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Latest Developments in Minimally Invasive Spinal Treatment—2nd Edition
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Latest Developments in Minimally Invasive Spinal Treatment—2nd Edition

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

Deadline for manuscript submissions: 20 June 2025 | Viewed by 4876

Special Issue Editor

Dr. Benjamin D. Elder

E-Mail Website
Guest Editor
Department of Neurosurgery, Orthopedics and Biomedical Engineering, Mayo Clinic School of Medicine, 200 1st St. SW, Rochester, MN 55905, USA
Interests: degenerative spine pathology; complex adult spinal deformities; spinal stenosis; scoliosis/kyphosis; spine tumors; spinal cord tumors; spinal fusion; herniated discs; craniocervical junction pathology; normal pressure hydrocephalus; tissue engineering strategies for spinal fusion
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

It is my pleasure to invite you to contribute to the Special Issue entitled “Latest Developments in Minimally Invasive Spinal Treatment—2nd Edition”. This is a new volume, proceeding the eight papers we published in the first volume (for more details, please visit: https://www.mdpi.com/journal/jcm/special_issues/Minimally_Invasive_Spinal_Treatment).

The use of minimally invasive strategies for the surgical treatment of spinal pathology has significantly increased, including the expansion of techniques for treating spinal tumors and spinal deformities. Additionally, there has been an explosion of new technologies over the past decade, including spinal robotics and new navigation-based techniques, that have made some of these techniques more accessible and increased patient safety. However, it has been challenging to identify the optimal assessments at follow-up to discern the most appropriate strategy for each patient.

This Special Issue aims to provide room for new concepts, ideas, and strategies that will help address the future needs of our patients. We are looking forward to your contributions to this Special Issue.

Dr. Benjamin D. Elder
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

  • minimally invasive spine surgery
  • spinal fusion
  • discectomy
  • endoscopic
  • spinal deformity surgery
  • robotic spine surgery
  • neuronavigation

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Published Papers (4 papers)

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Research

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13 pages, 581 KiB  
Article
Radiographic and Clinical Comparison of Polyetheretherketone Versus 3D-Printed Titanium Cages in Lumbar Interbody Fusion—A Single Institution’s Experience
by Diang Liu, Julie L. Chan, Art Eleanore, Kristin DeCost, Justin Luk, Lissette C. Neukam, Tasneem Zaihra Rizvi, Zhibang Lin, Zoher Ghogawala, Subu N. Magge, Andrew Y. Yew and Robert G. Whitmore
J. Clin. Med. 2025, 14(6), 1813; https://doi.org/10.3390/jcm14061813 - 7 Mar 2025
Viewed by 668
Abstract
Background/Objectives: Spinal fusion surgery is an accepted form of management for select patients who suffer from degenerative lumbar disease. The need for cost-effective durable techniques is paramount as our population ages. This study compares the radiographic and clinical outcomes of PEEK and 3D-printed [...] Read more.
Background/Objectives: Spinal fusion surgery is an accepted form of management for select patients who suffer from degenerative lumbar disease. The need for cost-effective durable techniques is paramount as our population ages. This study compares the radiographic and clinical outcomes of PEEK and 3D-printed titanium interbody cages. Methods: This study compared two cohorts which underwent either PEEK or 3D-printed titanium (3DPT) interbody fusion at a single institution between 2013 and 2022. The PEEK cohort was a retrospective analysis of a prospectively collected registry. The 3DPT data were prospectively collected. The inclusion criteria were adults >18 years who underwent 1 or 2 level lumbar interbody fusion for degenerative spine disease with at least 6 months follow-up. Patient demographics, radiographs, and PROMs were collected. The cohorts were compared using ANOVA for continuous variables and Fisher’s exact test for categorical variables, with significance set to 0.05. Results: The final study included 91 patients, 49 PEEK and 42 3DPT. The 3DPT patients were older (p = 0.047) with increased incidence of hypertension (p < 0.001). The 3DPT patients had less bone morphogenetic protein (BMP) usage (80.9% vs. 54.8%; p = 0.012), but more cellular allograft (p < 0.001). Fusion rate was high for both cohorts, with PEEK at 95.9% and 3DPT at 97.6%. There was no significant difference in reoperation rate. Both the PEEK and 3DPT cohorts demonstrated an improvement in the Oswestry Disability Index (ODI) and EuroQol 5 Dimension (EQ-5D) at 1 and 2 years compared to preoperative baseline. More patients in the 3DPT group met the MCID for EQ-5D at 1 and 2 years compared to PEEK; however, this was not significant (p = 0.350; p = 1.000). Conclusions: The 3DPT interbody provided comparable if not superior fusion properties to the PEEK interbody given the decreased use of BMP. Both cohorts demonstrated similar improvements in ODI and EQ-5D compared to preoperative baseline. These results suggest that 3DPT cages may be a cost-effective alternative in spinal fusion. Further studies utilizing a larger population with higher follow-up rates are indicated to determine the economic and clinical benefits of 3DPT compared to PEEK cages in lumbar fusion surgery. Full article
(This article belongs to the Special Issue Latest Developments in Minimally Invasive Spinal Treatment—2nd Edition)
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16 pages, 1865 KiB  
Article
Effects of Age and Muscle Activation on Three-Dimensional Spine Kinematics and Asymmetry in Elderly Adults
by Asghar Rezaei, Chih-Hsiu Cheng, Robert J. Pignolo, Lichun Lu and Kenton Kaufman
J. Clin. Med. 2025, 14(5), 1610; https://doi.org/10.3390/jcm14051610 - 27 Feb 2025
Viewed by 419
Abstract
Background/Objectives: Limited spinal range of motion (ROM) is linked to low back disorders, emphasizing the need to maintain mobility in the elderly. This study measured maximum spinal ROM, asymmetrical patterns, and the effects of age and muscle activation on spinal mobility. Methods: Forty [...] Read more.
Background/Objectives: Limited spinal range of motion (ROM) is linked to low back disorders, emphasizing the need to maintain mobility in the elderly. This study measured maximum spinal ROM, asymmetrical patterns, and the effects of age and muscle activation on spinal mobility. Methods: Forty healthy participants aged 50 and older were recruited. An optical motion capture system recorded three-dimensional coordinates of reflective markers placed on spinal landmarks. Asymmetry was analyzed in sidebending and axial rotation. Electromyography (EMG) data were collected bilaterally from paraspinal muscles at L3 during flexion, extension, sidebending, and axial rotation. Results: Trunk ROM averaged 111° in flexion, 38° in extension, 46° in sidebending, and 87° in axial rotation. Kinematic asymmetry was observed in sidebending and axial rotation. ROM decreased with age in flexion motion (p ≤ 0.04). EMG activity was significantly correlated with ROM data for all combined motions (p = 0.0002). The strongest EMG signal was recorded during flexion, whereas the weakest signal was observed during extension. EMG activity also correlated with kinematic asymmetry (p ≤ 0.03). Conclusions: Age and muscle activation significantly influence spinal ROM in the elderly. Lumbar kinematic asymmetry can be partially attributed to paraspinal muscle activation, underscoring the importance of analyzing asymmetrical motions in conjunction with EMG activity. Full article
(This article belongs to the Special Issue Latest Developments in Minimally Invasive Spinal Treatment—2nd Edition)
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Review

