{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T03:28:14Z","timestamp":1790998094036,"version":"4.1.0"},"reference-count":30,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T00:00:00Z","timestamp":1769040000000},"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: Following lumbar fusion procedures, adjacent segment degeneration (ASD) at cranial levels presents as a well-documented long-term complication, manifesting through recurrent pain, neurological deficits, and progressive functional decline. The prone single-position technique for lateral lumbar interbody fusion (PSP-LLIF) streamlines surgical workflow by eliminating the need for intraoperative patient repositioning; however, comprehensive evidence supporting its clinical and radiological effectiveness in managing cranial ASD remains insufficient. Material and Methods: This retrospective cohort study examined 30 consecutive patients presenting with symptomatic cranial adjacent segment disease who were treated with PSP-LLIF at a single institution. Patient-reported outcome measures included visual analog scale (VAS) assessments for axial and radicular pain, alongside the Oswestry Disability Index (ODI) for functional status evaluation. Radiological parameters included overall and segmental lumbar lordotic measurements, anterior and posterior disk height, fusion status, and instrumentation-related complications. Results: At 12-month postoperative evaluation, substantial clinical improvements were demonstrated. Mean VAS reductions measured 4.7 points for axial pain and 6.5 points for radicular pain, while ODI decreased by 28.5 points (p &lt; 0.05). Radiological assessment demonstrated mean increases of 6.3\u00b0 in lumbar lordosis and 5.1\u00b0 in segmental lordosis, along with significant gains in both anterior and posterior disk height (p &lt; 0.05). Solid fusion was radiographically confirmed at all instrumented levels. Temporary postoperative neurological symptoms developed in several patients but resolved spontaneously without requiring revision surgery. Conclusions: PSP-LLIF yields substantial clinical benefit and reliable radiological correction in patients with symptomatic cranial ASD. Optimal outcomes necessitate rigorous adherence to position-specific technical modifications, particularly maintenance of perpendicular fluoroscopic trajectories and implementation of continuous neural monitoring to account for prone-induced anatomical shifts. This approach represents a viable treatment strategy for patients with symptomatic cranial ASD.<\/jats:p>","DOI":"10.3390\/jcm15020895","type":"journal-article","created":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T09:21:40Z","timestamp":1769505700000},"page":"895","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Efficacy of Prone Single-Position Lateral Lumbar Interbody Fusion for Symptomatic Cranial Adjacent Segment Degeneration"],"prefix":"10.3390","volume":"15","author":[{"given":"Dong Hun","family":"Kim","sequence":"first","affiliation":[{"name":"Bucheon St. Mary\u2019s Hospital, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Don","family":"Kim","sequence":"additional","affiliation":[{"name":"Bucheon St. Mary\u2019s Hospital, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jung-Woo","family":"Hur","sequence":"additional","affiliation":[{"name":"Eunpyeong St. Mary\u2019s Hospital, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Young","family":"Kim","sequence":"additional","affiliation":[{"name":"Eunpyeong St. Mary\u2019s Hospital, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Taek","family":"Hong","sequence":"additional","affiliation":[{"name":"Eunpyeong St. Mary\u2019s Hospital, The Catholic University of Korea, Seoul 06591, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"807","DOI":"10.4184\/asj.2015.9.5.807","article-title":"Adjacent Segment Pathology After Lumbar Spinal Fusion","volume":"9","author":"Lee","year":"2015","journal-title":"Asian Spine J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1938","DOI":"10.1097\/01.brs.0000137069.88904.03","article-title":"Adjacent segment disease after lumbar or lumbosacral fusion: Review of the literature","volume":"29","author":"Park","year":"2004","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"582","DOI":"10.1186\/s13018-020-02032-7","article-title":"Risk factors for adjacent segment degeneration after posterior lumbar fusion surgery in treatment for degenerative lumbar disorders: A meta-analysis","volume":"15","author":"Wang","year":"2020","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2609","DOI":"10.1097\/01.brs.0000241066.55849.41","article-title":"Postoperative management protocol for incidental dural tears during degenerative lumbar spine surgery: A review of 3,183 consecutive degenerative lumbar cases","volume":"31","author":"Khan","year":"2006","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1007\/s00586-004-0821-2","article-title":"Incidental durotomy in lumbar spine surgery: Incidence and management","volume":"14","author":"Tafazal","year":"2005","journal-title":"Eur. Spine J."},{"key":"ref_6","first-page":"100594","article-title":"Association between paraspinal muscle quality and surgery for adjacent segment disease","volume":"21","author":"Du","year":"2025","journal-title":"N. Am. Spine Soc. J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1186\/s13018-019-1276-9","article-title":"Oblique lumbar interbody fusion for adjacent segment disease after posterior lumbar fusion: A case-controlled study","volume":"14","author":"Jin","year":"2019","journal-title":"J. Orthop. Surg. Res."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Zhang, B., Hu, Y., Kong, Q., Feng, P., Liu, J., and Ma, J. (2023). Comparison of Oblique Lumbar Interbody Fusion Combined with Posterior Decompression (OLIF-PD) and Posterior Lumbar Interbody Fusion (PLIF) in the Treatment of Adjacent Segmental Disease(ASD). J. Pers. Med., 13.","DOI":"10.3390\/jpm13020368"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e1067","DOI":"10.1016\/j.wneu.2020.12.172","article-title":"Usefulness of Oblique Lumbar Interbody Fusion as Revision Surgery: Comparison of Clinical and Radiological Outcomes Between Primary and Revision Surgery","volume":"149","author":"Jung","year":"2021","journal-title":"World Neurosurg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"E19","DOI":"10.1097\/BRS.0000000000004699","article-title":"Single-Position Prone Lateral Lumbar Interbody Fusion Increases Operative Efficiency and Maintains Safety in Revision Lumbar Spinal Fusion","volume":"49","author":"Buckland","year":"2024","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"408","DOI":"10.14444\/8626","article-title":"Prone Single Position Approach to Lateral Lumbar Interbody Fusion: Systematic Review and Meta-Analysis","volume":"18","author":"Rohde","year":"2024","journal-title":"Int. J. Spine Surg."