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Designing and clinical application of a 3D-printed personalized model of a radiofrequency needle guide with a maxillary fixator for puncture of the gasserian ganglion for trigeminal neuralgia treatment

J Neurosurg 142:1256–1262, 2025

The study presents a 3D-printed personalized model (3D PPM) for radiofrequency needle guidance in trigeminal neuralgia treatment, reducing radiation exposure and pain during procedures. It showed effectiveness in controlled needle insertion and minimized postoperative complications compared to traditional methods.

• A 3D-printed personalized model (3D PPM) of a radiofrequency needle guide with a maxillary fixator was designed for gasserian ganglion puncture in trigeminal neuralgia treatment.

• 3D PPM reduces radiation exposure and pain during needle insertion, and minimizes postoperative complications.

• The study found that the use of 3D PPM significantly decreased radiation time and dose area product compared to traditional methods.

• Pain severity during the procedure was less in patients using 3D PPM, with more reporting mild pain compared to those not using it.

• Cheek swelling was less frequent in the group using 3D PPM, though not statistically significant due to small sample size.

• The 3D PPM enhances the accuracy of needle insertion and reduces radiation exposure, making it beneficial for less experienced neurosurgeons.

• Limitations include the unsuitability for patients with metal dental implants or missing teeth due to fixation issues.

• Despite limitations, the study shows promising results for 3D PPM in radiofrequency therapy of the gasserian ganglion, suggesting further research is needed.

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Minimally invasive surgical decompression for lumbosacral extraforaminal stenosis (Far-Out Syndrome)

Acta Neurochirurgica (2025) 167:139

The document discusses a minimally invasive surgical technique for decompressing lumbosacral extraforaminal stenosis, known as “far-out syndrome,” focusing on the L5 nerve root. It highlights the procedure, indications, potential complications, and the importance of specific imaging techniques for accurate diagnosis and effective treatment.

• The study focuses on minimally invasive surgical decompression for lumbosacral extraforaminal stenosis, known as “far-out syndrome”.

• Accurate diagnosis is challenging due to unique anatomical characteristics, requiring oblique coronal MR imaging for detection.

• The procedure involves a paraspinal approach using a tubular retractor to decompress the L5 nerve root.

• Adequate decompression requires the resection of the L5 lower vertebral body bony spur, transverse process, and sacral ala.

• Key surgical landmarks include the transverse process, sacral ala, and superior articular process, which are drilled to relieve nerve compression.

• Common symptoms include unilateral leg pain, weakness, and neurogenic claudication, often presenting unilaterally.

• Surgical indications involve unilateral radiating leg pain resistant to conservative management and MRI evidence of extraforaminal compression.

• Complications can be avoided by ensuring adequate decompression and removing ventral bony spurs.

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Application of Topographical Anatomy of the Trochlear Nerve in Transtentorial Approaches: An Anatomic Study

Operative Neurosurgery 28:705–711, 2025

his study examines the topographical anatomy of the trochlear nerve in relation to the free edge of the tentorium (FET) for safer transtentorial surgical approaches. It identifies safe zones for FET transection, minimizing injury risk to the trochlear nerve, crucial for surgeries involving the cavernous sinus.

• Study Focus: The study investigates the relationship between the trochlear nerve (CN IV), oculomotor nerve (CN III), and the free edge of tentorium (FET) to identify a safe zone for surgical maneuvers.

• Methods: Ten embalmed specimens were analyzed using digital microcalipers to measure morphometric details such as the distance between CN IV and CN III.

• Key Findings: CN IV pierces the deep layer of the FET and continues within it before entering the cavernous sinus. A nerve-free portion of FET averages 1.93 mm, with significant variability among specimens.

• Surgical Implications: Transection of the FET poses the lowest risk of CN IV injury if performed less than 2 mm or more than 10 mm posterior to the oculomotor porus (OP).

