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Updates on Lumbar Spine Surgery for Degenerative Diseases
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Updates on Lumbar Spine Surgery for Degenerative Diseases

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Orthopedics".

Deadline for manuscript submissions: 28 August 2025 | Viewed by 1805

Special Issue Editor

Dr. Se-Jun Park

E-Mail Website
Guest Editor
Department of Orthopedic Surgery, Samsung Medical Center, Seoul, Republic of Korea
Interests: spine tumor; spine deformity; degenerative disease; lumbar spine surgery

Special Issue Information

Dear Colleagues,

In the context of an aging society, a significant number of patients suffer from degenerative lumbar disorders, which comprise the largest category of spinal diseases. Over the years, lumbar spine surgery has evolved considerably, predominantly classified into decompressive and fusion surgeries. Decompressive surgery encompasses traditional techniques such as microscopic laminectomy, laminotomy, and discectomy. However, endoscopic surgery has recently gained increasing popularity among surgeons due to its minimally invasive nature, and its indications have expanded from disc herniation to stenosis. Similarly, fusion surgery has experienced significant advancements. Minimally invasive techniques, including TLIF, OLIF, and MI-ALIF, have been introduced, and developments in fusion biology have substantially impacted surgical outcomes. Additionally, the importance of sagittal alignment in lumbar spine surgery has been increasingly recognized, not only in long-segment fusion surgeries but also in short-segment fusion procedures. Achieving proper sagittal alignment is essential for optimizing surgical results. We invite submissions on a wide range of topics within lumbar spine surgery, from endoscopic procedures to deformity correction.

Dr. Se-Jun Park
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 100 words) can be sent to the Editorial Office for announcement on this website.

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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

  • degenerative disease
  • lumbar spine surgery
  • fusion
  • decompressive surgery
  • sagittal alignment
  • complications
  • outcomes

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Published Papers (3 papers)

