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.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.
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.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.
8.Unveiling the Complex World of Extracellular Vesicles: Novel Characterization Techniques and Manufacturing Considerations
James J. LAI ; John J. HILL ; Casey Y. HUANG ; Gino C. LEE ; Karol W. MAI ; Maggie Y. SHEN ; Simon K. WANG
Chonnam Medical Journal 2024;60(1):1-12
Extracellular vesicles (EVs) function as potent mediators of intercellular communication for many in vivo processes, contributing to both health and disease related conditions. Given their biological origins and diverse functionality from correspondingly unique “cargo” compositions, both endogenous and modified EVs are garnering attention as promising therapeutic modalities and vehicles for targeted therapeutic delivery applications. Their diversity in composition, however, has revealed a significant need for more comprehensive analytical-based characterization methods, and manufacturing processes that are consistent and scalable. In this review, we explore the dynamic landscape of EV research and development efforts, ranging from novel isolation approaches, to their analytical assessment through novel characterization techniques, and to their production by industrial-scale manufacturing process considerations. Expanding the horizon of these topics to EVs for in-human applications, we underscore the need for stringent development and adherence to Good Manufacturing Practice (GMP) guidelines. Wherein, the intricate interplay of raw materials, production in bioreactors, and isolation practices, along with analytical assessments compliant with the Minimal Information for Studies of Extracellular Vesicles (MISEV) guidelines, in conjunction with reference standard materials, collectively pave the way for standardized and consistent GMP production processes.
9.Prevention and management of complications related to laparoscopic spleen-preserving hilar lymph node dissection for gastric cancer.
Z N HUANG ; C Y ZHENG ; J LU ; C M HUANG
Chinese Journal of Gastrointestinal Surgery 2023;26(2):132-137
Hilar splenic lymph node metastasis is one of the risk factors for poor prognosis in patients with proximal gastric cancer. Laparoscopic spleen-preserving splenic hilar lymph node dissection (LSPSHLD) can effectively improve the survival benefits of patients at high risk of splenic hilar lymph node metastasis. However, LSPSHLD is still a challenging surgical difficulty in radical resection of proximal gastric cancer. Moreover, improper operation can easily lead to splenic vascular injury, spleen injury and pancreatic injury and other related complications, due to the deep anatomical location of the splenic hilar region and the intricate blood vessels.Therefore, in the prevention and treatment of LSPSHLD-related complications, we should first focus on prevention, clarify the indication of surgery, and select the benefit group of LSPSHLD individually, so as to avoid the risk caused by over-dissection. Meanwhile, during the perioperative period of LSPSHLD, it is necessary to improve the cognition of related risk factors, conduct standardized and accurate operations in good surgical field exposure and correct anatomical level to avoid surrounding tissues and organs injury, and master the surgical skills and effective measures to deal with related complications, so as to improve the surgical safety of LSPSHLD.
Humans
;
Spleen/surgery*
;
Lymphatic Metastasis/pathology*
;
Stomach Neoplasms/pathology*
;
Gastrectomy/adverse effects*
;
Lymph Node Excision/adverse effects*
;
Lymph Nodes/pathology*
;
Laparoscopy/adverse effects*
;
Retrospective Studies

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