• Anatomical Observations: The FET is composed of deep and superficial layers, with the deep layer continuous with the petrous bone dura.

• Clinical Relevance: Knowledge of the topographical anatomy of CN III and CN IV is crucial for safe surgical approaches, especially in cases involving tumors or aneurysms.

• Limitations: The study’s experimental nature and limited sample size may not fully capture the anatomical variance encountered in vivo.

• Conclusion: The study provides essential anatomical guidance for reducing the risk of nerve injury during transtentorial surgical approaches.

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Impact of Sigmoid Sinus Anatomy on Assessing the Feasibility of the Retrofacial Access to the Entire Jugular Fossa Before Surgery

Operative Neurosurgery 28:677–686, 2025

The study evaluates the feasibility of the neuronavigated microsurgical transmastoid extended infralabyrinthine extradural retrofacial approach (mTEIER-A) in accessing the jugular fossa, emphasizing the significance of the sigmoid sinus position and horizontal angle of attack, while the sinus size has limited impact.

• The study examines the feasibility of the neuronavigated microsurgical transmastoid extended infralabyrinthine extradural retrofacial approach (mTEIER-A) for accessing the jugular fossa (JF), considering the position and size of the sigmoid sinus (SS) and the horizontal angle of attack.

• SS position medial to a reference line (P1) and horizontal angles greater than 12.5° enhance retrofacial access to the lateral aspect of the JF. The size of the SS has a limited impact.

• Precise preoperative planning is crucial to minimize the need for more invasive approaches, potentially reducing morbidity.

• The study was conducted on cadaveric specimens and highlights the importance of further clinical studies to validate findings.

• Creating an anterofacial space carries risks, including potential damage to the facial nerve (FN) and external auditory canal, which mTEIER-A aims to avoid.

• Statistical analysis confirms the significance of SS position and α-angle for retrofacial access, while SS size has a minor role.

• The study suggests that mTEIER-A is a viable approach for addressing intraosseous JFPs, emphasizing the need for careful preoperative imaging assessment.

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Sarcopenia Predicts the Development of Early Adjacent Segment Disease After Transforaminal Lumbar Interbody Fusion

Neurosurgery 96:1044–1053, 2025

This study explores whether sarcopenia, measured by psoas morphometrics, predicts early adjacent segment disease (ASD) after transforaminal lumbar interbody fusion (TLIF). Results indicate that decreased psoas area and P:VBR are strong predictors of ASD within three years post-surgery, suggesting implications for surgical decision-making and patient counseling.

• Sarcopenia predicts early adjacent segment disease (ASD) after transforaminal lumbar interbody fusion (TLIF) surgery, as shown by decreased psoas area and P:VBR ratios.

• A retrospective study of 109 patients found that 22 (20.2%) developed ASD within 3 years post-surgery.

• Sarcopenic patients had significantly higher rates of ASD (83.33%) compared to nonsarcopenic patients (7.69%).

• Older age, diabetes, and preoperative ODI are significant predictors of ASD.

• Sarcopenia is a stronger predictor of ASD than spinopelvic parameters like PT, LL, and PI-LL mismatch.

• Identifying sarcopenic patients can guide surgical decisions and postoperative care to prevent ASD.

• The study suggests using psoas morphometrics as a simple tool to identify patients at risk for ASD.

• Further research is needed to validate findings and explore the role of sarcopenia in other surgical approaches.

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Prognostic value of manual versus automatic methods for assessing extents of resection and residual tumor volume in glioblastoma

J Neurosurg 142:1298–1306, 2025

This study compares manual and automatic methods for assessing tumor resection extent and residual volume in glioblastoma patients. It finds that both methods have comparable prognostic value, suggesting that automatic segmentation with Raidionics is a viable alternative for future studies.

• Objective: The study compares the prognostic value of manual versus automatic methods for assessing the extent of resection (EOR) and residual tumor (RT) volume in glioblastoma patients.

