{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T03:28:13Z","timestamp":1790998093362,"version":"4.1.0"},"reference-count":42,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"17","license":[{"start":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T00:00:00Z","timestamp":1745798400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,4,28]]},"abstract":"\n BACKGROUND<\/jats:title>\n Combining lateral lumbar interbody fusion (LLIF) with open posterior surgery creates a hybrid surgical approach that can restore spinopelvic alignment by simultaneously addressing the anterior and posterior columns. The following is a case report detailing a hybrid prone LLIF with open S1 pedicle subtraction osteotomy (PSO) for correction of a major sagittal imbalance with a pelvic incidence (PI) > 100\u00b0.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n A 48-year-old female with previous L3\u2013S1 transforaminal interbody fusion presented with severe low back pain and standing imbalance. Imaging revealed significant sagittal malalignment and a PI of 103.1\u00b0. The patient underwent revision surgery, including an L2\u20133 prone LLIF and an S1 PSO. There were no significant complications in the perioperative period, and her first postoperative radiographs showed a reduction in PI (103.1\u00b0 to 72.1\u00b0), lumbar lordosis (LL) (87.4\u00b0 to 64.2\u00b0), PI-LL mismatch (14.5\u00b0 to 7.9\u00b0), and sagittal vertical axis (15.1 cm to 4.9 cm). At 1 year, she reported only minor deficits, ambulating without a cane. She has gone on to successful fusion without adjacent segment pathology.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n The prone LLIF and PSO combination offers a hybrid surgical approach utilizing the anterior and posterior columns to optimize construct and alignment goals for major sagittal deformity correction.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE24653<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case24653","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T20:14:19Z","timestamp":1745871259000},"source":"Crossref","is-referenced-by-count":1,"title":["S1 pedicle subtraction osteotomy combined with prone lateral lumbar interbody fusion for the correction of major lumbopelvic malalignment: illustrative case"],"prefix":"10.3171","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2722-9676","authenticated-orcid":true,"given":"Ashish","family":"Patel","sequence":"first","affiliation":[{"name":"The Spine Center, Duly Health and Care, Naperville, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3488-2614","authenticated-orcid":true,"given":"Michael R.","family":"McDermott","sequence":"additional","affiliation":[{"name":"The Spine Center, Duly Health and Care, Naperville, Illinois"},{"name":"Orthopedic Surgery Residency Program, Kettering Health Grandview Hospital, Dayton, Ohio"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Rogers","sequence":"additional","affiliation":[{"name":"The Spine Center, Duly Health and Care, Naperville, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alfred-John","family":"Bayaton","sequence":"additional","affiliation":[{"name":"The Spine Center, Duly Health and Care, Naperville, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Michna","sequence":"additional","affiliation":[{"name":"The Spine Center, Duly Health and Care, Naperville, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4529-0948","authenticated-orcid":true,"given":"Steven","family":"Mather","sequence":"additional","affiliation":[{"name":"The Spine Center, Duly Health and Care, Naperville, Illinois"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"6","key":"bib1","series-title":"Spine Deform","first-page":"1353","article-title":"Adult spine deformity surgery in elderly patients: are outcomes worse in patients 75 years and older?","volume":"8","author":"Lovato","year":"2020","unstructured":"Lovato ZRDeckey DGChung ASCrandall DGRevella JChang MS.Adult spine deformity surgery in elderly patients: are outcomes worse in patients 75 years and older? Spine Deform. 