{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,26]],"date-time":"2026-07-26T04:22:33Z","timestamp":1785039753301,"version":"3.55.0"},"reference-count":25,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T00:00:00Z","timestamp":1753660800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Objective: This study aimed to compare the clinical and radiological outcomes of dynamic rod stabilization with and without transforaminal lumbar interbody fusion (TLIF) in patients undergoing surgery for degenerative lumbar instability. Specifically, we evaluated the prognostic value of hybrid systems in reducing adjacent segment disease (ASD), enhancing fusion rates, and improving functional outcomes. Methods: A retrospective analysis was conducted on 62 patients treated between 2019 and 2022. Group 1 (n = 34) underwent dynamic rod stabilization alone, while Group 2 (n = 28) received dynamic stabilization combined with TLIF. Radiological assessments included disk height index (DHI) and fusion rates. Clinical outcomes were measured using the Visual Analog Scale (VAS) for back and leg pain at baseline, 12, and 24 months. Statistical analysis was performed using Jamovi\u00ae software (version 2.4.1). Results: The hybrid group (dynamic + TLIF) demonstrated significantly higher anterior fusion rates (p &lt; 0.001) and greater improvement in VAS scores for back (p = 0.005) and leg pain (p &lt; 0.001) at 12 months. Although operative time was longer (p = 0.002), there was no significant difference in hospital stay (p = 0.635). No significant differences were observed in ASD development (p = 0.11) or pseudoarthrosis (p = 0.396). The hybrid group maintained better lumbar lordosis and higher adjacent segment DHI. Conclusions: Hybrid dynamic stabilization combined with TLIF provides superior clinical outcomes and fusion rates compared to dynamic stabilization alone, without significantly increasing the risk of ASD. These findings support the use of hybrid constructs as a balanced strategy for treating degenerative lumbar instability.<\/jats:p>","DOI":"10.3390\/diagnostics15151887","type":"journal-article","created":{"date-parts":[[2025,7,28]],"date-time":"2025-07-28T08:51:33Z","timestamp":1753692693000},"page":"1887","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparison of Hybrid Dynamic Stabilization with TLIF Versus Dynamic Stabilization Alone in Degenerative Lumbar Instability"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8268-6306","authenticated-orcid":false,"given":"Uzay","family":"Erdogan","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Bakirkoy Prof. Dr. Mazhar Osman Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul 43606, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gurkan","family":"Berikol","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Health Sciences University, Sincan Training and Research Hospital, Ankara 06949, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8371-2983","authenticated-orcid":false,"given":"Ibrahim Taha","family":"Albas","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Istanbul Physical Therapy and Rehabilitation Training and Research Hospital, Istanbul 43606, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1342-7663","authenticated-orcid":false,"given":"Mehmet Yigit","family":"Akgun","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Koc University Hospital, Istanbul 43606, Turkey"},{"name":"Spine Center, Koc University Hospital, Istanbul 43606, Turkey"},{"name":"Koc University Research Center for Translational Medicine, Biomechanics and Endurance Laboratory, Istanbul 43606, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tunc","family":"Oktenoglu","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Koc University Hospital, Istanbul 43606, Turkey"},{"name":"Spine Center, Koc University Hospital, Istanbul 43606, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ozkan","family":"Ates","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Koc University Hospital, Istanbul 43606, Turkey"},{"name":"Spine Center, Koc University Hospital, Istanbul 43606, Turkey"},{"name":"Koc University Research Center for Translational Medicine, Biomechanics and Endurance Laboratory, Istanbul 43606, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Fahir","family":"Ozer","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Koc University Hospital, Istanbul 43606, Turkey"},{"name":"Spine Center, Koc University Hospital, Istanbul 43606, Turkey"},{"name":"Koc University Research Center for Translational Medicine, Biomechanics and Endurance Laboratory, Istanbul 43606, Turkey"},{"name":"Bioengineering and Orthopaedic Surgery Colleges of Engineering and Medicine, University of Toledo, Toledo, OH 43606, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,7,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1497","DOI":"10.2106\/00004623-200407000-00020","article-title":"Adjacent segment degeneration in the lumbar spine","volume":"86","author":"Ghiselli","year":"2004","journal-title":"J. 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