• Methods: Patients from 12 hospitals in Europe and North America underwent glioblastoma resection and were included in the study. Data were collected from local tumor registries and patient medical records.

• Results: Both manual and automatic RT volumes were negative prognostic factors for overall survival. Automatic segmentation with Raidionics showed comparable prognostic properties to manual measurements.

• Automatic Segmentation: Raidionics, an open-access software, performed automatic segmentation using pretrained deep learning models, which showed high quality and robustness.

• Survival Analysis: Cox regression models indicated that patients with gross-total resection had significantly longer overall survival compared to those with subtotal resection.

• Advantages of Automatic Methods: Automatic segmentation offers fast, quantitative image assessments and reduces interobserver variability, making it suitable for clinical trials.

• Limitations: Some cases showed a mismatch between manual and automatic segmentation, often due to poor-quality MR images or heterogeneous tumors.

• Conclusion: Automatic segmentation is a viable alternative to manual methods for evaluating tumor remnants, with similar prognostic value for survival in glioblastoma patients.

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Cognitive impacts of unilateral MR-guided focused ultrasound thalamotomy: a meta-analysis and a call for systematic neuropsychological assessment

J Neurosurg 142:1271–1279, 2025

A meta-analysis of unilateral MR-guided focused ultrasound thalamotomy for pharmacoresistant tremors shows no significant cognitive or emotional decline post-procedure. However, the limited studies and short-term assessments necessitate further research, especially on long-term effects and bilateral procedures.

• Objective: Evaluate cognitive and emotional effects of unilateral MR-guided focused ultrasound (MRgFUS) thalamotomy in patients with pharmacoresistant tremors.

• Methods: Conducted a meta-analysis following PRISMA guidelines, focusing on cognitive functions pre- and post-procedure.

• Results: No significant deterioration in cognitive domains or emotional states post-procedure.

• Sample: Included 112 patients, mostly with essential tremor and some with Parkinson’s disease.

• Findings: MRgFUS thalamotomy is safe concerning cognitive and emotional outcomes, but more research is needed for long-term effects.

• Limitations: Small number of studies, short-term assessments, and potential publication bias.

• Conclusion: Encouraging findings on safety, but further comprehensive investigations are necessary.

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Brainshift correction using navigated intraoperative ultrasound informs intraoperative decision‑making during glioma surgery

Acta Neurochirurgica (2025) 167:124

This paper discusses brainshift correction in glioma surgery using navigated intraoperative ultrasound (iUS) and MRI (iUS-MR fusion). It highlights the accuracy and practical benefits of iUS in correcting brainshift, improving neuronavigation accuracy, and aiding intraoperative decisions, especially near critical brain structures.

• Brainshift (BS) can significantly impact the accuracy of neuronavigation systems during intraoperative procedures, particularly in brain tumor surgeries.

• Rigid image fusion (RIF) using intraoperative ultrasound (iUS) and MRI is a cost-effective method to correct BS and enhance surgical accuracy.

• Factors contributing to BS include physical, surgical, and biological elements, leading to both linear and complex elastic shifts.

• iUS can be repeatedly used during surgery, offering real-time updates and corrections, thus serving as an independent tool for resection control.

• Challenges with iUS include the need for careful registration and the difficulty in correcting non-linear deformations.

• Case study: A successful application of iUS-MR fusion in a glioma surgery demonstrated improved tumor margin assessment and preservation of critical structures.

• Future advancements in automation and technology are required to address the limitations of current BS correction methods.

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Robotic Resection of Spinal and Paraspinal Tumors

Operative Neurosurgery 28:608–616, 2025

The study evaluates robotic resection of spinal nerve sheath tumors, demonstrating improved gross total resection rates and reduced hospital stays compared to open surgery. The multidisciplinary approach and advanced robotic techniques offer promising outcomes for complex paraspinal tumor surgeries.

