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Recent Advances in Spine Tumor Diagnosis and Treatment
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Recent Advances in Spine Tumor Diagnosis and Treatment

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

Deadline for manuscript submissions: 25 November 2025 | Viewed by 3110

Special Issue Editor

Dr. Jae Hwan Cho

E-Mail Website
Guest Editor
Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
Interests: thoracolumbar degenerative spine; adult spinal deformity; spinal tumor

Special Issue Information

Dear Colleagues,

This Special Issue provides a comprehensive overview of the latest advancements in the field of spine tumor diagnosis and treatment. Highlighting critical developments in spinal tumor management, the issue explores innovative approaches to diagnosing and treating spinal metastases, pathologic fractures, and cord compression. It delves into the evolving role of the surgeon, the integration of radiotherapy, and the importance of interdisciplinary collaboration between surgeons, medical oncologists, and radiologic oncologists. Additionally, the issue addresses the psychological aspects and pain management strategies essential for improving patient outcomes. Through cutting-edge research and expert insights, this edition aims to enhance understanding and foster advancements in spine tumor care.

Dr. Jae Hwan Cho
Guest Editor

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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 tumor
  • spinal metastasis
  • pathologic fracture
  • cord compression
  • separation surgery
  • radiotherapy
  • interdisciplinary collaboration
  • surgeon’s role
  • medical oncologist
  • radiologic oncologist
  • psychological aspects
  • pain management
  • innovative approaches
  • patient outcomes
  • diagnostic advancements

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Published Papers (5 papers)