2020;8(6):1353-1359."},{"key":"bib2","series-title":"World Neurosurg","first-page":"e94","article-title":"Sex differences in postoperative complications and functional status after deformity correction surgery: do men fare better than women?","volume":"148","author":"Montgomery","year":"2021","unstructured":"Montgomery EYPernik MNSingh RSex differences in postoperative complications and functional status after deformity correction surgery: do men fare better than women? World Neurosurg. 2021;148:e94-e100."},{"issue":"1","key":"bib3","series-title":"J Craniovertebr Junction Spine","first-page":"17","article-title":"Complications of adult spinal deformity surgery: a literature review","volume":"13","author":"Ak\u0131nt\u00fcrk","year":"2022","unstructured":"Ak\u0131nt\u00fcrk NZileli MYaman O.Complications of adult spinal deformity surgery: a literature review. J Craniovertebr Junction Spine. 2022;13(1):17-26."},{"issue":"13","key":"bib4","series-title":"Spine","first-page":"E803","article-title":"Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity: a prospective multicenter analysis","volume":"38","author":"Schwab","year":"2013","unstructured":"Schwab FJBlondel BBess SRadiographical spinopelvic parameters and disability in the setting of adult spinal deformity: a prospective multicenter analysis. Spine. 2013;38(13):E803-E812."},{"issue":"2","key":"bib5","series-title":"Neurosurg Clin N Am","first-page":"143","article-title":"Clinical and radiographic evaluation of the adult spinal deformity patient","volume":"24","author":"Smith","year":"2013","unstructured":"Smith JSShaffrey CIFu KMGClinical and radiographic evaluation of the adult spinal deformity patient. Neurosurg Clin N Am. 2013;24(2):143-156."},{"issue":"2","key":"bib6","series-title":"J Neurosurg Spine","first-page":"160","article-title":"Surgical treatment of pathological loss of lumbar lordosis (flatback) in patients with normal sagittal vertical axis achieves similar clinical improvement as surgical treatment of elevated sagittal vertical axis: clinical article","volume":"21","author":"Smith","year":"2014","unstructured":"Smith JSSingh MKlineberg ESurgical treatment of pathological loss of lumbar lordosis (flatback) in patients with normal sagittal vertical axis achieves similar clinical improvement as surgical treatment of elevated sagittal vertical axis: clinical article. J Neurosurg Spine. 2014;21(2):160-170."},{"issue":"1","key":"bib7","series-title":"Clin Spine Surg","first-page":"6","article-title":"Clinical and radiographic evaluation of adult spinal deformity","volume":"29","author":"Bess","year":"2016","unstructured":"Bess SProtopsaltis TSLafage VClinical and radiographic evaluation of adult spinal deformity. Clin Spine Surg. 2016;29(1):6-16."},{"issue":"1","key":"bib8","series-title":"J Neurosurg Spine","first-page":"69","article-title":"Location of correction within the lumbar spine impacts acute adjacent-segment kyphosis","volume":"30","author":"Lafage","year":"2019","unstructured":"Lafage RObeid ILiabaud BLocation of correction within the lumbar spine impacts acute adjacent-segment kyphosis. J Neurosurg Spine. 2019;30(1):69-77."},{"issue":"17","key":"bib9","series-title":"Spine","first-page":"1828","article-title":"Sagittal plane considerations and the pelvis in the adult patient","volume":"34","author":"Schwab","year":"2009","unstructured":"Schwab FLafage VPatel AFarcy JP.Sagittal plane considerations and the pelvis in the adult patient. Spine. 2009;34(17):1828-1833."},{"issue":"8","key":"bib10","series-title":"Clin Orthop Relat Res","first-page":"1603","article-title":"The amount of proximal lumbar lordosis is related to pelvic incidence","volume":"476","author":"Pesenti","year":"2018","unstructured":"Pesenti SLafage RStein DThe amount of proximal lumbar lordosis is related to pelvic incidence. Clin Orthop Relat Res. 2018;476(8):1603-1611."