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JCM
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Spine Surgery: Current Practice and Future Directions
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Spine Surgery: Current Practice 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: 30 October 2025 | Viewed by 1528

Special Issue Editors

Dr. Claudio Bernucci

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Guest Editor
Neurosurgery Unit, ASL Nuoro, Nuoro, Italy
Interests: neuroradiology; endoscopic neurosurgery; microneurosurgery; cervical spine; neuro-oncology; spine surgery; intervertebral disc arthroplasty; spine
Dr. Francesco Costa

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Guest Editor
Spine Surgery Unit (NCH4), Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Via Celoria 11, 20133 Milan, Italy
Interests: spine surgery; imaging; spinal surgery; spinal cord injury; neuro-oncology; tumors; computed tomography; navigation; economic analysis; biomechanics
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The progress of knowledge and technology in the diagnosis and treatment of the diseases affecting the spine has been remarkable in the last years. New instrumentation devices coupled with intraoperative imaging acquisition systems and dedicated ancillaries has allowed surgeons to reduce surgical trauma and obtain better results and faster recoveries. Therapeutic indications still remain unchanged, but new procedures have emerged in order to alleviate the symptoms complained of by the patients without reducing the mobility and the functions of the spine. Spine endoscopy, robot-assisted surgery, and moreover, regenerative therapies are the new frontiers for the coming years.

In this Special Issue, we welcome authors to submit papers on the clinical advance of spine surgery regarding different pathologies (trauma, tumor, degenerative, and deformity) in terms of both diagnosis and treatment.

Dr. Claudio Bernucci
Dr. Francesco Costa
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 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

  • degenerative
  • spinal trauma
  • spine tumors
  • neurosurgery
  • spine surgery
  • spinal deformity
  • scoliosis
  • robotics surgery
  • spinal cord injury
  • clinical practices
  • regenerative therapies

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Published Papers (1 paper)

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Research

14 pages, 690 KiB  
Article
Spinal Anesthesia Results in Lower Costs Compared to General Anesthesia for Patients Undergoing Lumbar Fusion—A Matched Cohort Study
by Favour C. Ononogbu-Uche, Abdullah Wael Saleh, Felix Toussaint, Taylor Wallace, Joshua Woo, Matthew T. Morris, Christopher I. Shaffrey, William M. Bullock, Nicole R. Guinn and Muhammad M. Abd-El-Barr
J. Clin. Med. 2025, 14(11), 3851; https://doi.org/10.3390/jcm14113851 - 30 May 2025
Viewed by 1339
Abstract
Background/Objectives: Degenerative lumbar spine disease (DLSD) is increasingly managed with minimally invasive surgery (MIS) and evolving anesthesia methods. While general anesthesia (GA) remains standard, spinal anesthesia (SA) may offer faster recovery and fewer side effects. This study compares the clinical and economic [...] Read more.
Background/Objectives: Degenerative lumbar spine disease (DLSD) is increasingly managed with minimally invasive surgery (MIS) and evolving anesthesia methods. While general anesthesia (GA) remains standard, spinal anesthesia (SA) may offer faster recovery and fewer side effects. This study compares the clinical and economic outcomes of GA versus SA in transforaminal lumbar interbody fusion (TLIF). Methods: A retrospective review of 18 TLIF patients (2018–2022) was performed, with 9 patients in each cohort. Patients were matched by demographics and procedure type. Data collected included operative time, blood loss, complications, postoperative opioid utilization, and 30-day readmissions. Costs were analyzed in categories: anesthesia, implants, inpatient care, operating room (OR) supplies, OR time, and PACU fees, using Wilcoxon Rank T-tests and Pearson Chi-Squared tests. Results: Clinical outcomes such as blood loss, and operative time were similar between groups. However, SA patients had significantly shorter LOS compared to GA (SA: 12 h vs. GA: 84 h, % difference: −150%, p = 0.04). Additionally, SA patients had lower total direct costs ($27,881.85 vs. $35,669.01; p = 0.027). Significant cost reductions with SA were noted in OR supplies/medications ($7367.93 vs. $10,879.46; p = 0.039) and inpatient costs ($621.65 vs. $3092.66; p = 0.027). Within these categories, reductions were observed for intravenous solutions, sedatives/anesthetics, pressure management, labs, imaging, evaluations, hospital care, and medications. Although costs for implants, anesthesia care, OR time, and PACU fees were lower with SA, these differences did not reach statistical significance. Conclusions: In TLIF for DLSD, SA provides significant economic advantages over GA while yielding comparable clinical outcomes. These results support SA as a cost-effective alternative, warranting further prospective studies to confirm these findings. Full article
(This article belongs to the Special Issue Spine Surgery: Current Practice and Future Directions)
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