1.Distinct Recovery Patterns After Transforaminal Lumbar Interbody Fusion: Comparing Minimally Invasive and Open Approaches Using Mixed-Effects Segmented Regression
Tomoyuki ASADA ; Eric R. ZHAO ; Adin M. EHRLICH ; Adrian LUI ; Andrea PEZZI ; Sereen HALAYQEH ; Tarek HARHASH ; Olivia C. TUMA ; Kasra ARAGHI ; Todd J. ALBERT ; James FARMER ; Russel C. HUANG ; Harvinder SANDHU ; Han Jo KIM ; Francis C. LOVECCHIO ; James E. DOWDELL ; Sravisht IYER ; Sheeraz A. QURESHI
Neurospine 2025;22(1):3-13
Objective:
While minimally invasive-transforaminal lumbar interbody fusion (MIS-TLIF) has shown superiority in key clinical metrics over the open approach, evidence regarding patient-reported outcomes remains limited. This study compared postoperative recovery trajectories and symptomatic improvement phases between MIS and open TLIF.
Methods:
This retrospective review included patients who underwent single-level MIS or open TLIF. Oswestry Disability Index (ODI) and Numerical Rating Scale (NRS) for back and leg pain were collected preoperatively and postoperatively. Segmented regression analysis with mixed-effects modeling, allowing for identification of distinct recovery phases, compared symptomatic trends between approaches.
Results:
Of 324 patients (268 MIS, 56 open), baseline demographics were similar except for greater preoperative leg pain in the MIS group (NRS: 6.0 vs. 5.0, p = 0.027). A segmented regression model identified 4 ODI recovery phases: postoperative disability phase (PDP, day 0 to 13), early improvement phase (day 13 to 28), late improvement phase (day 28 to 110), and plateau phase (later than day 110). The MIS group exhibited significantly lower disability exacerbation during PDP (β = 0.93 vs. 1.42 points per day, p = 0.008). Additionally, the plateau of NRS back occurred significantly earlier in the MIS group than in the open group (MIS, 26.7 ± 2.6 days vs. open, 51.7 ± 6.6 days, p < 0.001).
Conclusion
MIS-TLIF resulted in lower postoperative disability during the first 2 weeks compared to the open approach. Furthermore, low back pain achieved an earlier plateau in back pain by about 4 weeks in the MIS approach.
2.Distinct Recovery Patterns After Transforaminal Lumbar Interbody Fusion: Comparing Minimally Invasive and Open Approaches Using Mixed-Effects Segmented Regression
Tomoyuki ASADA ; Eric R. ZHAO ; Adin M. EHRLICH ; Adrian LUI ; Andrea PEZZI ; Sereen HALAYQEH ; Tarek HARHASH ; Olivia C. TUMA ; Kasra ARAGHI ; Todd J. ALBERT ; James FARMER ; Russel C. HUANG ; Harvinder SANDHU ; Han Jo KIM ; Francis C. LOVECCHIO ; James E. DOWDELL ; Sravisht IYER ; Sheeraz A. QURESHI
Neurospine 2025;22(1):3-13
Objective:
While minimally invasive-transforaminal lumbar interbody fusion (MIS-TLIF) has shown superiority in key clinical metrics over the open approach, evidence regarding patient-reported outcomes remains limited. This study compared postoperative recovery trajectories and symptomatic improvement phases between MIS and open TLIF.
Methods:
This retrospective review included patients who underwent single-level MIS or open TLIF. Oswestry Disability Index (ODI) and Numerical Rating Scale (NRS) for back and leg pain were collected preoperatively and postoperatively. Segmented regression analysis with mixed-effects modeling, allowing for identification of distinct recovery phases, compared symptomatic trends between approaches.
Results:
Of 324 patients (268 MIS, 56 open), baseline demographics were similar except for greater preoperative leg pain in the MIS group (NRS: 6.0 vs. 5.0, p = 0.027). A segmented regression model identified 4 ODI recovery phases: postoperative disability phase (PDP, day 0 to 13), early improvement phase (day 13 to 28), late improvement phase (day 28 to 110), and plateau phase (later than day 110). The MIS group exhibited significantly lower disability exacerbation during PDP (β = 0.93 vs. 1.42 points per day, p = 0.008). Additionally, the plateau of NRS back occurred significantly earlier in the MIS group than in the open group (MIS, 26.7 ± 2.6 days vs. open, 51.7 ± 6.6 days, p < 0.001).
Conclusion
MIS-TLIF resulted in lower postoperative disability during the first 2 weeks compared to the open approach. Furthermore, low back pain achieved an earlier plateau in back pain by about 4 weeks in the MIS approach.
3.Novel hormone therapies for advanced prostate cancer: Understanding and countering drug resistance.
