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Brain Sciences
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Contemporary Spinal Surgery: Surgical Optimization and Technological Innovation
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Contemporary Spinal Surgery: Surgical Optimization and Technological Innovation

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neurosurgery and Neuroanatomy".

Deadline for manuscript submissions: 30 September 2025 | Viewed by 1253

Special Issue Editors

Dr. Nicola Montemurro

E-Mail Website
Guest Editor
Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana (AOUP), University of Pisa, 56100 Pisa, Italy
Interests: brain tumor; glioblastoma; low-grade glioma; meningioma; neuro-oncology; augmented reality; virtual reality; tractography; spine tumor; traumatic brain injury; hydrocephalus
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Francesco Acerbi

E-Mail Website
Guest Editor
1. Department of Neurosurgery, Azienda Ospedaliero Universitaria Pisana (AOUP), University of Pisa, 56100 Pisa, Italy
2. Department of Translational Research and of New Surgical and Medical Technologies, University of Pisa, 56100 Pisa, Italy
Interests: neuro-oncology; spinal AVM; spinal tumor; neurovascular surgery; intraoperative fluorescence in neurosurgery; cerebral blood flow monitoring; experimental micro-neurosurgery

Special Issue Information

Dear Colleagues,

Spine surgery and neuroscience are continuously evolving fields; this has been evident especially in the last few years. New and old techniques have been improved to provide less invasive and more effective surgical treatments, through the use of robotic surgical planning, new intraoperative imaging and operating room equipment. Furthermore, spine-related neuroscience is becoming increasingly popular, with a growing number of papers reporting neuroplasticity and regeneration after spinal cord injury, neurostimulation for spinal lesions, pain neuromodulation, disc regeneration and the use of stem cells.

This Special Issue aims to discuss research and insights from experts in the field to explore the latest trends, challenges and innovations in spine surgery and the field of neuroscience. We welcome original research articles and reviews that address, though are not limited to, the following topics: minimally invasive techniques and innovations in surgical approaches; neuroplasticity and regeneration after spinal cord injury; pain neuromodulation; disc regeneration; stem cell-based therapies for spinal cord injury; the use of robotic systems in spine surgery; regenerative medicine in spinal disorders; the surgical treatment of spinal vascular malformations and tumors; strategies for optimizing patient recovery and reducing hospital stays; telehealth in spine care; the potential of artificial intelligence in enhancing surgical decision-making and patient management; and the role of endoscopy in spine surgery.

Dr. Nicola Montemurro
Prof. Dr. Francesco Acerbi
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • minimally invasive techniques
  • telehealth
  • spinal vascular malformation
  • spinal tumor
  • 3D printing
  • surgical planning
  • artificial intelligence
  • endoscopy in spine surgery

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (3 papers)

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Research

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11 pages, 3146 KiB  
Article
Kyphoplasty as a Treatment Option for Traumatic Burst Fractures: A Case Series Evaluating Patient Outcomes and Functional Benefits
by Anoop S. Chinthala, Barnabas Obeng-Gyasi, Trenton A. Line, Matthew K. Tobin, Gordon Mao and Bradley N. Bohnstedt
Brain Sci. 2025, 15(6), 659; https://doi.org/10.3390/brainsci15060659 - 19 Jun 2025
Viewed by 492
Abstract
Background/Objectives: Kyphoplasty and vertebroplasty are minimally invasive approaches for spinal fractures aiming to reduce pain, increase mobilization, and prevent further vertebral height loss. Their efficacy in treating burst fractures has been questioned due to fragment mobility and concerns for cement leakage. We aim [...] Read more.
Background/Objectives: Kyphoplasty and vertebroplasty are minimally invasive approaches for spinal fractures aiming to reduce pain, increase mobilization, and prevent further vertebral height loss. Their efficacy in treating burst fractures has been questioned due to fragment mobility and concerns for cement leakage. We aim to report outcomes in patients who underwent kyphoplasty for spinal burst fractures. Methods: We conducted a retrospective review of patients with burst fractures treated from 2018 to 2023. Those who underwent kyphoplasty or vertebroplasty and had follow-up imaging were included. Clinical characteristics and follow-up outcomes were obtained through chart review. The primary outcome was the need for surgical intervention after kyphoplasty. Results: We identified ten patients (mean age 67.9 years, range 36–93 years) with burst fractures who underwent kyphoplasty/vertebroplasty. Six received kyphoplasty/vertebroplasty within 1 week of injury and four between 1 and 4 months post-injury. Nine patients had a TLICS score of 2, and one had a TLICS score of 5. Kyphoplasty/vertebroplasty was performed for pain management in seven patients and significant/worsening vertebral height loss in three patients. At follow-up, 70% of patients reported an improvement in pain and 75% of patients reported improved mobility. One patient experienced progression of an L2 burst fracture but improved with conservative management. No patient required additional surgical fixation. Conclusions: In this series of ten patients with spinal burst fractures, standalone kyphoplasty was a safe and effective treatment. Our findings suggest kyphoplasty may be a viable treatment option for select spinal traumatic burst fractures, offering potential pain relief and mobility improvement in the short term. Full article
(This article belongs to the Special Issue Contemporary Spinal Surgery: Surgical Optimization and Technological Innovation)
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Review