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Research

14 pages, 609 KiB  
Article
Temporal Patterns of Risk Factors for Adjacent Segment Disease After Lumbar Fusion: 5 Years or More and up to 15 Years
by Jaewan Soh, Hae-Dong Jang, Jae Chul Lee, Taejong Jeong and Byung-Joon Shin
J. Clin. Med. 2025, 14(10), 3400; https://doi.org/10.3390/jcm14103400 - 13 May 2025
Viewed by 426
Abstract
Background/Objectives: There are many concerns regarding adjacent segment disease after lumbar spinal fusion. However, there are few studies that analyze risk factors by classifying adjacent segment disease (ASD) by onset. This study aimed to investigate related factors according to the period of [...] Read more.
Background/Objectives: There are many concerns regarding adjacent segment disease after lumbar spinal fusion. However, there are few studies that analyze risk factors by classifying adjacent segment disease (ASD) by onset. This study aimed to investigate related factors according to the period of occurrence of ASD in mid- to long-term follow-up patients after lumbar spinal fusion. Methods: We analyzed 139 patients who underwent ≤3-segment lumbar fusion for degenerative disease with a minimum 5-year follow-up from a consecutive series of 457 patients. Risk factors for adjacent segment disease (ASD) and early ASD (E-ASD, occurring ≤5 years) were evaluated, including patient factors (age, sex, BMI), preoperative factors (diagnosis, Pfirrmann grade), surgical factors (fusion method, number of segments), and radiological parameters (lumbar lordosis, fused segment angle, PI-LL mismatch). Multivariable Cox proportional hazards modelling and Kaplan–Meier survival analysis were performed to identify independent risk factors. Results: A total of 28 patients underwent revision surgery for ASD. Among them, 14 patients developed E-ASD. In the analysis of risk factors for ASD, the fusion method, and the postoperative PI-LL were statistically significant (p = 0.003, HR = 4.670, and p = 0.008, HR = 3.102, respectively). Regarding E-ASD, the fusion method was statistically significant (p = 0.038, HR = 5.444). The cumulative survival rate of ASD was 93.7% at 5 years and 76.4% at 10 years. Conclusions: ASD risk factors vary temporally after fusion surgery. Early ASD is primarily associated with the PLIF technique, while long-term risk relates to both the fusion method and sagittal alignment. Surgical planning should consider both the fusion technique and sagittal balance optimization to minimize ASD risk. Full article
(This article belongs to the Special Issue Updates on Lumbar Spine Surgery for Degenerative Diseases)
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10 pages, 573 KiB  
Article
Radiological Outcomes and Approach-Related Complications in Oblique Lateral Interbody Fusion at the Upper Lumbar Level
by Hee-Woong Chung, Han-Dong Lee, Myungsub Lee and Nam-Su Chung
J. Clin. Med. 2025, 14(10), 3333; https://doi.org/10.3390/jcm14103333 - 10 May 2025
Viewed by 328
Abstract
Background/Objectives: Despite recent advances in minimally invasive extrapleural lateral approaches, oblique lateral interbody fusion (OLIF) at the upper lumbar level is often difficult and limited to optimal reconstruction. We aimed to compare the radiological outcomes and approach-related complications of OLIF between the upper [...] Read more.
Background/Objectives: Despite recent advances in minimally invasive extrapleural lateral approaches, oblique lateral interbody fusion (OLIF) at the upper lumbar level is often difficult and limited to optimal reconstruction. We aimed to compare the radiological outcomes and approach-related complications of OLIF between the upper (L1–2 or L2–3) and lower (L3–4 or L4–5) levels. Methods: This study is a retrospective review of OLIF in the upper (n = 63) and lower (n = 60) lumbar level groups. Radiological parameters included the anterior/posterior disc height, coronal/sagittal disc angle, cage position, cage subsidence, and fusion rate at a postoperative 1-year follow-up. Approach-related complications including pleural/peritoneal lacerations, neurovascular injury, and other organ injuries were examined. Results: The baseline radiological parameters were similar between the two groups (all p > 0.05). At 1-year postoperatively, the anterior disc height (ADH) was significantly greater in the lower-level group (p = 0.031), while no significant differences were observed in the posterior disc height, coronal/sagittal disc angle, cage anterior position, or cage subsidence rate (all p > 0.05). The fusion rates were 97.9% and 95.0% at the upper and lower lumbar levels, respectively (p = 0.146). During OLIF at the upper lumbar level, chest tube insertion due to pleural laceration was observed in 11 (17.5%) cases. One case (1.2%) of segmental artery injury and two cases (3.2%) of pseudo-hernia were attributed to iliohypogastric nerve injury. Conclusions: Although the extrapleural approach in OLIF at the upper lumbar level is often limited, the radiological outcomes were comparable to those of OLIF at the lower lumbar level. Full article
(This article belongs to the Special Issue Updates on Lumbar Spine Surgery for Degenerative Diseases)
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13 pages, 6591 KiB  
Article
Anterior Versus Posterior Lumbar Interbody Fusion at L5-S1 in Hybrid Surgery for Adult Spinal Deformity: A Propensity Score Matching Analysis of Radiographic Results, Mechanical Complications, and Clinical Outcomes
by Se-Jun Park, Dong-Ho Kang, Jin-Sung Park, Minwook Kang, Chong-Suh Lee and Kyunghun Jung
J. Clin. Med. 2025, 14(5), 1431; https://doi.org/10.3390/jcm14051431 - 20 Feb 2025
Viewed by 777
Abstract
Objectives: The aim of this study was to compare the radiographic results, mechanical complications, and clinical outcomes between anterior and posterior lumbar interbody fusion at L5–S1 (ALIF51 and PLIF51 groups, respectively) using a matched cohort of patients undergoing long fusion for adult [...] Read more.
Objectives: The aim of this study was to compare the radiographic results, mechanical complications, and clinical outcomes between anterior and posterior lumbar interbody fusion at L5–S1 (ALIF51 and PLIF51 groups, respectively) using a matched cohort of patients undergoing long fusion for adult spinal deformity (ASD). Methods: Patients who underwent hybrid surgery of ≥5-level fusion to the pelvis with a minimum follow-up duration of 2 years were included. The baseline characteristics of the groups were controlled using a propensity score matching analysis. The radiographic results, mechanical complications such as proximal junctional kyphosis/failure and metal failure, and clinical outcomes were compared between the groups. Results: In total, 79 patients were assigned to each group with comparable baseline data, except for a higher frequency of anterior column realignment procedures in the PLIF51 group than in the ALIF51 group (49.4% vs. 31.6%). At the last follow-up, L5–S1 segmental lordosis (SL) was significantly greater in the ALIF51 group than in the PLIF51 group (12.1° vs. 7.3°, p < 0.001). The final C7–sagittal vertical axis (SVA) was significantly smaller in the ALIF51 group than in the PLIF51 group (25.4 mm vs. 35.5 mm, p = 0.032). However, other global sagittal parameters were comparable between the groups. The mechanical complication rates, including metal failure at L5–S1, and the final clinical outcomes were comparable between the groups. Conclusions: ALIF51 has modest advantages over PLIF51 in terms of better restoring L5–S1 SL and C7–SVA with avoiding more invasive procedures above the L5–S1 levels. Other sagittal parameters, mechanical complication rates, and clinical outcomes did not differ between the groups. Full article
(This article belongs to the Special Issue Updates on Lumbar Spine Surgery for Degenerative Diseases)
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