Diagnosis and Management of Spinal Diseases

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Clinical Diagnosis and Prognosis".

Deadline for manuscript submissions: 31 August 2025 | Viewed by 857

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Department of Orthopaedic Surgery, Far Eastern Memorial Hospital, New Taipei City, Taiwan
Interests: endoscopic spine surgery; minimally invasive spine surgery; orthopedic surgery; osteoporosis surgical treatment
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Special Issue Information

Dear Colleagues,

This Special Issue is devoted to the sophisticated and dynamic field of the “Diagnosis and Management of Spinal Diseases”, with a particular emphasis on the revolutionary roles of endoscopy, artificial intelligence (AI), and advanced radiological techniques. It highlights the latest advancements in diagnostic methodologies, including high-resolution endoscopy for the direct visualization of spinal structures, AI-driven algorithms for enhanced image analysis, and state-of-the-art radiological techniques such as MRI, CT scans, and advanced X-rays. These innovations are pivotal in identifying spinal conditions with unprecedented accuracy and precision. Furthermore, this Special Issue explores therapeutic management strategies, encompassing both surgical and nonsurgical approaches, tailored to individual patient needs based on these enhanced diagnostic capabilities. By integrating these cutting-edge diagnostic tools with evidence-based therapeutic interventions, this Special Issue aims to transform the landscape of spinal care, ultimately leading to more effective treatments and improved patient outcomes. It serves as an invaluable resource for healthcare professionals dedicated to pushing the boundaries of spinal diagnosis and management.

Dr. Jwo-Luen Pao
Guest Editor

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Keywords

  • spinal diseases
  • spinal conditions
  • endoscopy
  • artificial intelligence (AI)
  • radiological techniques
  • MRI
  • CT scans
  • X-rays
  • management

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Published Papers (2 papers)

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Research

16 pages, 1668 KiB  
Article
A Comparative Evaluation of Surgical Techniques Applied in Lumbar Synovial Cysts in Accordance with the Literature
by Mustafa Emre Sarac and Zeki Boga
Diagnostics 2025, 15(14), 1767; https://doi.org/10.3390/diagnostics15141767 - 13 Jul 2025
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Abstract
Background/Objectives: The aim of this study was to compare the clinical outcomes of cyst excision alone and the combination of excision and unilateral dynamic instrumentation in the surgical treatment of lumbar synovial cysts at the L4–L5 level and to determine which surgical approach [...] Read more.
Background/Objectives: The aim of this study was to compare the clinical outcomes of cyst excision alone and the combination of excision and unilateral dynamic instrumentation in the surgical treatment of lumbar synovial cysts at the L4–L5 level and to determine which surgical approach is more effective. Methods: Thirty-three patients who underwent operations on the L4–L5-level synovial cyst in a single center between January 2015 and January 2021 were included in this retrospective study. Patients were divided into two groups: cyst excision only (n = 18) and excision with unilateral dynamic instrumentation (n = 15). The pain levels of the patients were assessed by VAS score, and their functional status was assessed by the Oswestry Disability Index. The mean follow-up period was 28.2 ± 4.0 months in the excision group and 27.6 ± 4.4 months in the instrumentation group. Results: VAS and ODI scores improved significantly in both groups (p < 0.001). The improvement in low back pain VAS scores was more significant in the instrumentation group (delta VAS: −5.8 ± 1.3 vs. −5.0 ± 1.2, p = 0.042). The complication rate was 27.8% in the excision group and 13.3% in the instrumentation group. The development of listhesis was significantly more frequent in the excision group (16.7% vs. 0%, p = 0.028). Reoperation rates were 16.7% in the excision group and 6.7% in the instrumentation group. Conclusion: Although both surgical approaches are effective in the treatment of synovial cysts at the L4–L5 level, the addition of dynamic instrumentation unilaterally seems to be more advantageous, especially in the control of low back pain and prevention of listhesis risk. The choice of surgical technique should be individualized by considering patient-specific factors. Full article
(This article belongs to the Special Issue Diagnosis and Management of Spinal Diseases)
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13 pages, 5832 KiB  
Article
Implant Migration and Clinical Outcomes in Pediatric Symptomatic Flexible Flatfoot Treated with Subtalar Arthroereisis: A Cohort Study with Long-Term Follow-Up Results
by Yu-Po Huang, Nian-Jhen Wu, Shou-En Cheng, Shang-Ming Lin and Tsung-Yu Lan
Diagnostics 2025, 15(14), 1761; https://doi.org/10.3390/diagnostics15141761 - 11 Jul 2025
Viewed by 343
Abstract
Background/Objectives: Subtalar arthroereisis (STA) is a widely used surgical procedure for symptomatic pediatric flexible flatfoot. However, implant migration remains a concern due to its potential impact on long-term correction and complications. This study evaluated the migration pattern of STA implants and assessed [...] Read more.
Background/Objectives: Subtalar arthroereisis (STA) is a widely used surgical procedure for symptomatic pediatric flexible flatfoot. However, implant migration remains a concern due to its potential impact on long-term correction and complications. This study evaluated the migration pattern of STA implants and assessed long-term clinical and radiographic outcomes. Methods: This retrospective cohort study included 47 feet from children aged 8–13 years who underwent STA with adjunctive soft tissue procedures between 2014 and 2018, following ≥6 months of failed conservative treatment, with a minimum follow-up of 5 years. Exclusion criteria included neuromuscular or rigid flatfoot. Weight-bearing radiographs assessed anteroposterior (AP) and lateral Meary’s angles, reflecting forefoot-to-hindfoot alignment, and calcaneal pitch, indicative of longitudinal arch height. Implant migration was recorded and clinical outcomes were measured by the American Orthopedic Foot and Ankle Society (AOFAS) score. Measurements were recorded preoperatively, immediately postoperatively, and at 1 month, 3 months, 6 months, 1 year, and 5 years. Results: Radiographic correction was significant and sustained at 5 years. The AP Meary’s angle improved from 13.09° to 5.26° at 1 month and 6.69° at 5 years (p < 0.001); lateral Meary’s angle from 9.77° to 4.06° and 4.88° (p < 0.001); and calcaneal pitch from 14.52° to 16.87° and 16.89° (p < 0.001), respectively. AOFAS scores increased from 67.52 to 90.86 at 1 month and 96.33 at 5 years (p < 0.001). Implant migration peaked within the first postoperative month (mean: 3.2 mm on ankle AP view; 3.0 mm on foot AP view) and stabilized thereafter. Four cases of complications included implant dislodgement, subsidence, and persistent sinus tarsi tenderness, which were successfully resolved after appropriate management. No recurrence of deformity was observed. Conclusions: STA implant migration is most pronounced during the first month, likely due to physiological settling as the foot adapts to altered biomechanics. With appropriate implant selection, technique, and follow-up, migration does not compromise long-term correction or outcomes. In general, symptomatic cases can often be managed conservatively prior to implant removal. Full article
(This article belongs to the Special Issue Diagnosis and Management of Spinal Diseases)
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