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14 pages, 1037 KiB  
Review
Spinoplastic Surgery: A Review of Techniques, Indications, and Optimal Patient Selection
by Daniel Vernik, Camryn Payne, Krishna Sinha, Casey Martinez, Walter Nicholas Jungbauer, Jonathan L. Jeger, Michael Bohl, Alexander E. Ropper, Sebastian Winocour and Edward Reece
Brain Sci. 2025, 15(7), 705; https://doi.org/10.3390/brainsci15070705 - 30 Jun 2025
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Abstract
Background/Objectives: Spinoplastic surgery is an emerging multidisciplinary field developed to address and reduce the complication of pseudoarthrosis following complex spinal reconstructions. While the number of spinal fusion procedures continues to rise every year, fusion failure rates remain as high as 40%. Although pseudoarthrosis [...] Read more.
Background/Objectives: Spinoplastic surgery is an emerging multidisciplinary field developed to address and reduce the complication of pseudoarthrosis following complex spinal reconstructions. While the number of spinal fusion procedures continues to rise every year, fusion failure rates remain as high as 40%. Although pseudoarthrosis may not always manifest clinically, it remains a leading cause of persistent pain and need for subsequent revision surgeries. The multidisciplinary collaboration between spine and plastic surgeons in spinoplastic surgery has therefore emerged as a proactive strategy aimed at preventing complications, particularly in patients identified as high-risk for pseudoarthrosis. As the patient population expands and spinoplastic surgery continues to evolve, refining patient selection criteria becomes essential for achieving optimal surgical outcomes. This review aims to provide a comprehensive overview of recent advancements in spinoplastic surgery, highlighting current indications, surgical techniques, recent case reports, and strategies for identifying suitable candidates. Methods: We performed a narrative review of English language literature through April 2025. Spinoplastic case reports and case series published within the last 20 years were included in the review. Results: Indications for use of a spinoplastic approach clustered into prior fusion failure, extensive oncologic resection, severe spinal deformity, procedures requiring extensive spinal involvement, and/or patients at risk for impaired bone healing. Succesful radiographic union and improvement of symptoms were widely reported across all 9 case reports/series. Conclusions: Although evidence is presently limited, spinoplastic surgery appears to achieve high bone graft fusion rates with acceptable morbidity and functional improvement in a carefully selected group of high-risk spinal reconstruction patients. Still, larger prospective studies are warranted to refine patient selection and validate functional benefit. Full article
(This article belongs to the Special Issue Contemporary Spinal Surgery: Surgical Optimization and Technological Innovation)
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Other

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23 pages, 1135 KiB  
Systematic Review
Intraoperative Neurophysiological Monitoring in Contemporary Spinal Surgery: A Systematic Review of Clinical Outcomes and Cost-Effectiveness
by Luca Zanin, Laura Broglio, Pier Paolo Panciani, Riccardo Bergomi, Giorgia De Rosa, Luca Ricciardi, Giusy Guzzi, Alessandro Fiorindi, Carlo Brembilla, Francesco Restelli, Francesco Costa, Nicola Montemurro and Marco Maria Fontanella
Brain Sci. 2025, 15(7), 768; https://doi.org/10.3390/brainsci15070768 - 19 Jul 2025
Abstract
Background: Intraoperative neurophysiological monitoring (IONM) is increasingly used during spinal surgery to reduce the risk of neurological complications. This systematic review evaluates both the clinical outcomes and cost-effectiveness of IONM in contemporary spinal surgery. Methods: A comprehensive literature search was conducted to identify [...] Read more.
Background: Intraoperative neurophysiological monitoring (IONM) is increasingly used during spinal surgery to reduce the risk of neurological complications. This systematic review evaluates both the clinical outcomes and cost-effectiveness of IONM in contemporary spinal surgery. Methods: A comprehensive literature search was conducted to identify studies evaluating IONM in spinal surgery. Twenty-three studies were included: twenty-one reporting clinical outcomes and two focusing on economic analysis. Data on neurological deficits, monitoring accuracy, and cost-effectiveness were extracted and analyzed. Results: Analysis of the included studies showed that IONM reduced the risk of neurological deficits across various types of spinal surgery. The diagnostic accuracy varied by modality, with MEP showing the highest sensitivity (90.2%) and SSEP demonstrating high specificity (97.1%). The greatest benefit was observed in deformity surgery and spinal tumors. D-wave monitoring showed efficacy for intramedullary tumors. Economic analysis demonstrated that IONM is cost-effective when the neurological complication rate exceeds 0.3%, with potential savings of over USD 23,000 per case. Conclusions: IONM significantly improves neurological outcomes in spinal surgery and is cost-effective in most clinical scenarios, particularly in high-risk procedures. Multimodal monitoring approaches provide the most comprehensive neurological assessment. These findings support the routine use of IONM in contemporary spinal surgery, especially for complex cases. Full article
(This article belongs to the Special Issue Contemporary Spinal Surgery: Surgical Optimization and Technological Innovation)
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