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Diagnostics
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Contemporary Spine Diagnostics and Management
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Contemporary Spine Diagnostics and Management

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

Deadline for manuscript submissions: 30 June 2026 | Viewed by 3342

Special Issue Editor

Dr. Gun Choi

E-Mail Website
Guest Editor
Department of Spine Surgery, Pohang Woori Hospital, Pohang, Republic of Korea
Interests: degenerative spinal disease; AI in spine care; endoscopic spine surgery; minimally invasive

Special Issue Information

Dear Colleagues,

This Special Issue, entitled “Contemporary Spine Diagnostics and Management”, seeks to advance the field of spine care by integrating cutting-edge technologies and approaches that enhance diagnostic accuracy and therapeutic outcomes. We invite the submission of original research, reviews, and translational studies focused on early detection, risk stratification, and personalized treatment strategies for spinal disorders. Key areas of interest include innovative imaging techniques, AI-assisted diagnostics, molecular biomarkers, functional and biomechanical assessment tools, and minimally invasive, image-guided interventions. This Special Issue also emphasizes perioperative risk prediction, outcome modeling, rehabilitation, long-term monitoring, and telemedicine. We especially encourage contributions that explore diagnostic workflows, multidisciplinary care pathways, cost-effectiveness, and implementation strategies bridging research with clinical practice.

Dr. Gun Choi
Guest Editor

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 250 words) can be sent to the Editorial Office for assessment.

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. Diagnostics is an international peer-reviewed open access semimonthly 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 2600 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

  • spine diagnostics
  • spine management
  • AI-assisted diagnostics
  • minimally invasive interventions
  • molecular biomarkers
  • imaging techniques
  • telemedicine
  • multidisciplinary care

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Published Papers (3 papers)

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Research

Jump to: Review

13 pages, 1798 KB  
Article
L5–S1 Anatomic Features Relevant to Minimally Invasive Decompression and Fusion: A Cadaveric and Imaging-Based Study
by Miguel Relvas-Silva, André Rodrigues Pinho, Vitorino Veludo, Daniel Medina-Dias, António Pereira Rodrigues, Hélio Alves, Maria Dulce Madeira and Pedro Alberto Pereira
Diagnostics 2026, 16(4), 610; https://doi.org/10.3390/diagnostics16040610 - 19 Feb 2026
Viewed by 699
Abstract
Background/Objectives: The L5–S1 segment presents unique characteristics that make surgical access challenging in minimally invasive spine surgery (MISS) procedures. Variability in bony and neural anatomy may restrict transforaminal and extraforaminal approaches, yet few studies have combined cadaveric dissection with radiologic analysis to [...] Read more.
Background/Objectives: The L5–S1 segment presents unique characteristics that make surgical access challenging in minimally invasive spine surgery (MISS) procedures. Variability in bony and neural anatomy may restrict transforaminal and extraforaminal approaches, yet few studies have combined cadaveric dissection with radiologic analysis to define relevant morphology in L5–S1 approaches. The purpose of the study is to characterize anatomical and radiological features of the lumbosacral region relevant to MISS planning and execution. Methods: Twelve Thiel-embalmed donor bodies underwent CT imaging (lumbopelvic region) followed by posterior dissection. Bony landmarks were used to obtain bilateral anatomical measurements. Qualitative anatomical analysis included iliolumbar ligament morphology and extraforaminal access feasibility. CT-based morphometrics included L5 transverse process (TP) length; maximal and minimal distances between L5 TP and sacral ala; extraforaminal area bounded by L5 TP, L5–S1 facet (zygapophyseal) joint, and sacral ala; iliac crest-based approach angle to the L5–S1 intervertebral disc (IVD); minimal distance between this approach vector and the ventral ramus of the fifth lumbar spinal nerve (VRL5); facet angulation; and iliac crest height. Results: No left–right asymmetry was detected. Except for L5 TP length, all anatomical measurements obtained directly in the donor bodies differed significantly between sexes. A direct IVD access with a uniportal endoscopic working tube was feasible in 25% of cases. On CT analysis, the maximal and minimal distances between the L5 TP and sacral ala were 11.1 (4.0) mm and 5.6 ± 2.9 mm, with a mean extraforaminal area of 202.0 ± 45.9 mm2. The mean approach angle was 35.2 ± 5.0°, and an extraforaminal corridor to L5–S1 IVD was feasible in 75% of donated bodies. The median minimal distance between the approach vector and the VRL5 was 5.0 (7.1) mm, with frequent overlap. Conclusions: The results of this study reveal that the L5–S1 segment shows substantial interindividual morphologic variability, compromising the feasibility of transforaminal and extraforaminal MISS approaches, and highlight the need for individualized preoperative planning, neural identification and/or bony resection to create a safe working corridor. Full article
(This article belongs to the Special Issue Contemporary Spine Diagnostics and Management)
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14 pages, 3014 KB  
Article
Multicenter, Multinational, and Multivendor Validation of an Artificial Intelligence Application for Acute Cervical Spine Fracture Detection on CT
by Jinkyeong Sung, Peter D. Chang, Angela Ayobi, Martina Cotena, Mar Roca-Sogorb, Jinhee Jang, Daniel S. Chow and Yasmina Chaibi
Diagnostics 2026, 16(2), 194; https://doi.org/10.3390/diagnostics16020194 - 7 Jan 2026
Viewed by 835
Abstract
Background/Objectives: While previous studies have evaluated AI algorithms for cervical spine fracture (CSFx) detection on CT, many have lacked validation on diverse, multinational datasets or have focused primarily on overall case-level classification This study aimed to evaluate the performance of an AI application [...] Read more.
Background/Objectives: While previous studies have evaluated AI algorithms for cervical spine fracture (CSFx) detection on CT, many have lacked validation on diverse, multinational datasets or have focused primarily on overall case-level classification This study aimed to evaluate the performance of an AI application for acute CSFx detection in case-level classification, fracture localization, and spinal level labeling on multicenter, multinational, and multivendor CT data. Methods: Non-enhanced CTs were retrospectively collected from a U.S. teleradiology company, a French teleradiology company, and a U.S. university hospital. Four radiologists independently labeled the presence and location (including the spinal level) of acute CSFx to establish the reference standard. Per-case diagnostic performance, per-bounding box positive predictive value (PPV) for localization, and overall agreement of cervical vertebral level labeling of the AI were assessed. Results: A total of 155 patients (60.6 years ± 21.2 years, 104 men) with acute CSFx and 173 patients (51.9 years ± 22.7 years, 91 men) without acute CSFx were evaluated. Data were acquired using scanners from five manufacturers. For acute CSFx diagnosis, the AI achieved a per-case sensitivity of 90.3%, a specificity of 91.9%, an accuracy of 91.2%, an area under the receiver operating characteristic curve (AUC) of 0.91, and Matthews correlation coefficient of 0.82. Among 192 bounding boxes representing acute CSFx generated for 154 positive cases by the AI, 162 were true positives (per-bounding box PPV, 84.4%). Of the 186 bounding boxes for which the AI displayed cervical spinal level, 181 were labeled correctly (overall agreement, 97.3%). Conclusions: The AI application for detecting acute CSFx demonstrated high diagnostic performance on multicenter, multinational, and multivendor data, with high performance in fracture localization and spinal level labeling. Full article
(This article belongs to the Special Issue Contemporary Spine Diagnostics and Management)
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Review