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Research

13 pages, 1367 KiB  
Article
Instrumentation-Related Complications Following Nonfusion Posterior Fixation in Patients with Metastatic Spinal Tumors: Incidence and Risk Factors
by Yunjin Nam, Jin-Sung Park, Dong-Ho Kang, Chong-Suh Lee, Seung Woo Suh and Se-Jun Park
J. Clin. Med. 2025, 14(13), 4629; https://doi.org/10.3390/jcm14134629 - 30 Jun 2025
Viewed by 199
Abstract
Background/Objectives: Previous studies have reported satisfactory outcomes and low rates of instrumentation-related complications (IRCs) following nonfusion posterior fixation in patients with metastatic spinal tumors (MSTs). However, to adequately assess the longevity and durability of nonfusion instrumentation in patients with longer life expectancy, [...] Read more.
Background/Objectives: Previous studies have reported satisfactory outcomes and low rates of instrumentation-related complications (IRCs) following nonfusion posterior fixation in patients with metastatic spinal tumors (MSTs). However, to adequately assess the longevity and durability of nonfusion instrumentation in patients with longer life expectancy, an extended follow-up period is essential. This study aims to evaluate the incidence of and risk factors for IRCs in patients with MSTs who underwent nonfusion posterior fixation and had radiographic follow-up data available for at least one year postoperatively. Methods: Consecutive data were collected from patients who underwent pedicle screw-based posterior fixation without fusion for MSTs in the thoracic and/or lumbar region from 2005 to 2018. The IRCs included screw loosening, screw pull-out, and metal breakage. The IRC-free survival and related factors were analyzed by Kaplan–Meier survivorship analysis with the log-rank test within a minimum follow-up period of one year. A multivariate analysis was performed using a Cox proportional-hazards regression model. Results: In total, 61 patients were included. The mean follow-up period was 28.3 months (range: 12.0–102.6 months). There were 27 cases (44.2%) of IRCs, including 22 cases of screw loosening, four cases of screw pull-out, and one case of rod breakage, at an average of 9.6 months (range: 1.0–38.1 months). The median IRC-free survival was 38.1 months (range: 1.0–102.6 months). Only three patients experienced pain aggravation with IRCs. No revision surgery was performed. A multivariate analysis identified that fixation length was a risk factor for IRCs (odds ratio: 0.358, 95% confidence interval: 0.114–0.888; p = 0.027). Conclusions: IRCs are frequent but mostly asymptomatic after nonfusion posterior fixation in patients with MSTs followed up for at least one year. Overall, the IRC-free survival was long enough considering the patient survival. Fixation length was a significant risk factor for IRCs regardless of MST location. Full article
(This article belongs to the Special Issue Recent Advances in Spine Tumor Diagnosis and Treatment)
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11 pages, 3399 KiB  
Article
BioGlue® Induced Mass Formation Aggravating Spinal Canal Invasion After Intradural Tumor Surgery
by Sun Woo Jang, Sang Hyub Lee, Hong Kyung Shin, Sang Ryong Jeon, Danbi Park, Chongman Kim and Jin Hoon Park
J. Clin. Med. 2025, 14(13), 4540; https://doi.org/10.3390/jcm14134540 - 26 Jun 2025
Viewed by 252
Abstract
Background/Objectives: The aim of this study was to evaluate whether the use of BioGlue® increases the risk of postoperative mass formation and subsequent spinal canal invasion after intradural spinal tumor surgery. Methods: After retrospectively reviewing patients who underwent intradural tumor [...] Read more.
Background/Objectives: The aim of this study was to evaluate whether the use of BioGlue® increases the risk of postoperative mass formation and subsequent spinal canal invasion after intradural spinal tumor surgery. Methods: After retrospectively reviewing patients who underwent intradural tumor surgery from 2018 to 2023, we evaluated mass formation as detected in postoperative MRI according to the Epidural Spinal Cord Compression (ESCC) grade. Patients were divided into two groups based on the use of BioGlue®, and we analyzed MRI postoperatively to compare the differences in ESCC grades and the incidence of symptomatic spinal canal invasion between the two groups. Additionally, we performed a logistic regression analysis to identify risk factors associated with mass formation and to explore their relationship with BioGlue®. Results: This study included a total of 153 patients, 87 in the BioGlue® and 66 in the non-BioGlue® groups. In the BioGlue® group, 18 patients had ESCC grade 2, and 11 had grade 3. Conversely, in the non-BioGlue® group, only 8 patients had ESCC grade 2, and none had grade 3 (p = 0.001). Among the cases of symptomatic spinal canal invasion, all five cases were identified in the BioGlue® group (p = 0.001). Both univariate and multivariate analyses showed that BioGlue® was a significant risk factor for spinal canal invasion (univariate: OR = 3.931, p = 0.005, multivariate: OR = 3.812, p = 0.003). Conclusions: Our findings indicated that BioGlue® was a significant risk factor for mass formation aggravating spinal canal invasion after intradural tumor surgery. Full article
(This article belongs to the Special Issue Recent Advances in Spine Tumor Diagnosis and Treatment)
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12 pages, 733 KiB  
Article
Clinical Significance of Prognostic Nutritional Index in Patients Who Underwent Palliative Surgery for Spine Metastasis
by Young-Hoon Kim, Kee-Yong Ha, Hyung-Youl Park, Kihyun Kwon, Yunseong Kim, Hyun W. Bae and Sang-Il Kim
J. Clin. Med. 2025, 14(12), 4372; https://doi.org/10.3390/jcm14124372 - 19 Jun 2025
Viewed by 290
Abstract
Background/Objectives: Malnutrition is common in patients with metastatic spine tumors (MSTs) and may adversely affect surgical outcomes. The Prognostic Nutritional Index (PNI) reflects both nutritional and immune status, but its role in palliative MST surgery is not well defined. The aim of [...] Read more.
