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Cutting Edge of Minimally Invasive Spine Surgery
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Cutting Edge of Minimally Invasive Spine Surgery

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

Deadline for manuscript submissions: closed (28 February 2025) | Viewed by 4031

Special Issue Editor

Prof. Dr. Yoshihisa Kotani

E-Mail Website
Guest Editor
Department of Orthopedic Surgery, Kansai Medical University Medical Center, Osaka 570-8507, Japan
Interests: spine surgery; minimally invasive surgery; spinal deformity; anterior spine fusion
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The recent advancements in minimally invasive spinal surgery have been remarkable, benefiting many patients. As reported by numerous past clinical studies, the contributions of minimally invasive spinal surgery include reduced blood loss, shortened surgical times, and decreased damage to spinal soft tissues, leading to a reduction in residual pain. Minimally invasive spinal surgery encompasses a wide range of conditions, from spinal deformities to lumbar degenerative diseases, infections, and pseudarthrosis, with novel techniques being introduced across anterior, lateral, and posterior approaches.

The coupling of enabling technologies such as spinal endoscopy, spinal navigation, and robotics with surgical procedures has significantly contributed to reducing complications and improving surgical precision. This Special Issue aims to provide the latest information on minimally invasive spinal surgery techniques, enabling technologies, and novel spinal materials spanning the entire spine.

Prof. Dr. Yoshihisa Kotani
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.

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

  • spine surgery
  • minimally invasive surgery
  • spinal deformity
  • spine fusion
  • enabling technology
  • spinal navigation
  • robotic surgery
  • spine materials
  • spinal endoscopy

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Published Papers (4 papers)