Zhipeng WANG ; Jie WANG ; Dengxiong LI ; Ruicheng WU ; Jianlin HUANG ; Luxia YE ; Zhouting TUO ; Qingxin YU ; Fanglin SHAO ; Dilinaer WUSIMAN ; William C CHO ; Siang Boon KOH ; Wei XIONG ; Dechao FENG
Journal of Pharmaceutical Analysis 2025;15(9):101232-101232
Prostate cancer is the most prevalent malignant tumor among men, ranking first in incidence and second in mortality globally. Novel hormone therapies (NHT) targeting the androgen receptor (AR) pathway have become the standard of care for metastatic prostate cancer. This review offers a comprehensive overview of NHT, including abiraterone, enzalutamide, apalutamide, darolutamide, and rezvilutamide, which have demonstrated efficacy in delaying disease progression and improving patient survival and quality of life. Nevertheless, resistance to NHT remains a critical challenge. The mechanisms underlying resistance are complex, involving AR gene amplification, mutations, splice variants, increased intratumoral androgens, and AR-independent pathways such as the glucocorticoid receptor, neuroendocrine differentiation, DNA repair defects, autophagy, immune evasion, and activation of alternative signaling pathways. This review discusses these resistance mechanisms and examines strategies to counteract them, including sequential treatment with novel AR-targeted drugs, chemotherapy, poly ADP-ribose polymerase inhibitors, radionuclide therapy, bipolar androgen therapy, and approaches targeting specific resistance pathways. Future research should prioritize elucidating the molecular basis of NHT resistance, optimizing existing therapeutic strategies, and developing more effective combination regimens. Additionally, advanced sequencing technologies and resistance research models should be leveraged to identify novel therapeutic targets and improve drug delivery efficiencies. These advancements hold the potential to overcome NHT resistance and significantly enhance the management and prognosis of patients with advanced prostate cancer.
4.Distinct Recovery Patterns After Transforaminal Lumbar Interbody Fusion: Comparing Minimally Invasive and Open Approaches Using Mixed-Effects Segmented Regression
Tomoyuki ASADA ; Eric R. ZHAO ; Adin M. EHRLICH ; Adrian LUI ; Andrea PEZZI ; Sereen HALAYQEH ; Tarek HARHASH ; Olivia C. TUMA ; Kasra ARAGHI ; Todd J. ALBERT ; James FARMER ; Russel C. HUANG ; Harvinder SANDHU ; Han Jo KIM ; Francis C. LOVECCHIO ; James E. DOWDELL ; Sravisht IYER ; Sheeraz A. QURESHI
Neurospine 2025;22(1):3-13
Objective:
While minimally invasive-transforaminal lumbar interbody fusion (MIS-TLIF) has shown superiority in key clinical metrics over the open approach, evidence regarding patient-reported outcomes remains limited. This study compared postoperative recovery trajectories and symptomatic improvement phases between MIS and open TLIF.
Methods:
This retrospective review included patients who underwent single-level MIS or open TLIF. Oswestry Disability Index (ODI) and Numerical Rating Scale (NRS) for back and leg pain were collected preoperatively and postoperatively. Segmented regression analysis with mixed-effects modeling, allowing for identification of distinct recovery phases, compared symptomatic trends between approaches.
Results:
Of 324 patients (268 MIS, 56 open), baseline demographics were similar except for greater preoperative leg pain in the MIS group (NRS: 6.0 vs. 5.0, p = 0.027). A segmented regression model identified 4 ODI recovery phases: postoperative disability phase (PDP, day 0 to 13), early improvement phase (day 13 to 28), late improvement phase (day 28 to 110), and plateau phase (later than day 110). The MIS group exhibited significantly lower disability exacerbation during PDP (β = 0.93 vs. 1.42 points per day, p = 0.008). Additionally, the plateau of NRS back occurred significantly earlier in the MIS group than in the open group (MIS, 26.7 ± 2.6 days vs. open, 51.7 ± 6.6 days, p < 0.001).
Conclusion
MIS-TLIF resulted in lower postoperative disability during the first 2 weeks compared to the open approach. Furthermore, low back pain achieved an earlier plateau in back pain by about 4 weeks in the MIS approach.
5.Distinct Recovery Patterns After Transforaminal Lumbar Interbody Fusion: Comparing Minimally Invasive and Open Approaches Using Mixed-Effects Segmented Regression
Tomoyuki ASADA ; Eric R. ZHAO ; Adin M. EHRLICH ; Adrian LUI ; Andrea PEZZI ; Sereen HALAYQEH ; Tarek HARHASH ; Olivia C. TUMA ; Kasra ARAGHI ; Todd J. ALBERT ; James FARMER ; Russel C. HUANG ; Harvinder SANDHU ; Han Jo KIM ; Francis C. LOVECCHIO ; James E. DOWDELL ; Sravisht IYER ; Sheeraz A. QURESHI
Neurospine 2025;22(1):3-13
Objective:
While minimally invasive-transforaminal lumbar interbody fusion (MIS-TLIF) has shown superiority in key clinical metrics over the open approach, evidence regarding patient-reported outcomes remains limited. This study compared postoperative recovery trajectories and symptomatic improvement phases between MIS and open TLIF.