},{"key":"bib11","series-title":"Adv Orthop","first-page":"5572181","article-title":"Optimal correction of adult spinal deformities requires restoration of distal lumbar lordosis","volume":"2021","author":"Pesenti","year":"2021","unstructured":"Pesenti SProst SMcCausland AMOptimal correction of adult spinal deformities requires restoration of distal lumbar lordosis. Adv Orthop. 2021;2021:5572181."},{"key":"bib12","series-title":"World Neurosurg","first-page":"249","article-title":"Anterior column realignment has similar results to pedicle subtraction osteotomy in treating adults with sagittal plane deformity","volume":"105","author":"Mundis","year":"2017","unstructured":"Mundis GMJrTurner JDKabirian NAnterior column realignment has similar results to pedicle subtraction osteotomy in treating adults with sagittal plane deformity. World Neurosurg. 2017;105:249-256."},{"issue":"5","key":"bib13","series-title":"J Neurosurg Spine","first-page":"565","article-title":"The comprehensive anatomical spinal osteotomy and anterior column realignment classification","volume":"29","author":"Uribe","year":"2018","unstructured":"Uribe JSSchwab FMundis GMThe comprehensive anatomical spinal osteotomy and anterior column realignment classification. J Neurosurg Spine. 2018;29(5):565-575."},{"issue":"8","key":"bib14","series-title":"JBJS Rev","first-page":"e1900100","article-title":"Surgical restoration of sagittal alignment of the spine: correlation with improved patient-reported outcomes: a systematic review and meta-analysis","volume":"8","author":"Ochtman","year":"2020","unstructured":"Ochtman AEAKruyt MCJacobs WCHSurgical restoration of sagittal alignment of the spine: correlation with improved patient-reported outcomes: a systematic review and meta-analysis. JBJS Rev. 2020;8(8):e1900100."},{"issue":"21","key":"bib15","series-title":"Chin Med J (Engl)","first-page":"2639","article-title":"Osteotomy techniques for spinal deformity","volume":"129","author":"Hu","year":"2016","unstructured":"Hu WHWang Y.Osteotomy techniques for spinal deformity. Chin Med J (Engl). 2016;129(21):2639-2641."},{"key":"bib16","series-title":"World Neurosurg","first-page":"e589","article-title":"Combined lateral transpsoas anterior column realignment with pedicle subtraction osteotomy to treat severe sagittal plane deformity: cadaveric feasibility study and early clinical experience","volume":"121","author":"Godzik","year":"2019","unstructured":"Godzik JHlubek RJde Andrada Pereira BCombined lateral transpsoas anterior column realignment with pedicle subtraction osteotomy to treat severe sagittal plane deformity: cadaveric feasibility study and early clinical experience. World Neurosurg. 2019;121:e589-e595."},{"issue":"8","key":"bib17","series-title":"Eur Spine J","first-page":"2657","article-title":"Clinical and radiological outcomes of lumbar posterior subtraction osteotomies are correlated to pelvic incidence and FBI index: prospective series of 63 cases","volume":"25","author":"Cogniet","year":"2016","unstructured":"Cogniet AAunoble SRigal JDemezon HSadikki RLe Huec JC.Clinical and radiological outcomes of lumbar posterior subtraction osteotomies are correlated to pelvic incidence and FBI index: prospective series of 63 cases. Eur Spine J. 2016;25(8):2657-2667."},{"issue":"5","key":"bib18","series-title":"J Neurosurg Spine","first-page":"577","article-title":"Complication profile associated with S1 pedicle subtraction osteotomy compared with 3-column osteotomies at other thoracolumbar levels for adult spinal deformity: series of 405 patients with 9 S1 osteotomies","volume":"33","author":"Lau","year":"2020","unstructured":"Lau DHaddad AFDeviren VAmes CP.Complication profile associated with S1 pedicle subtraction osteotomy compared with 3-column osteotomies at other thoracolumbar levels for adult spinal deformity: series of 405 patients with 9 S1 osteotomies. J Neurosurg Spine. 