{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T15:58:32Z","timestamp":1790179112536,"version":"4.1.0"},"reference-count":34,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,10,17]]},"abstract":"\n OBJECTIVE<\/jats:title>\n \n Hundreds of thousands of Americans undergo decompression for lumbar spinal stenosis annually. The\n mild<\/jats:italic>\n (minimally invasive lumbar decompression) procedure was developed as a potentially less invasive alternative to open decompression; however, much of the evidence has been gathered from industry-sponsored studies. The present study sought to compare real-world clinical outcomes between the\n mild<\/jats:italic>\n procedure and open decompression for lumbar spinal stenosis.\n <\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n \n All patients who underwent the\n mild<\/jats:italic>\n procedure at a single-institution, multisite, tertiary care center from 2005 to October 2024 were included. One-to-one propensity score matching was used to identify patients who underwent open decompression at the same institution, with age, sex, smoking, and comorbidities as covariates. Primary outcomes were change in pain on the numeric rating scale (NRS), surgical reoperation, and perioperative complications. For pain, the minimal clinically important difference (MCID) was defined as a 30% improvement in NRS score.\n <\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n \n A total of 175 patients who underwent the\n mild<\/jats:italic>\n procedure (mean age 76.3 \u00b1 8.7 years; 44.6% female) were matched to 175 patients treated with open decompression (mean age 75.4 \u00b1 8.7 years; 44.0% female). Among patients with at least 60 days of follow-up, those treated with open decompression were more likely to achieve the MCID for pain (43.1% vs 22.2%, p < 0.001). Patients treated with\n mild<\/jats:italic>\n were more likely to require reoperation (46.2% vs 29.3%, p = 0.008). Those who underwent the\n mild<\/jats:italic>\n procedure experienced lower rates of durotomies (0% vs 2.9%, p = 0.024) but had higher rates of neurological deficits (6.3% vs 0.6%, p = 0.003).\n <\/jats:p>\n <\/jats:sec>\n \n CONCLUSIONS<\/jats:title>\n \n For patients with symptomatic lumbar stenosis, those who underwent open decompression were more likely to achieve pain improvement and less likely to require reoperation compared with those who underwent the\n mild<\/jats:italic>\n procedure.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/2025.6.spine25331","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T20:53:13Z","timestamp":1763412793000},"page":"55-61","source":"Crossref","is-referenced-by-count":3,"title":["Minimally invasive lumbar decompression versus open decompression for lumbar spinal stenosis: a propensity score\u2013matched analysis"],"prefix":"10.3171","volume":"44","author":[{"given":"Tiffany","family":"Chu","sequence":"first","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester;"},{"name":"Neuro-Informatics Laboratory, Mayo Clinic, Rochester;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah E.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester;"},{"name":"Neuro-Informatics Laboratory, Mayo Clinic, Rochester;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kameron","family":"Willis","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester;"},{"name":"Neuro-Informatics Laboratory, Mayo Clinic, Rochester;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karim R.","family":"Nathani","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester;"},{"name":"Neuro-Informatics Laboratory, Mayo Clinic, Rochester;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zach","family":"Pennington","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen P.","family":"Graepel","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim J.","family":"Lamer","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Division of Pain Medicine, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Richard","family":"Marsh","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan M.","family":"Hagedorn","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology and Perioperative Medicine, Division of Pain Medicine, Mayo Clinic, Rochester, Minnesota;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Selby G.