• Robotic arm surgical systems, like the DaVinci robot, are used for minimally invasive surgeries, though their application in neurosurgery is limited.

• A study evaluated the feasibility, safety, and outcomes of robotic resection for spinal nerve sheath tumors (NST).

• Gross total resection was achieved in all cases, with reduced length of stay and increased resection rates compared to traditional open surgery.

• The DaVinci robotic platform uses high-resolution 3D imaging and wristed instruments, enhancing precision in surgical procedures.

• Multidisciplinary collaboration is crucial, involving neurosurgeons and other specialists for successful robotic-assisted surgeries.

• Training and simulation are essential for neurosurgeons to effectively utilize robotic systems, given the lack of haptic feedback.

• The integration of robotic surgery in neurosurgery is expected to expand with technological advancements and improved training programs

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Buttock pain in lumbar disc herniation: clinical characteristics, risk factors, and surgical outcomes

J Neurosurg Spine 42:572–578, 2025

The study investigates buttock pain in patients with lumbar disc herniation (LDH), identifying it as a common, independent symptom. It found that buttock pain is associated with contained herniation and an intact annulus fibrosus, and can be effectively treated with endoscopic discectomy.

• Buttock pain is common in patients with lumbar disc herniation (LDH), particularly in the L3–S1 segments, and is often independent of back and leg pain.

• The study examined 321 patients with single-level LDH who underwent endoscopic discectomy, finding that 75.4% experienced buttock pain.

• Buttock pain is more prevalent in patients with contained LDH and an intact annulus fibrosus.

• Endoscopic discectomy is effective in treating buttock pain, with significant improvements observed shortly after surgery and at the 1-year follow-up.

• The occurrence of buttock pain is not associated with age, sex, or specific spinal levels, indicating it as an independent symptom.

• The study suggests that altered intradiscal pressure may be a pathogenic factor for buttock pain in contained LDH.

• Residual buttock pain was more likely in L3–4 LDH, though the sample size for this segment was limited.

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Revisiting Härtel’s technique for percutaneous transoval glycerol injection

Acta Neurochirurgica (2025) 167:126

The study revisits Härtel’s technique for percutaneous transoval glycerol injection in treating trigeminal neuralgia. It identifies an optimal entry point in the cheek, 2 mm below the horizontal plane, to improve procedural success and reduce complications, emphasizing the importance of precise needle guidance.

• Purpose: The study revisits Härtel’s technique for percutaneous transoval glycerol injection (GI) to treat trigeminal neuralgia, aiming to identify optimal needle entry points and trajectories using imaging-based simulations.

• Methods: CT and MRI-based simulations were conducted on eleven patients to determine optimal entry points and trajectories through the foramen ovale (FO) to reach Meckel’s cave.

• Findings: The optimal entry point is 2 mm below the horizontal plane through the angle of the mouth, providing better access to Meckel’s cave in most cases.

• Conclusion: Technical results of GI can be improved by selecting the optimal entry point and guiding the needle through the medial part of FO under fluoroscopy.

• Historical Context: Härtel’s technique, developed in 1912, provided a systematic approach to reach the trigeminal ganglion through FO.

• Variability in Techniques: Different variations of GI techniques have led to variable outcomes, highlighting the importance of standardizing the procedure.

• Simulation Insights: 3D simulations help in identifying reliable entry points and can be useful in cases with anatomical variations.

• Clinical Implications: The study suggests that lowering the entry point in the cheek could improve the success rate of GI procedures.

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A novel robot-assisted method for implanting intracortical sensorimotor devices for brain-computer interface studies

J Neurosurg 142:1280–1288, 2025

A novel robot-assisted method for implanting intracortical microelectrode arrays in brain-computer interface studies was successfully demonstrated in a tetraplegic participant. The technique ensured precise placement, facilitating high-quality signal communication for motor control and sensory feedback, with promising implications for restoring upper-limb function.

