Background: Three-level anterior cervical discectomy and fusion (ACDF) is widely used for multilevel cervical degenerative disc disease; however, the relationship between postoperative alignment trajectories, adjacent segment degeneration (ASD), and late patient-reported outcomes remains incompletely defined. This study evaluated plane-specific radiological alignment changes, MRI-based ASD, and late functional outcomes in a homogeneous three-level ACDF cohort. Methods: This single-center observational cohort included 29 patients who underwent three-level ACDF between January 2018 and December 2023 and had complete radiographic follow-up. Radiological data were collected retrospectively from institutional records and imaging archives. Cervical sagittal and coronal alignment were assessed using Cobb angles on radiographs obtained preoperatively and at 6 months, 1 year, and 2 years postoperatively. ASD was evaluated at the superior adjacent segment on 2-year MRI. Late patient-reported clinical outcomes were assessed at a mean follow-up of 42.6 ± 6.8 months using the Visual Analog Scale (VAS), Neck Disability Index (NDI), and Nottingham Health Profile (NHP). Results: Sagittal Cobb angle changed significantly over time (χ²(3) = 12.60, p = 0.006; Kendall’s W = 0.145), whereas coronal Cobb angle showed a statistically significant reduction over time, although the absolute magnitude of change was small (χ²(3) = 28.74, p < 0.001; Kendall’s W = 0.330). Lower sagittal Cobb angle correlated with worse NDI (r = −0.46, p = 0.004), and greater coronal Cobb angle correlated with worse physical activity scores (r = 0.52, p = 0.006). Higher Pfirrmann grade correlated with worse NDI (r = 0.49, p = 0.004) and pain scores (r = 0.44, p = 0.021). In exploratory regression analysis, sagittal Cobb angle and Pfirrmann grade were retained in the model for NDI, but these findings should be interpreted as hypothesis-generating. Conclusions: After three-level ACDF, sagittal and coronal alignment followed different postoperative trajectories. Lower sagittal alignment and greater adjacent disc degeneration were associated with worse late neck-related disability. However, given the modest sample size and exploratory nature of the regression analysis, these findings should be interpreted as hypothesis-generating. Larger prospective studies are needed to confirm whether sagittal alignment and MRI-based adjacent segment degeneration independently contribute to late functional outcomes.

Background and Objectives: In this study, uncoupled auxiliary trans-sacroiliac (UATS) screws were evaluated as a mechanically independent adjunct to conventional S2-alar-iliac (S2AI) fixation in long lumbopelvic constructs. We assessed their exploratory biomechanical behavior and preliminary clinical feasibility. Methods: Conventional bilateral S2AI fixation and the same construct supplemented with bilateral UATS screws were compared in an exploratory finite element analysis under flexion, extension, lateral bending, and axial rotation. A retrospective clinical series of 26 patients undergoing UATS-supported lumbopelvic reconstruction was also evaluated. Results: Across the four loading modes, the UATS configuration showed lower global implant-system stress (81–92% reduction) and lower global sacral stress (43–67% reduction) within the computational model. The clinical cohort was revision dominant (25/26 patients). Mean SIJ-related pain VAS decreased from 8.0 ± 1.5 to 2.4 ± 1.0 and ODI from 68.1% ± 18.1% to 16.7% ± 8.6% at final follow-up (both p < 0.001). These clinical changes reflect the overall reconstructive procedure and cannot be attributed independently to UATS fixation. Conclusions: UATS placement was technically feasible in this small, revision-dominant cohort and altered stress distribution in an exploratory, unvalidated finite element model. The present study does not establish independent clinical efficacy or superiority over established pelvic fixation or SIJ fusion strategies.

Glioblastoma, classified as a grade IV astrocytoma, is an aggressive and malignant primary brain tumor with no known cure. Despite the implementation of standard medical and surgical treatment protocols, the disease often progresses with unsatisfactory outcomes. This study aimed to evaluate the cytotoxic, proapoptotic, and antimetastatic effects of anti-angiogenic monoclonal antibody bevacizumab combined with the sphingosine-1-phosphate receptor modulator fingolimod on rat glioma C6 cells. The cytotoxicity of bevacizumab and fingolimod was evaluated using the MTT assay. Proapoptotic activity was assessed through flow cytometric analyses, including Annexin V–FITC staining, caspase 3/7 activation, and mitochondrial membrane potential measurements. Morphological changes were examined using confocal microscopy. Antimetastatic effects were evaluated via anti-migration and colony formation assays. The combination of bevacizumab and fingolimod exhibited antiproliferative, cytotoxic, proapoptotic, and antimetastatic effects on C6 glioma cells at low IC₅₀ concentrations. Based on growth inhibitory, proapoptotic, and antimetastatic activities on C6 glioma cells, the combination of bevacizumab and fingolimod demonstrates significant growth-inhibitory, proapoptotic, and antimetastatic activities against C6 glioma cells, suggesting its potential as a promising pharmacotherapeutic approach for the treatment of glioblastoma.