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Jacksonville, Florida; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William E.","family":"Krauss","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brett","family":"Freedman","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad","family":"Bydon","sequence":"additional","affiliation":[{"name":"Department of Neurologic Surgery, Mayo Clinic, Rochester;"},{"name":"Neuro-Informatics Laboratory, Mayo Clinic, Rochester;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"17","key":"b1","series-title":"JAMA","first-page":"1688","article-title":"Diagnosis and management of lumbar spinal stenosis: a review","volume":"327","author":"Katz JN","year":"2022","unstructured":"Katz JN, Zimmerman ZE, Mass H, Makhni MC. Diagnosis and management of lumbar spinal stenosis: a review. JAMA. 2022;327(17):1688\u20131699."},{"key":"b2","series-title":"J Spine Res","first-page":"159","article-title":"Preoperative health-related quality of life and associated factors in lumbar spinal stenosis","volume":"3","author":"Higuchi D","year":"2012","unstructured":"Higuchi D. Preoperative health-related quality of life and associated factors in lumbar spinal stenosis. J Spine Res. 2012;3:159\u2013165."},{"issue":"6","key":"b3","series-title":"Pain Pract","first-page":"417","article-title":"Functional and patient-reported outcomes in symptomatic lumbar spinal stenosis following percutaneous decompression","volume":"12","author":"Mekhail N","year":"2012","unstructured":"Mekhail N, Costandi S, Abraham B, Samuel SW. Functional and patient-reported outcomes in symptomatic lumbar spinal stenosis following percutaneous decompression. Pain Pract. 2012;12(6):417\u2013425."},{"issue":"3","key":"b4","series-title":"Pain Pract","first-page":"184","article-title":"Long-term results of percutaneous lumbar decompression mild\u00ae for spinal stenosis","volume":"12","author":"Mekhail N","year":"2012","unstructured":"Mekhail N, Vallejo R, Coleman MH, Benyamin RM. Long-term results of percutaneous lumbar decompression mild\u00ae for spinal stenosis. Pain Pract. 2012;12(3):184\u2013193."},{"issue":"7","key":"b5","series-title":"Reg Anesth Pain Med","first-page":"789","article-title":"Long-term safety and efficacy of minimally invasive lumbar decompression procedure for the treatment of lumbar spinal stenosis with neurogenic claudication: 2-year results of MiDAS ENCORE","volume":"43","author":"Staats PS","year":"2018","unstructured":"Staats PS, Chafin TB, Golovac S, Long-term safety and efficacy of minimally invasive lumbar decompression procedure for the treatment of lumbar spinal stenosis with neurogenic claudication: 2-year results of MiDAS ENCORE. Reg Anesth Pain Med. 2018;43(7):789\u2013794."},{"issue":"4;5","key":"b6","series-title":"Pain Phys","first-page":"229","article-title":"MiDAS Encore I. MILD\u00ae is an effective treatment for lumbar spinal stenosis with neurogenic claudication: MiDAS ENCORE randomized controlled trial","volume":"4;19","author":"Benyamin RM","year":"2016","unstructured":"Benyamin RM, Staats PS. MiDAS Encore I. MILD\u00ae is an effective treatment for lumbar spinal stenosis with neurogenic claudication: MiDAS ENCORE randomized controlled trial. Pain Phys. 2016;4;19(4;5):229\u2013242."},{"issue":"Suppl 11","key":"b7","series-title":"Arthritis Care Res (Hoboken)","first-page":"S240","article-title":"Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and measure of Intermittent and Constant Osteoarthritis Pain (ICOAP).","volume":"63","author":"Hawker GA","year":"2011","unstructured":"Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and measure of Intermittent and Constant Osteoarthritis Pain (ICOAP).Arthritis Care Res (Hoboken). 2011;63 Suppl 11:S240\u2013S252."},{"issue":"1","key":"b8","series-title":"Pain Physician","first-page":"35","article-title":"New image-guided ultra-minimally invasive lumbar decompression method: the mild procedure","volume":"13","author":"Deer TR","year":"2010","unstructured":"Deer TR, Kapural L. New image-guided ultra-minimally invasive lumbar decompression method: the mild procedure. Pain Physician. 2010;13(1):35\u201341."},{"issue":"4","key":"b9","series-title":"Pain Physician","first-page":"369","article-title":"MiDAS I (mild Decompression Alternative to Open Surgery): a preliminary report of a prospective, multi-center clinical study","volume":"13","author":"Chopko B","year":"2010","unstructured":"Chopko B, Caraway DL. MiDAS I (mild Decompression Alternative to Open Surgery): a preliminary report of a prospective, multi-center clinical study. Pain Physician. 