• A novel robot-assisted method for implanting intracortical microelectrode arrays in brain-computer interface (BCI) studies is presented, focusing on surgical techniques and challenges.

• The technique was applied in a 31-year-old male with tetraplegia, enabling 2D control of a virtual arm with high success rates and maintaining recording quality over time.

• The robotic neurosurgery technique provides high accuracy and time efficiency, reducing human error and surgeon burden in repetitive procedures.

• Preoperative imaging and robotic systems were used for precise planning and execution of array implantations, ensuring minimal cortical damage and high signal quality.

• The study demonstrated that robotic neurosurgery could be successfully translated into BCI device implantation, aiming to restore upper-limb function.

• Future challenges include refining insertion methods, increasing automation, and addressing intraoperative adjustments for microvessels.

• The study was conducted under an investigational device exemption from the US Food and Drug Administration and received institutional review board approval.

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Management strategies for cervical schwannomas: a comprehensive review

J Neurosurg Spine 42:650–658, 2025

The review discusses cervical schwannomas, focusing on their pathophysiology, clinical presentation, and management strategies, including surgical resection and stereotactic body radiation therapy (SBRT). It emphasizes the importance of a multidisciplinary approach for optimal patient outcomes and highlights the need for ongoing research.

• Cervical schwannomas are benign tumors originating from Schwann cells, often occurring in the intradural, extramedullary space of the cervical spine.

• MRI is the primary imaging modality for diagnosing schwannomas, characterized by avid Gd uptake and specific radiographic features.

• Surgical resection is the main treatment approach, with gross-total resection preferred to minimize recurrence. Various surgical techniques are available depending on tumor location.

• Stereotactic body radiation therapy (SBRT) is a viable alternative for patients who are not surgical candidates, offering good local control and symptomatic relief.

• Histological analysis distinguishes schwannomas through specific features such as Antoni A and B areas and Verocay bodies. Immunohistochemical stains like S100 and SOX10 aid in diagnosis.

• Multidisciplinary management is crucial, integrating surgical and nonsurgical options to optimize patient outcomes and quality of life.

• Observation may be suitable for asymptomatic patients with slow-growing lesions, with regular monitoring to assess progression.

• Malignant transformation into peripheral nerve sheath tumors is rare but possible, particularly in patients with NF1.

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Gamma Knife radiosurgery for relapsing trigeminal neuralgia following microvascular decompression

J Neurosurg 142:1247–1255, 2025

Salvage Gamma Knife radiosurgery (GKRS) offers effective, noninvasive treatment for relapsing trigeminal neuralgia after microvascular decompression, with a favorable complications profile. Patients with facial numbness and better initial pain responses may experience more durable pain relief following salvage GKRS.

• Gamma Knife radiosurgery (GKRS) is explored as a treatment for relapsing trigeminal neuralgia (TN) following microvascular decompression (MVD).

• The study aimed to assess the response rate, complications, and predictors of pain relapse for salvage GKRS after MVD.

• 83.1% of patients experienced initial pain relief after salvage GKRS, with a median time to relapse of 1.75 years.

• Facial numbness post-GKRS decreased pain relapse risk, while a worse initial pain response increased it.

• Radiofrequency ablation (RFA) prior to MVD reduced the likelihood of an initial response to GKRS.

• Salvage GKRS is presented as an effective, noninvasive option for recurring TN after MVD, with a favorable complications profile compared to salvage MVD.

• The study acknowledges limitations, including potential selection bias and small sample size, and suggests further research with larger cohorts

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Surgical Management of Acute Subdural Hematoma: A Meta-Analysis

Neurosurgery 96:922–936, 2025

The meta-analysis evaluates surgical interventions for acute subdural hematoma, comparing craniotomy and decompressive craniectomy. It finds similar mortality and functional outcomes in matched cohorts, despite worse baseline parameters in craniectomy patients. The study emphasizes the need for future trials to validate these findings.

