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New Perspectives in Lumbar Spine Surgery: Treatment and Management
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New Perspectives in Lumbar Spine Surgery: Treatment and Management

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

Deadline for manuscript submissions: 25 November 2025 | Viewed by 2991

Special Issue Editor

Dr. Giuseppe La Rocca

E-Mail Website
Guest Editor
1. Unit of Neurosurgery, Mater Olbia Hospital, 07026 Olbia, Italy
2. Institute of Neurosurgery, IRCCS Fondazione Policlinico Universitario Agostino Gemelli, Catholic University, 00168 Rome, Italy
Interests: degenerative spine; traumatic spine; spine tumor; spine surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

This Special Issue aims to present a comprehensive overview of the latest advancements in clinical practices related to lumbar and spine surgeries. “New Perspectives in Lumbar Spine Surgery: Treatment and Management” offers a fresh outlook on the clinical landscape of lumbar and spine surgical interventions. This Special Issue delves into innovative approaches, cutting-edge technologies, and evidence-based strategies aimed at enhancing patient outcomes and quality of life. From minimally invasive procedures to advanced imaging modalities, this collection of articles sheds light on the evolving field of lumbar and spine surgery, providing valuable insights for healthcare professionals and researchers alike.

Dr. Giuseppe La Rocca
Guest Editor

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Keywords

  • lumbar surgery
  • spine surgery
  • minimally invasive techniques
  • advanced imaging
  • surgical innovations
  • patient outcomes
  • evidence-based practices
  • postoperative care
  • rehabilitation strategies
  • surgical management

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Published Papers (3 papers)

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Research

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17 pages, 1855 KB  
Article
Long-Term Clinical Efficacy of the Disc-FX Procedure in Contained Disc Herniation: A 7-Year Follow-Up from a Single-Center Cohort Study
by Magdalena Rybaczek, Kacper Prokop, Karol Sawicki, Robert Rutkowski, Aleksander Lebejko, Grzegorz Perestret, Zenon Mariak, Paweł Grabala and Tomasz Łysoń
J. Clin. Med. 2025, 14(18), 6378; https://doi.org/10.3390/jcm14186378 - 10 Sep 2025
Viewed by 117
Abstract
Background: Contained lumbar disc herniation is a prevalent cause of chronic low back pain and functional impairment. The Disc-FX system, a minimally invasive, percutaneous technique integrating nucleotomy, nucleus ablation, and annuloplasty, offers a multimodal approach to managing early degenerative disc disease. Despite promising [...] Read more.
Background: Contained lumbar disc herniation is a prevalent cause of chronic low back pain and functional impairment. The Disc-FX system, a minimally invasive, percutaneous technique integrating nucleotomy, nucleus ablation, and annuloplasty, offers a multimodal approach to managing early degenerative disc disease. Despite promising short-term outcomes, evidence regarding long-term effectiveness remains limited. Methods: This single-center cohort study evaluated 197 patients (median age: 48 years; 56.85% female) who underwent the Disc-FX procedure between 2017 and 2024. Patients were followed for up to 84 months. Pain and disability were assessed using a Visual Analog Scale (VAS) and the Oswestry Disability Index (ODI), respectively, while satisfaction was measured by the MacNab criteria. Multivariable models, including cumulative link models and linear mixed-effects models, were used to identify predictors of outcomes. Results: The Disc-FX procedure resulted in significant and sustained improvements in pain and function. Mean VAS scores decreased from 7.79 preoperatively to 4.31 at 12 months and remained below baseline at 84 months (5.05). ODI scores improved from 15.43 preoperatively to 9.62 at 36 months, rising slightly to 12.75 at 84 months. Good or excellent outcomes were reported in 66.9% of patients according to MacNab criteria. Male sex (OR = 0.41), longer symptom duration (OR = 0.85), and presence of radicular symptoms (OR = 0.39) were significantly associated with less favorable outcomes. Reoperation occurred in 26.4% of cases, predominantly within the first year and most frequently at L4/L5. Complications were rare (3.08%). Conclusions: This study provides robust evidence supporting the long-term clinical efficacy of the Disc-FX procedure in selected patients with contained lumbar disc herniation. While overall outcomes are favorable, optimal results depend on early intervention and careful patient selection, particularly in relation to symptom chronicity and the presence of radicular signs. Full article
(This article belongs to the Special Issue New Perspectives in Lumbar Spine Surgery: Treatment and Management)
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Review