2010;13(4):369\u2013378."},{"issue":"1","key":"b10","series-title":"Neurosurgery","first-page":"86","article-title":"Failure of percutaneous remodeling of the ligamentum flavum and lamina for neurogenic claudication","volume":"71","author":"Wilkinson JS","year":"2012","unstructured":"Wilkinson JS, Fourney DR. Failure of percutaneous remodeling of the ligamentum flavum and lamina for neurogenic claudication. Neurosurgery. 2012;71(1):86\u201392."},{"issue":"2","key":"b11","series-title":"Pain Pract","first-page":"107","article-title":"The 2-year cost-effectiveness of 3 options to treat lumbar spinal stenosis patients","volume":"15","author":"Udeh BL","year":"2015","unstructured":"Udeh BL, Costandi S, Dalton JE, Ghosh R, Yousef H, Mekhail N. The 2-year cost-effectiveness of 3 options to treat lumbar spinal stenosis patients. Pain Pract. 2015;15(2):107\u2013116."},{"issue":"5","key":"b12","series-title":"Pain Pract","first-page":"516","article-title":"The incidence of lumbar spine surgery following Minimally Invasive Lumbar Decompression and Superion Indirect Decompression System for treatment of lumbar spinal stenosis: a retrospective review","volume":"22","author":"Hagedorn JM","year":"2022","unstructured":"Hagedorn JM, Yadav A, D\u2019Souza RS, The incidence of lumbar spine surgery following Minimally Invasive Lumbar Decompression and Superion Indirect Decompression System for treatment of lumbar spinal stenosis: a retrospective review. Pain Pract. 2022;22(5):516\u2013521."},{"issue":"3","key":"b13","series-title":"Pain Pract","first-page":"431","article-title":"Incidence of subsequent surgical decompression following minimally invasive approaches to treat lumbar spinal stenosis: a retrospective review","volume":"24","author":"Shahzad H","year":"2024","unstructured":"Shahzad H, Hussain N, D\u2019Souza RS, Incidence of subsequent surgical decompression following minimally invasive approaches to treat lumbar spinal stenosis: a retrospective review. Pain Pract. 2024;24(3):431\u2013439."},{"issue":"2","key":"b14","series-title":"Pain Phys","first-page":"25","article-title":"MiDAS ENCORE: randomized controlled clinical trial report of 6-month results","volume":"19","author":"Staats PS","year":"2016","unstructured":"Staats PS, Benyamin RM. MiDAS ENCORE: randomized controlled clinical trial report of 6-month results. Pain Phys. 2016;19(2):25\u201337."},{"issue":"4","key":"b15","series-title":"Pain Med","first-page":"625","article-title":"The MOTION study: a randomized controlled trial with objective real-world outcomes for lumbar spinal stenosis patients treated with the mild\u00ae procedure: one-year results","volume":"23","author":"Deer TR","year":"2022","unstructured":"Deer TR, Costandi SJ, Washabaugh E, The MOTION study: a randomized controlled trial with objective real-world outcomes for lumbar spinal stenosis patients treated with the mild\u00ae procedure: one-year results. Pain Med. 2022;23(4):625\u2013634."},{"issue":"1","key":"b16","series-title":"Pain Pract","first-page":"109","article-title":"The MOTION study: two-year results of a real-world randomized controlled trial of the mild\u00ae procedure for treatment of lumbar spinal stenosis","volume":"24","author":"Deer TR","year":"2024","unstructured":"Deer TR, Chafin TB, Costandi SJ, The MOTION study: two-year results of a real-world randomized controlled trial of the mild\u00ae procedure for treatment of lumbar spinal stenosis. Pain Pract. 2024;24(1):109\u2013119."},{"issue":"2","key":"b17","series-title":"Interv Pain Med","first-page":"100412","article-title":"Percutaneous image-guided lumbar decompression and outpatient laminectomy for the treatment of lumbar spinal stenosis: a 2-year Medicare claims benchmark study","volume":"3","author":"Staats PS","year":"2024","unstructured":"Staats PS, Dorsi MJ, Reece DE, Strand NH, Poree L, Hagedorn JM. Percutaneous image-guided lumbar decompression and outpatient laminectomy for the treatment of lumbar spinal stenosis: a 2-year Medicare claims benchmark study. Interv Pain Med. 2024;3(2):100412."