2020;33(5):577-587."},{"issue":"2","key":"bib19","series-title":"Oper Neurosurg (Hagerstown)","first-page":"e84","article-title":"Sacral pedicle subtraction osteotomy for treatment of high-grade spondylolisthesis: a technical note and review of the literature","volume":"23","author":"Safaee","year":"2022","unstructured":"Safaee MMScheer JKLau DFury MDeviren VAmes CP.Sacral pedicle subtraction osteotomy for treatment of high-grade spondylolisthesis: a technical note and review of the literature. Oper Neurosurg (Hagerstown). 2022;23(2):e84-e90."},{"issue":"1","key":"bib20","series-title":"Int J Spine Surg","first-page":"110","article-title":"Single-position prone lateral lumbar interbody fusion technique guide: surgical tips and tricks","volume":"18","author":"McDermott","year":"2024","unstructured":"McDermott MRogers MPrior RSingle-position prone lateral lumbar interbody fusion technique guide: surgical tips and tricks. Int J Spine Surg. 2024;18(1):110-116."},{"issue":"6","key":"bib21","series-title":"Eur Spine J","first-page":"1992","article-title":"A retrospective review of single-position prone lateral lumbar interbody fusion cases: early learning curve and perioperative outcomes","volume":"32","author":"Patel","year":"2023","unstructured":"Patel ARogers MMichna R.A retrospective review of single-position prone lateral lumbar interbody fusion cases: early learning curve and perioperative outcomes. Eur Spine J. 2023;32(6):1992-2002."},{"issue":"6","key":"bib1","series-title":"Spine Deform","first-page":"1353","article-title":"Adult spine deformity surgery in elderly patients: are outcomes worse in patients 75 years and older?","volume":"8","author":"Lovato","year":"2020","unstructured":"Lovato ZRDeckey DGChung ASCrandall DGRevella JChang MS.Adult spine deformity surgery in elderly patients: are outcomes worse in patients 75 years and older? Spine Deform. 2020;8(6):1353-1359."},{"key":"bib2","series-title":"World Neurosurg","first-page":"e94","article-title":"Sex differences in postoperative complications and functional status after deformity correction surgery: do men fare better than women?","volume":"148","author":"Montgomery","year":"2021","unstructured":"Montgomery EYPernik MNSingh RSex differences in postoperative complications and functional status after deformity correction surgery: do men fare better than women? World Neurosurg. 2021;148:e94-e100."},{"issue":"1","key":"bib3","series-title":"J Craniovertebr Junction Spine","first-page":"17","article-title":"Complications of adult spinal deformity surgery: a literature review","volume":"13","author":"Ak\u0131nt\u00fcrk","year":"2022","unstructured":"Ak\u0131nt\u00fcrk NZileli MYaman O.Complications of adult spinal deformity surgery: a literature review. J Craniovertebr Junction Spine. 2022;13(1):17-26."},{"issue":"13","key":"bib4","series-title":"Spine","first-page":"E803","article-title":"Radiographical spinopelvic parameters and disability in the setting of adult spinal deformity: a prospective multicenter analysis","volume":"38","author":"Schwab","year":"2013","unstructured":"Schwab FJBlondel BBess SRadiographical spinopelvic parameters and disability in the setting of adult spinal deformity: a prospective multicenter analysis. Spine. 2013;38(13):E803-E812."},{"issue":"2","key":"bib5","series-title":"Neurosurg Clin N Am","first-page":"143","article-title":"Clinical and radiographic evaluation of the adult spinal deformity patient","volume":"24","author":"Smith","year":"2013","unstructured":"Smith JSShaffrey CIFu KMGClinical and radiographic evaluation of the adult spinal deformity patient. Neurosurg Clin N Am. 2013;24(2):143-156."