• Acute Subdural Hematoma (ASDH) requires urgent surgical intervention, typically through craniotomy (CO) or decompressive craniectomy (DC).

• Meta-analysis included 18 studies with 8886 patients, assessing functional outcomes and mortality rates between CO and DC.

• Functional outcomes showed similar Glasgow Outcome Scale-Extended (GOSE) scores between CO and DC, but Glasgow Outcome Scale (GOS) scores favored CO.

• Mortality analysis indicated lower short-term mortality for CO, but similar long-term mortality between CO and DC in matched cohorts.

• Complications and reoperation rates were comparable between CO and DC, with cerebrospinal fluid diversion more common in DC.

• Quality of Life (QOL) was not thoroughly assessed due to differences in measurement tools and limited data.

• The study highlights the need for further clinical trials to validate findings and address gaps in existing literature

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Acute Implantation of a Bioresorbable Polymer Scaffold in Patients With Complete Thoracic Spinal Cord Injury: A Randomized Controlled Trial (INSPIRE 2.0)

Neurosurgery 96:751–762, 2025

The INSPIRE 2.0 trial evaluated the safety and efficacy of a bioresorbable polymer scaffold for treating thoracic spinal cord injury. The study concluded that the scaffold did not provide a probable clinical benefit, leading to the trial’s early termination due to lack of efficacy and funding issues.

• The study INSPIRE 2.0 assessed the safety and potential benefit of a bioresorbable polymer scaffold (Neuro-Spinal Scaffold) in patients with complete thoracic spinal cord injury (SCI).

• Conducted as a randomized controlled trial at Level I trauma centers in the U.S., the study compared NSS implantation with standard-of-care spine surgery.

• The primary endpoint was the proportion of patients with an improvement of ≥1 AIS grade at 6 months post-surgery.

• Results showed no significant benefit of NSS over standard surgery; 20% of NSS patients improved compared to 30% of control patients.

• The study was terminated early due to not meeting its primary endpoint and subsequent withdrawal of industry sponsorship.

• Safety events were mostly mild or moderate, with no serious adverse device effects reported.

• The study highlighted the challenges of conducting clinical trials on spinal cord injury and the importance of reporting negative results.

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Electrocorticography and navigated transcranial magnetic stimulation–tailored supratotal resection for epileptogenic low-grade gliomas

J Neurosurg 142:918–926, 2025

The study evaluates ECoG-nTMS–tailored supratotal resection (ETT-SpTR) for low-grade gliomas with epilepsy, demonstrating improved seizure control and preserved neurological function compared to gross-total resection. ETT-SpTR effectively identifies high-risk epilepsy areas, enhancing epileptic and functional outcomes without permanent deficits.

• Objective: Evaluate the effectiveness of ECoG-nTMS–tailored supratotal resection (ETT-SpTR) for low-grade gliomas (LGGs) in controlling seizures and preserving neurological function.

• Methods: Retrospective analysis of patients with LGG and epileptic seizures undergoing resective surgery, comparing gross-total resection (GTR) with ETT-SpTR.

• Results: ETT-SpTR significantly improved seizure control (85.7% Engel class IA) compared to GTR (25% Engel class IA) with no permanent neurological deficits.

• Conclusion: ETT-SpTR is effective in improving epileptic outcomes and preserving functions without causing permanent neurological worsening.

• Preoperative Techniques: Functional cortical areas were identified using TMS, and ECoG guided the removal of high-risk epilepsy areas (HREAs).

• Statistical Analysis: Significant differences in seizure control between groups, with ETT-SpTR showing better outcomes.

• Limitations: Small patient cohort and limited follow-up period; future studies required for confirmation.

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Development of a unified and comprehensive definition of successful spinal fusion: a systematic review

J Neurosurg Spine 42:403–412, 2025

The document discusses a systematic review aimed at creating a unified definition of successful spinal fusion by integrating clinical symptoms, imaging modalities, and bone healing processes. It proposes a clinical algorithm for evaluating fusion success, emphasizing the need for standardized assessment criteria.