},{"issue":"17","key":"b1","series-title":"JAMA","first-page":"1688","article-title":"Diagnosis and management of lumbar spinal stenosis: a review","volume":"327","author":"Katz JN","year":"2022","unstructured":"Katz JN, Zimmerman ZE, Mass H, Makhni MC. Diagnosis and management of lumbar spinal stenosis: a review. JAMA. 2022;327(17):1688\u20131699."},{"key":"b2","series-title":"J Spine Res","first-page":"159","article-title":"Preoperative health-related quality of life and associated factors in lumbar spinal stenosis","volume":"3","author":"Higuchi D","year":"2012","unstructured":"Higuchi D. Preoperative health-related quality of life and associated factors in lumbar spinal stenosis. J Spine Res. 2012;3:159\u2013165."},{"issue":"6","key":"b3","series-title":"Pain Pract","first-page":"417","article-title":"Functional and patient-reported outcomes in symptomatic lumbar spinal stenosis following percutaneous decompression","volume":"12","author":"Mekhail N","year":"2012","unstructured":"Mekhail N, Costandi S, Abraham B, Samuel SW. Functional and patient-reported outcomes in symptomatic lumbar spinal stenosis following percutaneous decompression. Pain Pract. 2012;12(6):417\u2013425."},{"issue":"3","key":"b4","series-title":"Pain Pract","first-page":"184","article-title":"Long-term results of percutaneous lumbar decompression mild\u00ae for spinal stenosis","volume":"12","author":"Mekhail N","year":"2012","unstructured":"Mekhail N, Vallejo R, Coleman MH, Benyamin RM. Long-term results of percutaneous lumbar decompression mild\u00ae for spinal stenosis. Pain Pract. 2012;12(3):184\u2013193."},{"issue":"7","key":"b5","series-title":"Reg Anesth Pain Med","first-page":"789","article-title":"Long-term safety and efficacy of minimally invasive lumbar decompression procedure for the treatment of lumbar spinal stenosis with neurogenic claudication: 2-year results of MiDAS ENCORE","volume":"43","author":"Staats PS","year":"2018","unstructured":"Staats PS, Chafin TB, Golovac S, Long-term safety and efficacy of minimally invasive lumbar decompression procedure for the treatment of lumbar spinal stenosis with neurogenic claudication: 2-year results of MiDAS ENCORE. Reg Anesth Pain Med. 2018;43(7):789\u2013794."},{"issue":"4;5","key":"b6","series-title":"Pain Phys","first-page":"229","article-title":"MiDAS Encore I. MILD\u00ae is an effective treatment for lumbar spinal stenosis with neurogenic claudication: MiDAS ENCORE randomized controlled trial","volume":"4;19","author":"Benyamin RM","year":"2016","unstructured":"Benyamin RM, Staats PS. MiDAS Encore I. MILD\u00ae is an effective treatment for lumbar spinal stenosis with neurogenic claudication: MiDAS ENCORE randomized controlled trial. Pain Phys. 2016;4;19(4;5):229\u2013242."},{"issue":"Suppl 11","key":"b7","series-title":"Arthritis Care Res (Hoboken)","first-page":"S240","article-title":"Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and measure of Intermittent and Constant Osteoarthritis Pain (ICOAP).","volume":"63","author":"Hawker GA","year":"2011","unstructured":"Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and measure of Intermittent and Constant Osteoarthritis Pain (ICOAP).Arthritis Care Res (Hoboken). 2011;63 Suppl 11:S240\u2013S252."},{"issue":"1","key":"b8","series-title":"Pain Physician","first-page":"35","article-title":"New image-guided ultra-minimally invasive lumbar decompression method: the mild procedure","volume":"13","author":"Deer TR","year":"2010","unstructured":"Deer TR, Kapural L. New image-guided ultra-minimally invasive lumbar decompression method: the mild procedure. Pain Physician. 2010;13(1):35\u201341."},{"issue":"4","key":"b9","series-title":"Pain Physician","first-page":"369","article-title":"MiDAS I (mild Decompression Alternative to Open Surgery): a preliminary report of a prospective, multi-center clinical study","volume":"13","author":"Chopko B","year":"2010","unstructured":"Chopko B, Caraway DL. MiDAS I (mild Decompression Alternative to Open Surgery): a preliminary report of a prospective, multi-center clinical study. Pain Physician. 2010;13(4):369\u2013378."},{"issue":"1","key":"b10","series-title":"Neurosurgery","first-page":"86","article-title":"Failure of percutaneous remodeling of the ligamentum flavum and lamina for neurogenic claudication","volume":"71","author":"Wilkinson JS","year":"2012","unstructured":"Wilkinson JS, Fourney DR. Failure of percutaneous remodeling of the ligamentum flavum and lamina for neurogenic claudication. Neurosurgery. 