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24 pages, 2134 KB  
Review
CT Evaluation of Lumbar Interbody Fusion: A Comprehensive Review with an Integrated Framework for Principle-Based Interpretation
by Szu-Hsiang Peng and Jwo-Luen Pao
Diagnostics 2026, 16(1), 140; https://doi.org/10.3390/diagnostics16010140 - 1 Jan 2026
Cited by 1 | Viewed by 1501
Abstract
Background/Objectives: Computed tomography remains the reference standard for assessing lumbar interbody fusion, yet significant methodological heterogeneity, documented across more than 250 different assessment combinations, directly impacts treatment decisions and outcome reporting. The main challenge is applying uniform criteria to technique-specific anatomical configurations that [...] Read more.
Background/Objectives: Computed tomography remains the reference standard for assessing lumbar interbody fusion, yet significant methodological heterogeneity, documented across more than 250 different assessment combinations, directly impacts treatment decisions and outcome reporting. The main challenge is applying uniform criteria to technique-specific anatomical configurations that generate distinct bridging patterns. Methods: This narrative review synthesizes evidence from 2000 to 2025 through PubMed and Google Scholar searches, examining imaging protocols, radiographic criteria validated against surgical exploration and reliability studies, and classification systems with emphasis on clinical application. Results: Modern protocols that incorporate iterative metal artifact reduction and dual-energy imaging substantially improve visualization of the hardware–bone interface. Zone-based evaluation shows that bridging patterns primarily reflect cage configuration and graft placement strategy rather than the surgical approach alone—a key distinction that affects assessment methodology. Validation studies confirm higher inter-observer reliability for extracage zones (ICC 0.79–0.84) compared to intracage regions (ICC 0.70–0.79). Evidence supports three main bridging patterns: graft-dependent consolidation, ungrafted-zone bridging, and accessibility-dependent variation. Assessment at 12 months captures most successful fusions, although 15–16% show delayed progress and require longer follow-up. Conclusions: This review synthesizes current evidence on technical optimization and temporal healing patterns, proposing a principle-based interpretive framework that accommodates technique-specific differences instead of strict categorical criteria. This framework allows personalized assessment correlated with surgical documentation, addressing the documented heterogeneity while enhancing diagnostic consistency. Full article
(This article belongs to the Special Issue Contemporary Spine Diagnostics and Management)
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