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Spine Surgery Innovations: Treatments and Technologies

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

Deadline for manuscript submissions: 22 January 2027 | Viewed by 880

Editors


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Guest Editor
Hospital for Special Surgery, New York, NY, USA
Interests: lateral lumbar interbody fusion; anterior lumbar interbody fusion; muscle-preservation; alignment; 3D-print technologies; spine biomechanics

E-Mail Website
Guest Editor
Hospital for Special Surgery, New York, NY, USA
Interests: surgical navigation; disc replacement; adult spinal deformity; adolescent idiopathic scoliosis; minimally invasive surgery; robotic spinal surgery

Special Issue Information

Dear Colleagues,

Advances in spine surgery are rapidly reshaping the way surgeons approach complex degenerative, deformity, and reconstructive procedures. This Special Issue of the Journal of Clinical Medicine will highlight cutting-edge innovations that aim to improve surgical precision, patient safety, and long-term outcomes. Artificial intelligence and robotics are increasingly integrated into the operating room, enhancing navigation, intraoperative decision-making, and predictive analytics for patient-specific planning. At the same time, muscle-preserving and minimally invasive approaches are transforming traditional exposure techniques by reducing collateral tissue damage, shortening recovery times, and preserving long-term spinal function.

Muscle- and motion-preserving strategies and clearly defined alignment targets are central themes, with growing evidence supporting their role in reducing adjacent segment disease and improving quality of life. Parallel advances in implant technology, including porous materials, bioactive coatings, and the use of bone growth factors, are facilitating enhanced osseointegration and fusion success. The emergence of custom-made and patient-specific implants further exemplifies the trend toward personalization in spine care.

Through original research, clinical series, and review articles, this issue will explore how these technological and biological innovations intersect to define the next era of spine surgery, emphasizing safer, smarter, and more durable solutions for patients worldwide.

Dr. Marco D. Burkhard
Dr. Tomoyuki Asada
Guest Editors

Manuscript Submission Information

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Keywords

  • AI
  • robotics
  • navigation
  • muscle preservation
  • minimally invasive surgery
  • motion preservation
  • alignment targets
  • implant materials
  • bone growth factors
  • custom-made implants

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Published Papers (1 paper)

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Research

12 pages, 1167 KB  
Article
Asymmetric Safety Corridors for Free-Hand S2-Alar-Iliac Screw Placement: Quantifying Direction-Specific Tolerance Around Patient-Specific Optimal Trajectories
by Se Jun Park, Dong Kyu Kim, Sun Joon Yoo, Hyun Jun Jang, Bong Ju Moon, Jeong Yoon Park, Jun Jae Shin, Sung Uk Kuh, Dong Kyu Chin, Keun Su Kim and Kyung Hyun Kim
J. Clin. Med. 2026, 15(12), 4495; https://doi.org/10.3390/jcm15124495 - 10 Jun 2026
Viewed by 166
Abstract
Background/Objectives: Optimal trajectories for S2-alar-iliac (S2AI) screw placement have been widely studied; however, in fluoroscopy-assisted free-hand techniques, exact reproduction is rarely achievable. This study aimed to quantify direction-specific safety margins around patient-specific optimal trajectories and to determine their relationship with pelvic parameters. Methods: [...] Read more.
Background/Objectives: Optimal trajectories for S2-alar-iliac (S2AI) screw placement have been widely studied; however, in fluoroscopy-assisted free-hand techniques, exact reproduction is rarely achievable. This study aimed to quantify direction-specific safety margins around patient-specific optimal trajectories and to determine their relationship with pelvic parameters. Methods: We retrospectively analyzed patients who underwent S2AI screw fixation with available preoperative and postoperative CT imaging. Pelvic parameters, including pelvic tilt (PT), sacral slope (SS), and pelvic incidence (PI), were measured. Optimal transverse and sagittal screw angles were determined using CT-based planning. Postoperative CT was used to assess actual screw trajectories and cortical violations. Direction-specific generalized estimating equation models were used to evaluate associations between trajectory deviation and screw malposition. Receiver operating characteristic (ROC) analysis was performed to determine cutoff values for safe deviation. Results: A total of 62 patients (105 screws) were included in axial analysis and 41 patients (76 screws) in sagittal analysis. PT and PI showed significant inverse correlations with both optimal transverse and sagittal angles (all p < 0.001). Greater lateral and medial deviations were significantly associated with corresponding cortical violations (OR 2.33, 95% CI 1.51–3.59; and OR 2.10, 95% CI 1.40–3.15 per degree, respectively; both p < 0.001). Inferior deviation was significantly associated with violation in the sagittal plane (OR 1.39, 95% CI 1.18–1.65 per degree; p < 0.001), whereas superior deviation was not significant. ROC analysis demonstrated asymmetric safety margins: 1.5° lateral (AUC = 0.972), 8.1° medial (AUC = 0.965), and 18.5° inferior (AUC = 0.897). Conclusions: S2AI screw placement may be conceptualized as a tolerance-based process centered on a patient-specific optimal trajectory. Safety margins are direction-dependent and asymmetric, with a narrow tolerance for lateral deviation. These findings provide practical guidance for intraoperative trajectory adjustment in free-hand techniques. Full article
(This article belongs to the Special Issue Spine Surgery Innovations: Treatments and Technologies)
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