},{"issue":"2","key":"bib6","series-title":"J Neurosurg Spine","first-page":"160","article-title":"Surgical treatment of pathological loss of lumbar lordosis (flatback) in patients with normal sagittal vertical axis achieves similar clinical improvement as surgical treatment of elevated sagittal vertical axis: clinical article","volume":"21","author":"Smith","year":"2014","unstructured":"Smith JSSingh MKlineberg ESurgical treatment of pathological loss of lumbar lordosis (flatback) in patients with normal sagittal vertical axis achieves similar clinical improvement as surgical treatment of elevated sagittal vertical axis: clinical article. J Neurosurg Spine. 2014;21(2):160-170."},{"issue":"1","key":"bib7","series-title":"Clin Spine Surg","first-page":"6","article-title":"Clinical and radiographic evaluation of adult spinal deformity","volume":"29","author":"Bess","year":"2016","unstructured":"Bess SProtopsaltis TSLafage VClinical and radiographic evaluation of adult spinal deformity. Clin Spine Surg. 2016;29(1):6-16."},{"issue":"1","key":"bib8","series-title":"J Neurosurg Spine","first-page":"69","article-title":"Location of correction within the lumbar spine impacts acute adjacent-segment kyphosis","volume":"30","author":"Lafage","year":"2019","unstructured":"Lafage RObeid ILiabaud BLocation of correction within the lumbar spine impacts acute adjacent-segment kyphosis. J Neurosurg Spine. 2019;30(1):69-77."},{"issue":"17","key":"bib9","series-title":"Spine","first-page":"1828","article-title":"Sagittal plane considerations and the pelvis in the adult patient","volume":"34","author":"Schwab","year":"2009","unstructured":"Schwab FLafage VPatel AFarcy JP.Sagittal plane considerations and the pelvis in the adult patient. Spine. 2009;34(17):1828-1833."},{"issue":"8","key":"bib10","series-title":"Clin Orthop Relat Res","first-page":"1603","article-title":"The amount of proximal lumbar lordosis is related to pelvic incidence","volume":"476","author":"Pesenti","year":"2018","unstructured":"Pesenti SLafage RStein DThe amount of proximal lumbar lordosis is related to pelvic incidence. Clin Orthop Relat Res. 2018;476(8):1603-1611."},{"key":"bib11","series-title":"Adv Orthop","first-page":"5572181","article-title":"Optimal correction of adult spinal deformities requires restoration of distal lumbar lordosis","volume":"2021","author":"Pesenti","year":"2021","unstructured":"Pesenti SProst SMcCausland AMOptimal correction of adult spinal deformities requires restoration of distal lumbar lordosis. Adv Orthop. 2021;2021:5572181."},{"key":"bib12","series-title":"World Neurosurg","first-page":"249","article-title":"Anterior column realignment has similar results to pedicle subtraction osteotomy in treating adults with sagittal plane deformity","volume":"105","author":"Mundis","year":"2017","unstructured":"Mundis GMJrTurner JDKabirian NAnterior column realignment has similar results to pedicle subtraction osteotomy in treating adults with sagittal plane deformity. World Neurosurg. 2017;105:249-256."},{"issue":"5","key":"bib13","series-title":"J Neurosurg Spine","first-page":"565","article-title":"The comprehensive anatomical spinal osteotomy and anterior column realignment classification","volume":"29","author":"Uribe","year":"2018","unstructured":"Uribe JSSchwab FMundis GMThe comprehensive anatomical spinal osteotomy and anterior column realignment classification. J Neurosurg Spine. 2018;29(5):565-575."},{"issue":"8","key":"bib14","series-title":"JBJS Rev","first-page":"e1900100","article-title":"Surgical restoration of sagittal alignment of the spine: correlation with improved patient-reported outcomes: a systematic review and meta-analysis","volume":"8","author":"Ochtman","year":"2020","unstructured":"Ochtman AEAKruyt MCJacobs WCHSurgical restoration of sagittal alignment of the spine: correlation with improved patient-reported outcomes: a systematic review and meta-analysis. JBJS Rev. 2020;8(8):e1900100."},{"issue":"21","key":"bib15","series-title":"Chin Med J (Engl)","first-page":"2639","article-title":"Osteotomy techniques for spinal deformity","volume":"129","author":"Hu","year":"2016","unstructured":"Hu WHWang Y.Osteotomy techniques for spinal deformity. Chin Med J (Engl). 