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"E1197","DOI":"10.1097\/BRS.0b013e31825d26d7","article-title":"Does the formation of vertebral endplate cysts predict nonunion after lumbar interbody fusion?","volume":"37","author":"Fujibayashi","year":"2012","journal-title":"Spine (Phila Pa 1976)"},{"key":"ref_13","first-page":"2057","article-title":"CT evaluation of lumbar interbody fusion: Current concepts","volume":"26","author":"Williams","year":"2005","journal-title":"AJNR Am. J. Neuroradiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1016\/j.spinee.2021.10.012","article-title":"Single position lumbar fusion: A systematic review and meta-analysis","volume":"22","author":"Mills","year":"2022","journal-title":"Spine J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"717","DOI":"10.21037\/jss.2018.12.03","article-title":"Single position versus lateral-then-prone positioning for lateral interbody fusion and pedicle screw fixation","volume":"4","author":"Ziino","year":"2018","journal-title":"J. Spine Surg."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"65","DOI":"10.4055\/cios.2016.8.1.65","article-title":"Lumbar Lordosis of Spinal Stenosis Patients During Intraoperative Prone Positioning","volume":"8","author":"Lee","year":"2016","journal-title":"Clin. Orthop. Surg."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"e131","DOI":"10.1016\/j.wneu.2021.06.067","article-title":"The Effect of Patient Position on Psoas Morphology and in Lumbar Lordosis","volume":"153","author":"Amaral","year":"2021","journal-title":"World Neurosurg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1016\/j.spinee.2013.06.066","article-title":"Nerve injury after lateral lumbar interbody fusion: A review of 919 treated levels with identification of risk factors","volume":"14","author":"Lykissas","year":"2014","journal-title":"Spine J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1621","DOI":"10.1007\/s11999-011-2088-3","article-title":"Complications of the lateral transpsoas approach for lumbar interbody arthrodesis: A case series and literature review","volume":"470","author":"Sofianos","year":"2012","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1007\/s12178-017-9444-1","article-title":"Lateral Lumbar Interbody Fusion-Outcomes and Complications","volume":"10","author":"Salzmann","year":"2017","journal-title":"Curr. Rev. Musculoskelet. Med."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"562","DOI":"10.21037\/jss-20-579","article-title":"Complications associated with L4-5 anterior retroperitoneal trans-psoas interbody fusion: A single institution series","volume":"6","author":"Sadrameli","year":"2020","journal-title":"J. Spine Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"112","DOI":"10.14444\/8390","article-title":"Early Clinical Outcomes of the Prone Transpsoas Lumbar Interbody Fusion Technique","volume":"17","author":"Wellington","year":"2023","journal-title":"Int. J. Spine Surg."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"380","DOI":"10.3171\/2023.4.SPINE221180","article-title":"Complications associated with single-position prone lateral lumbar interbody fusion: A systematic review and pooled analysis","volume":"39","author":"Farber","year":"2023","journal-title":"J. Neurosurg. Spine"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"932","DOI":"10.1186\/s40001-025-03239-2","article-title":"Influence of prone, supine, and lateral positions during spine surgery on vascular, abdominal, and postural anatomy: A comprehensive review and Bayesian meta-analysis","volume":"30","author":"Smajic","year":"2025","journal-title":"Eur. J. Med. Res."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"331","DOI":"10.21037\/jss-23-34","article-title":"Prone position lateral interbody fusion\u2014A narrative review","volume":"9","author":"Patel","year":"2023","journal-title":"J. Spine Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1765","DOI":"10.1177\/21925682211049170","article-title":"Location of the Femoral Nerve in the Lateral Decubitus Versus Prone Position","volume":"13","author":"Alluri","year":"2023","journal-title":"Glob. Spine J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"110","DOI":"10.14444\/8573","article-title":"Single-Position Prone Lateral Lumbar Interbody Fusion Technique Guide: Surgical Tips and Tricks","volume":"18","author":"McDermott","year":"2024","journal-title":"Int. J. Spine Surg."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"358","DOI":"10.3171\/2021.6.SPINE21420","article-title":"Single-position prone lateral transpsoas approach: Early experience and outcomes","volume":"36","author":"Farber","year":"2022","journal-title":"J. Neurosurg. Spine"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"135","DOI":"10.21037\/jss-23-95","article-title":"Single position, prone oblique lateral interbody fusion (OLIF)-case illustration and technical considerations","volume":"10","author":"Wu","year":"2024","journal-title":"J. Spine Surg."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"S154","DOI":"10.1016\/j.spinee.2025.08.170","article-title":"Prone single position lateral interbody fusion for symptomatic cranial adjacent segment degeneration: Technical considerations and preliminary clinical outcomes","volume":"25","author":"Hur","year":"2025","journal-title":"Spine J."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/2\/895\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T09:30:41Z","timestamp":1769506241000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/2\/895"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,22]]},"references-count":30,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,1]]}},"alternative-id":["jcm15020895"],"URL":"https:\/\/doi.org\/10.3390\/jcm15020895","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,22]]}}}