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Complex Spine Surgery: The Road from Childhood to Adults and...
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Complex Spine Surgery: The Road from Childhood to Adults and Future Directions

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

Deadline for manuscript submissions: closed (31 October 2025) | Viewed by 1745

Special Issue Editors

Prof. Dr. Jacob M. Buchowski

E-Mail Website
Guest Editor
Department of Orthopedic Surgery, Washington University School of Medicine, 660 S Euclid Ave., St. Louis, MO 63110, USA
Interests: surgical treatment of degenerative conditions of the cervical and lumbar spine; disc herniations; spinal stenosis
Dr. Pawel Grabala

E-Mail Website
Guest Editor
1. Department of Orthopaedics and Paediatric Orthopaedics, Central Teaching Hospital of the Medical University of Lodz, 92-213 Lodz, Poland
2. Department of Neurosurgery, University of Bialystok Clinical Hospital, 15-276 Bialystok, Poland
Interests: scoliosis and other spinal conditions; vertebral fractures; early onset scoliosis; congenital scoliosis; neglected and severe spinal deformity in children and adolescents; complex spine surgery
Special Issues, Collections and Topics in MDPI journals
Dr. Michael A. Galgano

E-Mail Website
Guest Editor
Department of Neurosurgery, University of North Carolina, Chapel Hill, NC 27516, USA
Interests: complex spine surgery; spinal oncology; spinal deformity

Special Issue Information

Dear Colleagues,

Over the last ten years, spinal surgery has witnessed numerous technological advancements and innovations, leading to shifts in treatment approaches across various specialties. The objectives of this Special Issue are to provide readers with a comprehensive summary of novel technologies for the treatment of complex spine disorders, conduct a critical evaluation of their efficacy and utility, and clarify the current level of scientific evidence pertaining to these areas, from childhood to adults with future directions. We would like to focus on methods of comprehensive treatment of spinal deformities, at any age and with different etiologies, and to show the results of such treatment during the observation period.

Special focus will be placed on recent advances in spinal tumor surgery, i.e., surgical treatment of spinal deformities any age, using both commonly proven and innovative surgical techniques; surgical management of severe and neglected spinal deformities using traction techniques and three-column osteotomies; the treatment of metastatic spine disease with or without spinal cord compression and the treatment of malignant primary bone tumors; the prevention and surgical treatment of adjacent segment disease and proximal junctional kyphosis; the restoration of sagittal balance; emerging technologies and their implications; and minimally invasive surgery (MIS) and treatment of the aging spine with fast-track surgery and prehabilitation.

Prof. Dr. Jacob M. Buchowski
Dr. Pawel Grabala
Dr. Michael A. Galgano
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 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. Journal of Clinical Medicine 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

  • complex spine
  • scoliosis
  • kyphosis
  • spinal deformities
  • spinal tumor
  • spinal reconstruction
  • sagittal balance
  • coronal imbalance

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Published Papers (1 paper)

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Review

44 pages, 552 KB  
Review
Modulation of Surgical Site Infection Risk in Spinal and Thoracic Surgeries Through Operative Parameters: A Narrative Review
by Joanna Suszczyńska, Michał Grabala and Paweł Grabala
J. Clin. Med. 2025, 14(22), 8124; https://doi.org/10.3390/jcm14228124 - 17 Nov 2025
Viewed by 1204
Abstract
Background: Surgical site infections (SSIs) following spinal and thoracic procedures are associated with prolonged hospitalization and increased morbidity, with incidence rates of 2–15% in spinal surgery and 3–12% in thoracic procedures. Multiple patient-related and procedure-specific factors contribute to wound complications, including diabetes mellitus, [...] Read more.
Background: Surgical site infections (SSIs) following spinal and thoracic procedures are associated with prolonged hospitalization and increased morbidity, with incidence rates of 2–15% in spinal surgery and 3–12% in thoracic procedures. Multiple patient-related and procedure-specific factors contribute to wound complications, including diabetes mellitus, obesity, smoking, extended surgical time, excessive tissue dissection, and hardware implantation. Implementing evidence-based prevention and early intervention strategies is essential in high-risk surgical cohorts. Methods: This narrative review followed searches in PubMed, Scopus, ScienceDirect, Cochrane Library, and Embase for studies published between January 2000 and October 2025. Eligible peer-reviewed articles examined SSI incidence, risk factors, or prevention strategies in adult patients undergoing thoracic or spinal surgery. Data extraction focused on operative parameters, antibiotic prophylaxis regimens, negative-pressure wound therapy (NPWT) use, and patient outcomes. Results: Evidence from found recent studies was synthesized. Key findings demonstrated that operative duration > 4 h increased SSI odds by 41% per additional hour, and blood loss > 500 mL doubled infection risk. Prophylactic NPWT reduced deep SSI rates by 50% in high-risk patients (BMI ≥ 35, diabetes, multilevel instrumentation). Intrawound vancomycin powder reduced deep SSIs by 50–60%, particularly in multilevel fusions. Administering prophylactic antibiotics within 30 min of incision was significantly more effective than at 60 min, with a 23% relative risk reduction. Weight-adjusted antibiotic dosing in obese patients lowered SSI rates from 5.1% to 2.9%. Conclusions: Operative parameters strongly predict SSI risk. An integrated risk- and evidence-based approach to wound management following spinal and thoracic surgeries—combining optimized antibiotic prophylaxis, risk-stratified NPWT application, and operative technique modifications—can significantly reduce SSI incidence. Successful implementation requires institutional commitment, multidisciplinary collaboration, and continuous quality improvement to optimize patient outcomes. Full article
(This article belongs to the Special Issue Complex Spine Surgery: The Road from Childhood to Adults and Future Directions)
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