2016;129(21):2639-2641."},{"key":"bib16","series-title":"World Neurosurg","first-page":"e589","article-title":"Combined lateral transpsoas anterior column realignment with pedicle subtraction osteotomy to treat severe sagittal plane deformity: cadaveric feasibility study and early clinical experience","volume":"121","author":"Godzik","year":"2019","unstructured":"Godzik JHlubek RJde Andrada Pereira BCombined lateral transpsoas anterior column realignment with pedicle subtraction osteotomy to treat severe sagittal plane deformity: cadaveric feasibility study and early clinical experience. World Neurosurg. 2019;121:e589-e595."},{"issue":"8","key":"bib17","series-title":"Eur Spine J","first-page":"2657","article-title":"Clinical and radiological outcomes of lumbar posterior subtraction osteotomies are correlated to pelvic incidence and FBI index: prospective series of 63 cases","volume":"25","author":"Cogniet","year":"2016","unstructured":"Cogniet AAunoble SRigal JDemezon HSadikki RLe Huec JC.Clinical and radiological outcomes of lumbar posterior subtraction osteotomies are correlated to pelvic incidence and FBI index: prospective series of 63 cases. Eur Spine J. 2016;25(8):2657-2667."},{"issue":"5","key":"bib18","series-title":"J Neurosurg Spine","first-page":"577","article-title":"Complication profile associated with S1 pedicle subtraction osteotomy compared with 3-column osteotomies at other thoracolumbar levels for adult spinal deformity: series of 405 patients with 9 S1 osteotomies","volume":"33","author":"Lau","year":"2020","unstructured":"Lau DHaddad AFDeviren VAmes CP.Complication profile associated with S1 pedicle subtraction osteotomy compared with 3-column osteotomies at other thoracolumbar levels for adult spinal deformity: series of 405 patients with 9 S1 osteotomies. J Neurosurg Spine. 2020;33(5):577-587."},{"issue":"2","key":"bib19","series-title":"Oper Neurosurg (Hagerstown)","first-page":"e84","article-title":"Sacral pedicle subtraction osteotomy for treatment of high-grade spondylolisthesis: a technical note and review of the literature","volume":"23","author":"Safaee","year":"2022","unstructured":"Safaee MMScheer JKLau DFury MDeviren VAmes CP.Sacral pedicle subtraction osteotomy for treatment of high-grade spondylolisthesis: a technical note and review of the literature. Oper Neurosurg (Hagerstown). 2022;23(2):e84-e90."},{"issue":"1","key":"bib20","series-title":"Int J Spine Surg","first-page":"110","article-title":"Single-position prone lateral lumbar interbody fusion technique guide: surgical tips and tricks","volume":"18","author":"McDermott","year":"2024","unstructured":"McDermott MRogers MPrior RSingle-position prone lateral lumbar interbody fusion technique guide: surgical tips and tricks. Int J Spine Surg. 2024;18(1):110-116."},{"issue":"6","key":"bib21","series-title":"Eur Spine J","first-page":"1992","article-title":"A retrospective review of single-position prone lateral lumbar interbody fusion cases: early learning curve and perioperative outcomes","volume":"32","author":"Patel","year":"2023","unstructured":"Patel ARogers MMichna R.A retrospective review of single-position prone lateral lumbar interbody fusion cases: early learning curve and perioperative outcomes. Eur Spine J. 2023;32(6):1992-2002."}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/9\/17\/article-CASE24653.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/9\/17\/article-CASE24653.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/9\/17\/article-CASE24653.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T23:38:13Z","timestamp":1770075493000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/9\/17\/article-CASE24653.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,28]]},"references-count":42,"journal-issue":{"issue":"17"},"URL":"https:\/\/doi.org\/10.3171\/case24653","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,28]]}}}