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15 pages, 5003 KiB  
Article
Analysis of Risk Factors for Augmented Vertebral Refracture After Percutaneous Kyphoplasty in Osteoporotic Vertebral Compression Fractures
by Yonghao Wu, Shuaiqi Zhu, Yuqiao Li, Chenfei Zhang, Weiwei Xia, Zhenqi Zhu and Kaifeng Wang
J. Clin. Med. 2025, 14(2), 329; https://doi.org/10.3390/jcm14020329 - 8 Jan 2025
Cited by 1 | Viewed by 852
Abstract
Objectives: The aim of this study was to investigate the incidence of vertebral refractures following percutaneous kyphoplasty (PKP) and to explore risk factors for augmented vertebral refractures, thereby assisting spinal surgeons in clinical practice. Methods: We analyzed the records of 495 [...] Read more.
Objectives: The aim of this study was to investigate the incidence of vertebral refractures following percutaneous kyphoplasty (PKP) and to explore risk factors for augmented vertebral refractures, thereby assisting spinal surgeons in clinical practice. Methods: We analyzed the records of 495 patients with single-segment osteoporotic vertebral compression fractures (OVCFs) who were treated with single-entry PKP at our institution from March 2016 to August 2022. Univariate analysis, binary logistic regression, and ROC curve analysis were performed to determine potential risk factors, independent risk factors, and discrimination ability. Results: A total of 168 patients were included in the study, with a median follow-up duration of 7.00 months. In total, 143 patients did not experience vertebral refracture after surgery, while 25 patients did, including 22 augmented vertebral fractures and 3 adjacent vertebral compression refractures. The correction rate of the Cobb angle (p < 0.001; OR = 1.070) and postoperative anti-osteoporosis treatment (p = 0.002; OR = 0.021) were independently associated with augmented vertebral refracture. The ROC curves showed that these variables demonstrated satisfactory predictive values for augmented vertebral refracture. Conclusions: A high degree of restoration of the Cobb angle was the factor contributing to vertebral refracture after PKP. Conversely, postoperative anti-osteoporosis treatment was observed to be a protective factor against subsequent vertebral refracture. Full article
(This article belongs to the Special Issue Cutting Edge of Minimally Invasive Spine Surgery)
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12 pages, 4262 KiB  
Article
Risk Factor Analysis of Mechanical Complications in Surgical Treatment of Thoracolumbar Deformity with Osteoporotic Vertebral Fracture
by Yoshihisa Kotani, Takahiro Tanaka, Atsushi Ikeura and Takanori Saito
J. Clin. Med. 2024, 13(24), 7618; https://doi.org/10.3390/jcm13247618 - 13 Dec 2024
Viewed by 606
Abstract
Objective: Adult spinal deformity (ASD) with osteoporotic vertebral fractures (OVF) often requires vertebral body resection and replacement. However, postoperative mechanical complications (MC) have been unsolved issues. This study retrospectively investigated the risk of MC following anterior-posterior spinal fusion (APF) with vertebral body resection [...] Read more.
Objective: Adult spinal deformity (ASD) with osteoporotic vertebral fractures (OVF) often requires vertebral body resection and replacement. However, postoperative mechanical complications (MC) have been unsolved issues. This study retrospectively investigated the risk of MC following anterior-posterior spinal fusion (APF) with vertebral body resection and replacement for OVF with ASD. Methods: Among 91 cases undergoing APF with vertebral body resection and replacement, 43 cases met the deformity criteria. The mean age was 74.2 years, and the mean number of fused segments was 5.7. Pre and postoperative spinal alignments were measured, and the risk of MC occurrence, including PJK, DJK, and cage sinking, was determined through multivariate analysis. The AUC and cutoff values were calculated through ROC analysis. Results: The incidence of MC, PJK, and DJK were 28%, 12%, and 14%, respectively. Multivariate analysis for MC revealed postoperative PI-LL and operative time (cutoff: 40.5 degrees, 238 min) as significant risk factors, while postoperative PI-LL was a significant risk factor for PJK (cutoff: 42.4 degrees). Evaluation considering only thoracolumbar level showed postoperative local kyphosis as a significant MC risk factor (cutoff: 11 degrees). There was a positive correlation between operative time and preoperative local kyphosis, with a cutoff value of 238 min being equivalent to 21 degrees. Conclusion: The postoperative mismatch over 40 degrees and preoperative local kyphosis over 21 degrees were considered as a high risk for MCs. The postoperative kyphosis of 11 degrees was the risk factor of MC in the thoracolumbar level. The meticulous preoperative assessment, including local and global alignment, and local flexibility as well as detailed surgical planning of fixation range and the requirement of osteotomy, are crucial. Full article
(This article belongs to the Special Issue Cutting Edge of Minimally Invasive Spine Surgery)
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14 pages, 3298 KiB  
Article
Effects of Vacuum Phenomenon on Cage Subsidence and Fusion Outcomes in Oblique Lumbar Interbody Fusion: A Cohort Study
by Jae-Hyuk Yang, Kun-Joon Lee, Seung-Yup Lee, In-Hee Kim, Sang Yun Seok, Hansongi Suh and Hyung Rae Lee
J. Clin. Med. 2024, 13(23), 7036; https://doi.org/10.3390/jcm13237036 - 21 Nov 2024
Viewed by 904
Abstract
Background: Oblique lumbar interbody fusion (OLIF) is a minimally invasive technique used to manage degenerative lumbar conditions. The presence of vacuum phenomenon (VP) and associated endplate sclerosis may increase the risk of cage subsidence. This study evaluated the relationship between VP grade, [...] Read more.
Background: Oblique lumbar interbody fusion (OLIF) is a minimally invasive technique used to manage degenerative lumbar conditions. The presence of vacuum phenomenon (VP) and associated endplate sclerosis may increase the risk of cage subsidence. This study evaluated the relationship between VP grade, endplate sclerosis, and subsidence in OLIF. Methods: This retrospective cohort study included 165 patients who underwent a single-level OLIF for lumbar stenosis. Patients were stratified into VP grades (0–3) based on preoperative computed tomography scans. Disc height, endplate sclerosis, and cage subsidence were radiologically assessed. Clinical outcomes, including back and leg pain visual analog scale, Oswestry Disability Index, and EuroQol-5 Dimension, were measured preoperatively and at follow-up. Results: High VP grades were associated with low preoperative disc height and increased endplate sclerosis. Although no significant differences in clinical outcomes or final fusion rates across VP grades were observed, the subsidence rate increased with VP grade, with a significant difference between VP grades 1 and 2 (p = 0.045) and between VP grades 2 and 3 (p = 0.032), indicating that subsidence rates increased as the VP grade advanced. Conclusions: High VP grades, particularly grades 2 and 3, may increase the risk of cage subsidence following OLIF. Therefore, VP grading may be worth considering during surgical planning to reduce the subsidence risk and improve outcomes. Full article
(This article belongs to the Special Issue Cutting Edge of Minimally Invasive Spine Surgery)
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18 pages, 1473 KiB  
Systematic Review
Incidence and Risk Assessment of Acute Kidney Injury (AKI) in Spine Surgery: A Case Report and Literature Review
by Calogero Velluto, Giovan Giuseppe Mazzella, Laura Scaramuzzo, Maria Ilaria Borruto, Michele Inverso, Lorenzo Fulli, Matteo Costanzi, Marco Rossi and Luca Proietti
J. Clin. Med. 2025, 14(4), 1210; https://doi.org/10.3390/jcm14041210 - 12 Feb 2025
Viewed by 827
Abstract
Background: Acute kidney injury (AKI) is a critical medical condition characterized by a sudden decline in renal function, often resulting in severe complications and increased mortality. In the context of spine surgery, particularly for adult spine deformities, the risk of AKI is significant [...] Read more.
Background: Acute kidney injury (AKI) is a critical medical condition characterized by a sudden decline in renal function, often resulting in severe complications and increased mortality. In the context of spine surgery, particularly for adult spine deformities, the risk of AKI is significant due to the complexity and duration of these procedures, as well as the substantial intraoperative blood loss and hemodynamic instability they can entail. Despite advancements in surgical and perioperative care, AKI remains a major concern. This paper presents a case report of AKI following spine deformity surgery and conducts a comprehensive literature review to evaluate the incidence and risk factors associated with AKI in this specific surgical population. Methods: A systematic literature search was conducted across the PubMed, Medline, and Cochrane Library databases, focusing on studies published between January 2000 and December 2023. The inclusion criteria targeted studies reporting on adult patients undergoing spine surgery, specifically detailing the incidence and risk factors of AKI. Exclusion criteria included studies on pediatric patients, non-English publications, and those lacking clear AKI diagnostic criteria. Data from the selected studies were independently extracted by two reviewers and analyzed using descriptive statistics and meta-analysis techniques where applicable. The case report highlights a patient who developed AKI following extensive spine surgery for Adult Spine Deformity (ASD), detailing the clinical course, diagnostic approach, and management strategies employed. Results: The literature review revealed that the incidence of AKI in spine surgery varies widely and is influenced by factors such as patient demographics, type of surgery, and perioperative management. Identified risk factors include significant blood loss, prolonged operative time, intraoperative hypotension, and the use of nephrotoxic drugs. The findings underscore the importance of vigilant perioperative monitoring and proactive management strategies to mitigate the risk of AKI. These strategies include optimizing hemodynamic stability, minimizing blood loss, and careful management of nephrotoxic medications. Conclusions: By integrating a detailed case report with a thorough review of the existing literature, this paper aims to enhance the understanding of AKI in spine surgery and inform clinical practices to improve patient outcomes. Full article
(This article belongs to the Special Issue Cutting Edge of Minimally Invasive Spine Surgery)
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