC, Dettori JR. Introduction\/summary statement: adjacent segment pathology. Spine (Phila Pa 1976). 2012;37(22 Suppl):S1\u2013S7."},{"issue":"20","key":"b32","series-title":"Spine (Phila Pa 1976)","first-page":"2268","article-title":"Changes in scoliotic curvature and lordotic angle during the early phase of degenerative lumbar scoliosis","volume":"27","author":"Murata Y","year":"2002","unstructured":"Murata Y, Takahashi K, Hanaoka E, Utsumi T, Yamagata M, Moriya H. Changes in scoliotic curvature and lordotic angle during the early phase of degenerative lumbar scoliosis. Spine (Phila Pa 1976). 2002;27(20):2268\u20132273."},{"issue":"25","key":"b33","series-title":"Spine (Phila Pa 1976)","first-page":"2782","article-title":"Cobb angle progression in adolescent scoliosis begins at the intervertebral disc","volume":"34","author":"Will RE","year":"2009","unstructured":"Will RE, Stokes IA, Qiu X, Walker MR, Sanders JO. Cobb angle progression in adolescent scoliosis begins at the intervertebral disc. Spine (Phila Pa 1976). 2009;34(25):2782\u20132786."},{"key":"b34","series-title":"J Orthop Surg Res","first-page":"164","article-title":"Retrospective exploration of risk factors for L5 radiculopathy following lumbar floating fusion surgery","volume":"10","author":"Orita S","year":"2015","unstructured":"Orita S, Yamagata M, Ikeda Y,  Retrospective exploration of risk factors for L5 radiculopathy following lumbar floating fusion surgery. J Orthop Surg Res. 2015;10:164."},{"issue":"15","key":"b35","series-title":"Spine (Phila Pa 1976)","first-page":"1701","article-title":"Lumbar adjacent segment degeneration and disease after arthrodesis and total disc arthroplasty","volume":"33","author":"Harrop JS","year":"2008","unstructured":"Harrop JS, Youssef JA, Maltenfort M,  Lumbar adjacent segment degeneration and disease after arthrodesis and total disc arthroplasty. Spine (Phila Pa 1976). 2008;33(15):1701\u20131707."},{"issue":"11","key":"b36","series-title":"Spine (Phila Pa 1976)","first-page":"1312","article-title":"Diagnosis and operative treatment of intraforaminal and extraforaminal nerve root compression","volume":"16","author":"Kunogi J","year":"1991","unstructured":"Kunogi J, Hasue M. Diagnosis and operative treatment of intraforaminal and extraforaminal nerve root compression. Spine (Phila Pa 1976). 1991;16(11):1312\u20131320."},{"issue":"2","key":"b37","series-title":"J Neurosurg Spine","first-page":"150","article-title":"Biomechanical study on the effect of five different lumbar reconstruction techniques on adjacent-level intradiscal pressure and lamina strain","volume":"5","author":"Sudo H","year":"2006","unstructured":"Sudo H, Oda I, Abumi K, Ito M, Kotani Y, Minami A. Biomechanical study on the effect of five different lumbar reconstruction techniques on adjacent-level intradiscal pressure and lamina strain. J Neurosurg Spine. 2006;5(2):150\u2013155."},{"issue":"4","key":"b38","series-title":"J Orthop Sci","first-page":"719","article-title":"Pre-existing adjacent level foraminal stenosis does not affect the outcome of a single level lumbar interbody fusion","volume":"28","author":"Shimamura Y","year":"2023","unstructured":"Shimamura Y, Kanayama M, Oha F,  Pre-existing adjacent level foraminal stenosis does not affect the outcome of a single level lumbar interbody fusion. J Orthop Sci. 2023;28(4):719\u2013723."},{"issue":"8","key":"b39","series-title":"Eur Spine J","first-page":"2347","article-title":"De novo degenerative lumbar scoliosis: a systematic review of prognostic factors for curve progression","volume":"25","author":"Faraj SSA","year":"2016","unstructured":"Faraj SSA, Holewijn RM, van Hooff ML, de Kleuver M, Pellis\u00e9 F, Haanstra TM. De novo degenerative lumbar scoliosis: a systematic review of prognostic factors for curve progression. Eur Spine J. 2016;25(8):2347\u20132358."},{"issue":"3","key":"b40","series-title":"J Bone Joint Surg Am","first-page":"403","article-title":"Orientation of the lumbar facet joints: association with degenerative disc disease","volume":"78","author":"Boden SD","year":"1996","unstructured":"Boden SD, Riew KD, Yamaguchi K, Branch TP, Schellinger D, Wiesel SW. Orientation of the lumbar facet joints: association with degenerative disc disease. J Bone Joint Surg Am. 1996;78(3):403\u2013411."},{"issue":"8","key":"b41","series-title":"Spine J","first-page":"1841","article-title":"The influence of facet joint orientation and tropism on the stress at the adjacent segment after lumbar fusion surgery: a biomechanical analysis","volume":"15","author":"Kim HJ","year":"2015","unstructured":"Kim HJ, Kang KT, Son J, Lee CK, Chang BS, Yeom JS. The influence of facet joint orientation and tropism on the stress at the adjacent segment after lumbar fusion surgery: a biomechanical analysis. Spine J. 2015;15(8):1841\u20131847."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/40\/5\/article-p570.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/40\/5\/article-p570.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/40\/5\/article-p570.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,6]],"date-time":"2024-12-06T13:18:03Z","timestamp":1733491083000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/40\/5\/article-p570.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,1]]},"references-count":41,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.3171\/2023.12.spine23999","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2024,5,1]]}}}