2012;71(1):86\u201392."},{"issue":"2","key":"b11","series-title":"Pain Pract","first-page":"107","article-title":"The 2-year cost-effectiveness of 3 options to treat lumbar spinal stenosis patients","volume":"15","author":"Udeh BL","year":"2015","unstructured":"Udeh BL, Costandi S, Dalton JE, Ghosh R, Yousef H, Mekhail N. The 2-year cost-effectiveness of 3 options to treat lumbar spinal stenosis patients. Pain Pract. 2015;15(2):107\u2013116."},{"issue":"5","key":"b12","series-title":"Pain Pract","first-page":"516","article-title":"The incidence of lumbar spine surgery following Minimally Invasive Lumbar Decompression and Superion Indirect Decompression System for treatment of lumbar spinal stenosis: a retrospective review","volume":"22","author":"Hagedorn JM","year":"2022","unstructured":"Hagedorn JM, Yadav A, D\u2019Souza RS, The incidence of lumbar spine surgery following Minimally Invasive Lumbar Decompression and Superion Indirect Decompression System for treatment of lumbar spinal stenosis: a retrospective review. Pain Pract. 2022;22(5):516\u2013521."},{"issue":"3","key":"b13","series-title":"Pain Pract","first-page":"431","article-title":"Incidence of subsequent surgical decompression following minimally invasive approaches to treat lumbar spinal stenosis: a retrospective review","volume":"24","author":"Shahzad H","year":"2024","unstructured":"Shahzad H, Hussain N, D\u2019Souza RS, Incidence of subsequent surgical decompression following minimally invasive approaches to treat lumbar spinal stenosis: a retrospective review. Pain Pract. 2024;24(3):431\u2013439."},{"issue":"2","key":"b14","series-title":"Pain Phys","first-page":"25","article-title":"MiDAS ENCORE: randomized controlled clinical trial report of 6-month results","volume":"19","author":"Staats PS","year":"2016","unstructured":"Staats PS, Benyamin RM. MiDAS ENCORE: randomized controlled clinical trial report of 6-month results. Pain Phys. 2016;19(2):25\u201337."},{"issue":"4","key":"b15","series-title":"Pain Med","first-page":"625","article-title":"The MOTION study: a randomized controlled trial with objective real-world outcomes for lumbar spinal stenosis patients treated with the mild\u00ae procedure: one-year results","volume":"23","author":"Deer TR","year":"2022","unstructured":"Deer TR, Costandi SJ, Washabaugh E, The MOTION study: a randomized controlled trial with objective real-world outcomes for lumbar spinal stenosis patients treated with the mild\u00ae procedure: one-year results. Pain Med. 2022;23(4):625\u2013634."},{"issue":"1","key":"b16","series-title":"Pain Pract","first-page":"109","article-title":"The MOTION study: two-year results of a real-world randomized controlled trial of the mild\u00ae procedure for treatment of lumbar spinal stenosis","volume":"24","author":"Deer TR","year":"2024","unstructured":"Deer TR, Chafin TB, Costandi SJ, The MOTION study: two-year results of a real-world randomized controlled trial of the mild\u00ae procedure for treatment of lumbar spinal stenosis. Pain Pract. 2024;24(1):109\u2013119."},{"issue":"2","key":"b17","series-title":"Interv Pain Med","first-page":"100412","article-title":"Percutaneous image-guided lumbar decompression and outpatient laminectomy for the treatment of lumbar spinal stenosis: a 2-year Medicare claims benchmark study","volume":"3","author":"Staats PS","year":"2024","unstructured":"Staats PS, Dorsi MJ, Reece DE, Strand NH, Poree L, Hagedorn JM. Percutaneous image-guided lumbar decompression and outpatient laminectomy for the treatment of lumbar spinal stenosis: a 2-year Medicare claims benchmark study. Interv Pain Med. 2024;3(2):100412."}],"container-title":["Journal of Neurosurgery: Spine"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/44\/1\/article-p55.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/44\/1\/article-p55.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-spine\/44\/1\/article-p55.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T13:45:22Z","timestamp":1772804722000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-spine\/44\/1\/article-p55.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,17]]},"references-count":34,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.3171\/2025.6.spine25331","relation":{},"ISSN":["1547-5654"],"issn-type":[{"value":"1547-5654","type":"print"}],"subject":[],"published":{"date-parts":[[2025,10,17]]}}}