{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T18:23:38Z","timestamp":1792175018186,"version":"4.4.0"},"reference-count":27,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2025,6,14]],"date-time":"2025-06-14T00:00:00Z","timestamp":1749859200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Stand-alone lateral lumbar interbody fusion (LLIF) remains a debated approach in spinal surgery, with limited published evidence supporting its efficacy without supplemental fixation. This prospective study presents the institutional case series on single-level L3-L4 stand-alone LLIF, using next-generation 3D-printed titanium cages, as treatment for degenerative disc disease (DDD). Methods: A cohort of 49 patients with symptomatic DDD, unresponsive to conservative therapy, underwent stand-alone LLIF at L3-L4 (neither posterior pedicle screws nor lateral plating). Clinical outcomes (VAS and ODI) and radiological parameters (disc height, segmental\/lumbar lordosis) were collected preoperatively and at 1, 6, and 12 months. Repeated-measures ANOVA with Bonferroni correction was adopted for statistical analysis. Results: Significant improvements were observed in pain and disability scores at all time points, with the mean VAS score decreasing from 6.53 to 0.29, and ODI from 27.6% to 3.84% at one year (p &lt; 0.001). Radiographic analysis confirmed durable increases in disc height and segmental lordosis. Solid fusion was achieved in 97.9% of cases. No patient required posterior revision; transient neurological symptoms were mild and self-limiting. Conclusions: This study demonstrates that stand-alone LLIF at L3-L4 is safe and effective in achieving stable fusion and clinical\u2013radiological improvement. These results challenge the necessity of supplemental fixation and support the broader adoption of a less invasive fusion paradigm.<\/jats:p>","DOI":"10.3390\/jcm14124233","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T06:40:27Z","timestamp":1750056027000},"page":"4233","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Stand-Alone Lateral Lumbar Interbody Fusion at L3-L4 with 3D-Printed Porous Titanium Cages: A Safe and Effective Alternative in the Treatment of Degenerative Disc Disease (DDD)"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5110-8386","authenticated-orcid":false,"given":"Luca","family":"Ricciardi","sequence":"first","affiliation":[{"name":"UOC di Neurochirurgia, Azienda Ospedaliera Universitaria Sant\u2019Andrea, Dipartimento NESMOS, Sapienza Universit\u00e0 di Roma, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2475-1955","authenticated-orcid":false,"given":"Andrea","family":"Perna","sequence":"additional","affiliation":[{"name":"Department of Orthopedics and Trauma Surgery, Fondazione Casa Sollievo Della Sofferenza IRCCS, 71013 San Giovanni Rotondo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5087-6006","authenticated-orcid":false,"given":"Sokol","family":"Trungu","sequence":"additional","affiliation":[{"name":"UOC di Neurochirurgia, Azienda Ospedaliera Universitaria Sant\u2019Andrea, Dipartimento NESMOS, Sapienza Universit\u00e0 di Roma, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Miscusi","sequence":"additional","affiliation":[{"name":"UOC di Neurochirurgia, Aziendal Ospedaliera Sant\u2019Anna, Dipartimento di Medicina Traslazionale e per la Romagna, Universit\u00e0 degli Studi di Ferrara, 44122 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alba","family":"Scerrati","sequence":"additional","affiliation":[{"name":"UOC di Neurochirurgia, Aziendal Ospedaliera Sant\u2019Anna, Dipartimento di Medicina Traslazionale e per la Romagna, Universit\u00e0 degli Studi di Ferrara, 44122 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annamaria","family":"Narciso","sequence":"additional","affiliation":[{"name":"UOC di Neurochirurgia, Azienda Ospedaliera Universitaria Sant\u2019Andrea, Dipartimento NESMOS, Sapienza Universit\u00e0 di Roma, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4888-7620","authenticated-orcid":false,"given":"Salvatore","family":"Cracchiolo","sequence":"additional","affiliation":[{"name":"UOC di Neurochirurgia, Aziendal Ospedaliera Sant\u2019Anna, Dipartimento di Medicina Traslazionale e per la Romagna, Universit\u00e0 degli Studi di Ferrara, 44122 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Favarato","sequence":"additional","affiliation":[{"name":"UOC di Neurochirurgia, Aziendal Ospedaliera Sant\u2019Anna, Dipartimento di Medicina Traslazionale e per la Romagna, Universit\u00e0 degli Studi di Ferrara, 44122 Ferrara, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8401-9339","authenticated-orcid":false,"given":"Antonino","family":"Raco","sequence":"additional","affiliation":[{"name":"UOC di Neurochirurgia, Azienda Ospedaliera Universitaria Sant\u2019Andrea, Dipartimento NESMOS, Sapienza Universit\u00e0 di Roma, 00185 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,6,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Ghezelbash, F., Schmidt, H., Shirazi-Adl, A., and El-Rich, M. 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