Background/Objectives: Malnutrition is common in patients with metastatic spine tumors (MSTs) and may adversely affect surgical outcomes. The Prognostic Nutritional Index (PNI) reflects both nutritional and immune status, but its role in palliative MST surgery is not well defined. The aim of this study was to investigate the association between preoperative the PNI and postoperative outcomes, including functional recovery and survival, in patients undergoing palliative surgery for MSTs. Methods: A brief description of the main methods or treatments applied. This can include any relevant preregistration or specimen information. Results: Patients with a higher PNI (≥42.8) demonstrated significantly better postoperative ambulation and longer overall survival compared to those with a lower PNI (<42.8). The higher PNI group showed earlier ambulation (p = 0.017) and longer median survival (30.7 vs. 7.0 months; p = 0.002). Multivariate analysis confirmed that a PNI ≥ 42.8 was an independent predictor of early ambulation (HR = 1.516; 95% CI: 1.010–2.277; p = 0.045) and prolonged survival (HR = 0.955; 95% CI: 0.927–0.985; p = 0.003). No significant association was found between the PNI and postoperative infections. Conclusions: The PNI is a simple and effective predictor of postoperative functional recovery and survival in patients undergoing palliative surgery for MSTs. Its routine preoperative assessment may help stratify surgical risk, guide nutritional interventions, and optimize clinical outcomes in this vulnerable population. Full article
(This article belongs to the Special Issue Recent Advances in Spine Tumor Diagnosis and Treatment)
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12 pages, 768 KiB  
Article
Impact of the Spinal Instability Neoplastic Score on Postoperative Prognosis in Patients with Metastatic Cancer of the Cervical Spine
by Dong-Ho Kang, Kyunghun Jung, Jin-Sung Park, Minwook Kang, Chong-Suh Lee and Se-Jun Park
J. Clin. Med. 2024, 13(24), 7860; https://doi.org/10.3390/jcm13247860 - 23 Dec 2024
Viewed by 1060
Abstract
Background: Although the Spinal Instability Neoplastic Score (SINS) is widely utilized to evaluate spinal instability, its prognostic value for survival in patients with cervical spinal metastases remains unclear. This study investigated the association between the SINS and survival outcomes in patients with metastatic [...] Read more.
Background: Although the Spinal Instability Neoplastic Score (SINS) is widely utilized to evaluate spinal instability, its prognostic value for survival in patients with cervical spinal metastases remains unclear. This study investigated the association between the SINS and survival outcomes in patients with metastatic cervical spine cancer. Methods: This retrospective cohort study included 106 patients who underwent surgery for metastatic cervical spine cancer at a single institution between 1995 and 2023. Patients were divided into two groups: high SINS (≥13) and low-to-moderate SINS (0–12). Overall survival (OS) was the primary outcome and was analyzed using Kaplan–Meier estimates and Cox regression. Secondary outcomes included changes in Eastern Cooperative Oncology Group Performance Status (ECOG-PS), operation time, estimated blood loss, and postoperative complications. Results: The median OS was significantly shorter in the high SINS group compared to the low-to-moderate SINS group (5.3 months versus 8.6 months; p = 0.023). A high SINS was independently associated with increased mortality risk (hazard ratio [HR], 1.959; 95% CI, 1.221–3.143; p = 0.005). Lung cancer (HR, 4.004; 95% CI, 1.878–8.535; p < 0.001) and rectal cancer (HR, 3.293; 95% CI, 1.126–9.632; p = 0.029) were predictive of worse survival, whereas postoperative chemotherapy (HR, 0.591; 95% CI, 0.381–0.917; p = 0.019) and radiotherapy (HR, 0.531; 95% CI, 0.340–0.827; p = 0.005) were associated with improved survival. Changes in the ECOG-PS and postoperative complication rates were not significantly different between the groups. Conclusions: A high SINS was associated with significantly shorter survival in patients with metastatic cervical spine cancer, reflecting both mechanical instability and tumor aggressiveness. Full article
(This article belongs to the Special Issue Recent Advances in Spine Tumor Diagnosis and Treatment)
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14 pages, 2079 KiB  
Article
Can Preoperative Hounsfield Unit Measurement Help Predict Mechanical Failure in Metastatic Spinal Tumor Surgery?
by Hyung Rae Lee, Jae Hwan Cho, Sang Yun Seok, San Kim, Dae Wi Cho and Jae Hyuk Yang
J. Clin. Med. 2024, 13(23), 7017; https://doi.org/10.3390/jcm13237017 - 21 Nov 2024
Viewed by 856
Abstract
Background/Objectives: This study aimed to identify risk factors associated with mechanical failure in patients undergoing spinal instrumentation without fusion for metastatic spinal tumors. Methods: We retrospectively evaluated data from 220 patients with spinal tumors who underwent instrumentation without fusion. Propensity scores were used [...] Read more.
Background/Objectives: This study aimed to identify risk factors associated with mechanical failure in patients undergoing spinal instrumentation without fusion for metastatic spinal tumors. Methods: We retrospectively evaluated data from 220 patients with spinal tumors who underwent instrumentation without fusion. Propensity scores were used to match preoperative variables, resulting in the inclusion of 24 patients in the failure group (F group) and 72 in the non-failure group (non-F group). Demographic, surgical, and radiological characteristics were compared between the two groups. Logistic regression and Kaplan–Meier survival analyses were conducted to identify predictors of mechanical failure. Results: Propensity score matching resulted in a balanced distribution of covariates. Lower Hounsfield unit (HU) values at the lowest instrumented vertebra (LIV) were the only independent predictor of implant failure (p = 0.037). A cutoff value of 127.273 HUs was determined to predict mechanical failure, with a sensitivity of 59.1%, specificity of 73.4%, and area under the curve of 0.655 (95% confidence interval: 0.49–0.79). A significant difference in survival was observed between the groups with HU values above and below the cutoff (p = 0.0057). Cement-augmented screws were underutilized, with an average of only 0.2 screws per patient in the F group. Conclusions: Preoperative LIV HU values < 127.273 were strongly associated with an increased risk of mechanical failure following spinal instrumentation without fusion. Alternative surgical strategies including the use of cement-augmented screws are recommended for patients with low HU values. Full article
(This article belongs to the Special Issue Recent Advances in Spine Tumor Diagnosis and Treatment)
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