• A systematic review was conducted to develop a unified definition of successful spinal fusion, incorporating clinical symptoms and imaging modalities.

• The review involved 20 studies evaluating 1,324 spinal fusion procedures, resulting in a clinical algorithm for determining fusion success.

• The algorithm stratifies patients as symptomatic or asymptomatic, using specific imaging techniques based on pain type.

• Successful fusion for asymptomatic patients is considered after 12 months, while persistent symptoms indicate failure regardless of radiographic findings.

• Limitations include reliance on imaging and heterogeneous study data, but the algorithm aims to standardize fusion evaluation and improve outcomes.

• Future directions suggest using AI and machine learning for predictive algorithms and evaluating regional differences in fusion assessment.

• The proposed algorithm aims to improve diagnostic accuracy and provide a shared understanding of successful spinal fusion among clinicians.

• Implementation of the algorithm can enhance outcomes research and assess new developments in spinal fusion.

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Natural history, management, and outcomes of cerebellar cavernous malformations: A retrospective study of 130 patients

Neurosurgical Review (2025) 48:381

This study on cerebellar cavernous malformations (CMs) examines their natural history, management, and outcomes. It concludes that conservative management is generally effective for incidental lesions, while surgery is recommended for symptomatic cases, especially in accessible regions, due to the associated hemorrhage risks.

• This study investigates cerebellar cavernous malformations (CMs), focusing on natural history, management, and outcomes in 130 patients from 1990 to 2023.

• Hemorrhage risk for incidental lesions is 1.19%, while rehemorrhage risk for initially hemorrhagic lesions is 8.35%.

• Conservative management is recommended for incidental lesions, with surgery reserved for symptomatic, accessible cases.

• Surgery was performed on 31 patients, primarily for hemorrhage or cerebellar symptoms, with postoperative complications in three patients.

• Lesion location and size significantly influence hemorrhage risk and clinical outcomes, with eloquent regions posing higher risks.

• Long-term outcomes were generally favorable, with most patients experiencing improved or stable functional status.

• Psychological support is important due to potential cognitive and emotional impacts associated with cerebellar dysfunction.

• The study emphasizes the need for risk stratification based on lesion size and subregional anatomy within the cerebellum.

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Clinical and radiographic comparison of robot-assisted single-position versus traditional dual-position lateral lumbar interbody fusion

J Neurosurg Spine 42:443–452, 2025

The study compares robot-assisted single-position (RA-SP) and traditional dual-position (DP) lateral lumbar interbody fusion (LLIF) surgeries, finding RA-SP-LLIF reduces operative and fluoroscopy times with similar clinical and radiographic outcomes, suggesting enhanced surgical efficiency and safety.

• The study compares robot-assisted single-position (RA-SP) lateral lumbar interbody fusion (LLIF) with traditional dual-position LLIF in terms of clinical and radiographic outcomes.

• 59 patients were analyzed, with 31 undergoing RA-SP-LLIF and 28 undergoing traditional LLIF. Surgical parameters like operative duration, blood loss, and fluoroscopy duration were recorded.

• No significant differences were found in postoperative and follow-up times between groups, but both showed improvements in clinical scores such as VAS, ODI, and SF-36.

• RA-SP-LLIF showed significantly greater improvements in lumbar lordosis and segmental lordosis immediately postoperatively, although these differences were not significant at later evaluations.

• The RA-SP-LLIF group had shorter operative and fluoroscopy durations compared to the traditional LLIF group.

• RA-SP-LLIF is considered a promising technique for enhancing surgical efficiency, safety, and precision in lumbar spinal fusion procedures.

• Both procedures improved sagittal alignment parameters, but RA-SP-LLIF reduced surgery and anesthesia times by eliminating the need for repositioning.

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