Methods:
This retrospective review included patients who underwent single-level MIS or open TLIF. Oswestry Disability Index (ODI) and Numerical Rating Scale (NRS) for back and leg pain were collected preoperatively and postoperatively. Segmented regression analysis with mixed-effects modeling, allowing for identification of distinct recovery phases, compared symptomatic trends between approaches.
Results:
Of 324 patients (268 MIS, 56 open), baseline demographics were similar except for greater preoperative leg pain in the MIS group (NRS: 6.0 vs. 5.0, p = 0.027). A segmented regression model identified 4 ODI recovery phases: postoperative disability phase (PDP, day 0 to 13), early improvement phase (day 13 to 28), late improvement phase (day 28 to 110), and plateau phase (later than day 110). The MIS group exhibited significantly lower disability exacerbation during PDP (β = 0.93 vs. 1.42 points per day, p = 0.008). Additionally, the plateau of NRS back occurred significantly earlier in the MIS group than in the open group (MIS, 26.7 ± 2.6 days vs. open, 51.7 ± 6.6 days, p < 0.001).
Conclusion
MIS-TLIF resulted in lower postoperative disability during the first 2 weeks compared to the open approach. Furthermore, low back pain achieved an earlier plateau in back pain by about 4 weeks in the MIS approach.
6.Distinct Recovery Patterns After Transforaminal Lumbar Interbody Fusion: Comparing Minimally Invasive and Open Approaches Using Mixed-Effects Segmented Regression
Tomoyuki ASADA ; Eric R. ZHAO ; Adin M. EHRLICH ; Adrian LUI ; Andrea PEZZI ; Sereen HALAYQEH ; Tarek HARHASH ; Olivia C. TUMA ; Kasra ARAGHI ; Todd J. ALBERT ; James FARMER ; Russel C. HUANG ; Harvinder SANDHU ; Han Jo KIM ; Francis C. LOVECCHIO ; James E. DOWDELL ; Sravisht IYER ; Sheeraz A. QURESHI
Neurospine 2025;22(1):3-13
Objective:
While minimally invasive-transforaminal lumbar interbody fusion (MIS-TLIF) has shown superiority in key clinical metrics over the open approach, evidence regarding patient-reported outcomes remains limited. This study compared postoperative recovery trajectories and symptomatic improvement phases between MIS and open TLIF.
Methods:
This retrospective review included patients who underwent single-level MIS or open TLIF. Oswestry Disability Index (ODI) and Numerical Rating Scale (NRS) for back and leg pain were collected preoperatively and postoperatively. Segmented regression analysis with mixed-effects modeling, allowing for identification of distinct recovery phases, compared symptomatic trends between approaches.
Results:
Of 324 patients (268 MIS, 56 open), baseline demographics were similar except for greater preoperative leg pain in the MIS group (NRS: 6.0 vs. 5.0, p = 0.027). A segmented regression model identified 4 ODI recovery phases: postoperative disability phase (PDP, day 0 to 13), early improvement phase (day 13 to 28), late improvement phase (day 28 to 110), and plateau phase (later than day 110). The MIS group exhibited significantly lower disability exacerbation during PDP (β = 0.93 vs. 1.42 points per day, p = 0.008). Additionally, the plateau of NRS back occurred significantly earlier in the MIS group than in the open group (MIS, 26.7 ± 2.6 days vs. open, 51.7 ± 6.6 days, p < 0.001).
Conclusion
MIS-TLIF resulted in lower postoperative disability during the first 2 weeks compared to the open approach. Furthermore, low back pain achieved an earlier plateau in back pain by about 4 weeks in the MIS approach.
8.Advances in immunoPET/SPECT imaging: The role of Fab and F(ab')2 fragments in theranostics.
Wenpeng HUANG ; Jingwei ZHOU ; Yanchen LIU ; Yihan YANG ; Rachel J SALADIN ; Jessica C HSU ; Weibo CAI ; Lei KANG
Acta Pharmaceutica Sinica B 2025;15(8):3888-3924
With the advent of precision medicine and personalized treatment, targeted therapies have become pivotal in oncology. Noninvasive molecular imaging, especially immunoPET/SPECT, plays a crucial role in refining cancer diagnostics and treatment monitoring by visualizing biological processes at the molecular level. This review explores the dynamic field of immunoPET/SPECT imaging using Fab and F(ab')2 fragments, characterized by advantageous pharmacokinetics and swift clearance from the bloodstream, making them suitable for same-day imaging procedures. We examine contemporary strategies for radiolabeling these fragments with PET and SPECT radionuclides and discuss potential advancements and the challenges anticipated in the further development of Fab and F(ab')2 fragments. Despite the complexities involved in their development, these fragments hold significant promise for advanceing personalized cancer treatment. Keys to this advancement are innovative radiolabeling techniques, site-specific conjugation chemistries, and short-lived radionuclides, all of which are crucial for overcoming existing limitations and enhancing the clinical utility of these imaging agents. As research progresses, Fab and F(ab')2 fragments are expected to become central to the future of cancer diagnostics and therapeutic monitoring, thereby improving patient management and contributing significantly to the evolution of personalized medicine.

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