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14 pages, 2754 KB  
Review
A Comprehensive and Historical Review of Minimally Invasive Scoliosis Surgery in Adolescent Idiopathic Scoliosis: An Analysis of Research Trends and Hotspots
by Hong Jin Kim, Dong Yun Kim, Jae Hyuk Yang, Jungwook Lim and Seung Woo Suh
J. Clin. Med. 2025, 14(16), 5676; https://doi.org/10.3390/jcm14165676 - 11 Aug 2025
Viewed by 423
Abstract
Over the past two decades, interest in minimally invasive scoliosis surgery (MISS) for adolescent idiopathic scoliosis (AIS) has grown substantially, driven by advancements in growth-based surgical techniques. Given the substantial advancements in MISS for AIS, investigating the bibliometric data of the scientific literature [...] Read more.
Over the past two decades, interest in minimally invasive scoliosis surgery (MISS) for adolescent idiopathic scoliosis (AIS) has grown substantially, driven by advancements in growth-based surgical techniques. Given the substantial advancements in MISS for AIS, investigating the bibliometric data of the scientific literature is crucial to understanding the current research trend and providing valuable insights into its future directions. However, limited information on MISS for AIS exists in the literature. The publication data related to MISS for AIS from 2004 to 2024 were exported from the Web of Science. The research output between 2004 and 2024 was 373 for publication volume, 7760 for citations, and 46 for h-index. The annual publication and citation trend over time showed a gradual increase with fluctuations up until 2017, followed by a sharp upward trend starting in 2018. The foremost countries and affiliations in this field were the United States and Montreal University in Canada, respectively. The top 10 most-cited articles on MISS in AIS predominantly focused on the topic of vertebral body tethering (VBT). Among the productive authors, most contributions were focused on VBT, while several authors in South Korea significantly contributed to the study of MISS via a posterior approach. Historical development of VBT and posterior MISS identified their current advantages and limitations and highlighted potential future research directions. Full article
(This article belongs to the Special Issue New Perspectives in Lumbar Spine Surgery: Treatment and Management)
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Other

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22 pages, 589 KB  
Systematic Review
Current Trends and Future Directions in Lumbar Spine Surgery: A Review of Emerging Techniques and Evolving Management Paradigms
by Gianluca Galieri, Vittorio Orlando, Roberto Altieri, Manlio Barbarisi, Alessandro Olivi, Giovanni Sabatino and Giuseppe La Rocca
J. Clin. Med. 2025, 14(10), 3390; https://doi.org/10.3390/jcm14103390 - 13 May 2025
Cited by 1 | Viewed by 2086
Abstract
Background/Objectives: Lumbar spine surgery has undergone significant technological transformation in recent years, driven by the goals of minimizing invasiveness, improving precision, and enhancing clinical outcomes. Emerging tools—including robotics, augmented reality, computer-assisted navigation, and artificial intelligence—have complemented the evolution of minimally invasive surgical [...] Read more.
Background/Objectives: Lumbar spine surgery has undergone significant technological transformation in recent years, driven by the goals of minimizing invasiveness, improving precision, and enhancing clinical outcomes. Emerging tools—including robotics, augmented reality, computer-assisted navigation, and artificial intelligence—have complemented the evolution of minimally invasive surgical (MIS) approaches, such as endoscopic and lateral interbody fusions. Methods: This systematic review evaluates the literature from February 2020 to February 2025 on technological and procedural innovations in LSS. Eligible studies focused on degenerative lumbar pathologies, advanced surgical technologies, and reported clinical or perioperative outcomes. Randomized controlled trials, comparative studies, meta-analyses, and large case series were included. Results: A total of 32 studies met the inclusion criteria. Robotic-assisted surgery demonstrated high accuracy in pedicle screw placement (~92–94%) and reduced intraoperative blood loss and radiation exposure, although long-term clinical outcomes were comparable to conventional techniques. Intraoperative navigation improved instrumentation precision, while AR enhanced ergonomic workflow and reduced surgeon distraction. AI tools showed promise in surgical planning, guidance, and outcome prediction but lacked definitive evidence of clinical superiority. MIS techniques—including endoscopic discectomy and MIS-TLIF—offered reduced blood loss, shorter hospital stays, and faster recovery, with equivalent pain relief, fusion rates, and complication profiles compared to open procedures. Lateral and oblique approaches (XLIF/OLIF) further optimized alignment and indirect decompression, with favorable perioperative metrics. Conclusions: Recent innovations in lumbar spine surgery have enhanced technical precision and perioperative efficiency without compromising patient outcomes. While short-term benefits are clear, long-term clinical advantages and cost-effectiveness require further investigation. Integration of robotics, navigation, AI, and MIS into spine surgery reflects an ongoing shift toward personalized, data-driven, and less invasive care. Full article
(This article belongs to the Special Issue New Perspectives in Lumbar Spine Surgery: Treatment and Management)
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