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16 pages, 11426 KiB  
Review
Optimizing Single-Position Prone Lateral Lumbar Interbody Fusion with Exoscopic Technology: A Review of Key Innovations
by Christian Quinones, John Preston Wilson, Deepak Kumbhare, Bharat Guthikonda and Stanley Hoang
J. Clin. Med. 2025, 14(4), 1132; https://doi.org/10.3390/jcm14041132 - 10 Feb 2025
Viewed by 690
Abstract
Minimally invasive spine surgery has advanced significantly over the past decade, integrating technologies such as intraoperative navigation, robotics, and artificial intelligence with innovative techniques such as single-position prone lateral transpsoas lumbar interbody fusion (proLIF). While proLIF offers excellent clinical outcomes for a wide [...] Read more.
Minimally invasive spine surgery has advanced significantly over the past decade, integrating technologies such as intraoperative navigation, robotics, and artificial intelligence with innovative techniques such as single-position prone lateral transpsoas lumbar interbody fusion (proLIF). While proLIF offers excellent clinical outcomes for a wide range of lumbar pathologies, the lateral approach to lumbar spine presents technical and ergonomic challenges, including an increased need for soft-tissue dissection and unfavorable ergonomics for surgeons. This review details how the combination of emerging technologies has been applied in minimally invasive lumbar spine surgery. It also describes the novel application of an exoscope during navigation-guided proLIF. The benefits offered by the exoscope included high-resolution, three-dimensional visualization, enhanced maneuverability, and improved surgeon ergonomics. By combining emerging technologies with novel surgical approaches, this review demonstrates the recent advancements in minimally invasive spine surgery and underscores the exoscope’s potential to enhance visualization and optimize ergonomics for surgeons. Full article
(This article belongs to the Special Issue Latest Developments in Minimally Invasive Spinal Treatment—2nd Edition)
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17 pages, 4364 KiB  
Review
Evolution of the Transforaminal Lumbar Interbody Fusion (TLIF): From Open to Percutaneous to Patient-Specific
by Peter N. Drossopoulos, Favour C. Ononogbu-uche, Troy Q. Tabarestani, Chuan-Ching Huang, Mounica Paturu, Anas Bardeesi, Wilson Z. Ray, Christopher I. Shaffrey, C. Rory Goodwin, Melissa Erickson, John H. Chi and Muhammad M. Abd-El-Barr
J. Clin. Med. 2024, 13(8), 2271; https://doi.org/10.3390/jcm13082271 - 14 Apr 2024
Cited by 5 | Viewed by 2438
Abstract
The transforaminal lumbar interbody fusion (TLIF) has seen significant evolution since its early inception, reflecting advancements in surgical techniques, patient safety, and outcomes. Originally described as an improvement over the posterior lumbar interbody fusion (PLIF), the TLIF began as an open surgical procedure, [...] Read more.
The transforaminal lumbar interbody fusion (TLIF) has seen significant evolution since its early inception, reflecting advancements in surgical techniques, patient safety, and outcomes. Originally described as an improvement over the posterior lumbar interbody fusion (PLIF), the TLIF began as an open surgical procedure, that notably reduced the need for the extensive neural retractation that hindered the PLIF. In line with the broader practice of surgery, trending toward minimally invasive access, the TLIF was followed by the development of the minimally invasive TLIF (MIS-TLIF), a technique that further decreased tissue trauma and postoperative complications. Subsequent advancements, including Trans-Kambin’s Triangle TLIF (percLIF) and transfacet LIF, have continued to refine surgical access, minimize surgical footprint, and reduce the risk of injury to the patient. The latest evolution, as we will describe it, the patient-specific TLIF, is a culmination of the aforementioned adaptations and incorporates advanced imaging and segmentation technologies into perioperative planning, allowing surgeons to tailor approaches based on individual patient anatomy and pathology. These developments signify a shift towards more precise methods in spine surgery. The ongoing evolution of the TLIF technique illustrates the dynamic nature of surgery and emphasizes the need for continued adaptation and refinement. Full article
(This article belongs to the Special Issue Latest Developments in Minimally Invasive Spinal Treatment—2nd Edition)
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