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JCM
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Surgical Management of Complex Spinal Pathologies: Challenges and Innovations
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Surgical Management of Complex Spinal Pathologies: Challenges and Innovations

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

Deadline for manuscript submissions: 20 May 2026 | Viewed by 67

Special Issue Editor

Dr. Spyridon Komaitis

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Guest Editor
Centre for Spinal Studies and Surgery, Queen's Medical Centre, Nottingham University Hospitals, NHS Trust, Nottingham, UK
Interests: minimally invasive spinal surgery; adult spinal deformity; spinal surgery; degenerative disease of the spine; spine disorders

Special Issue Information

Dear Colleagues,

The surgical management of complex spinal pathologies continues to evolve rapidly with the development of advanced techniques, minimally invasive approaches, and novel technologies. Despite significant progress, these conditions—ranging from adult spinal deformity and complex degenerative conditions to revision surgery, spinal oncology, and spinal infection—remain among the most demanding challenges for spine surgeons worldwide. This Special Issue of Journal of Clinical Medicine aims to highlight surgical strategies, complication management, clinical outcomes, and decision-making frameworks in the treatment of complex spinal disorders. Original research and systematic reviews are welcome. Particular emphasis will be placed on complex surgical techniques, comparative studies of minimally invasive versus open approaches, the role of navigation and robotics, perioperative management, and long-term functional outcomes. By bringing together international expertise, this Special Issue seeks to provide an updated perspective that will enhance clinical practice and guide future research in the surgical treatment of complex spinal pathologies.

Dr. Spyridon Komaitis
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

  • complex spinal surgery
  • adult spinal deformity
  • complex degenerative pathologies
  • revision spine surgery
  • spinal oncology
  • robotics
  • navigation
  • surgical outcomes

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Published Papers (1 paper)

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Review

13 pages, 10187 KB  
Review
Transpedicular Transdural Approach for Calcified Thoracic Disc Herniations: Technical Commentary, Case Series, and Review of the Literature
by Spyridon Komaitis, Elie Najjar, Dritan Pasku, Konstantinos Zygogiannis, Daniel D’Aquino and Khalid M Salem
J. Clin. Med. 2025, 14(21), 7741; https://doi.org/10.3390/jcm14217741 (registering DOI) - 31 Oct 2025
Abstract
Background/Objectives: Calcified thoracic disc herniations are a formidable surgical challenge due to their proximity to the spinal cord and the heightened risk of iatrogenic neurological injury. Traditional anterior and posterolateral approaches, while effective in select scenarios, may not provide adequate exposure for [...] Read more.
Background/Objectives: Calcified thoracic disc herniations are a formidable surgical challenge due to their proximity to the spinal cord and the heightened risk of iatrogenic neurological injury. Traditional anterior and posterolateral approaches, while effective in select scenarios, may not provide adequate exposure for large, centrally located calcified discs. Methods: We performed a narrative review of the literature and retrospective case series of seven patients who underwent transpedicular–transdural thoracic discectomy for central or centrolateral calcified disc herniations at our institution in recent years. All patients were followed clinically for a minimum of three months postoperatively. Surgical technique and intraoperative nuances were also documented. Results: The transdural approach enabled direct access to the ventral thoracic spine, allowing for the effective decompression of calcified herniations in all cases. Six out of seven patients (86%) demonstrated clinical improvement or neurological stability at three-month follow-up, while one out of seven patients (14%) who presented with severe preoperative neurological deficits had persisting neurological deterioration postoperatively. The technical aspects of the microsurgical approach were critical to minimizing risk. Conclusions: The transpedicular–transdural approach is a viable and effective surgical option for select cases of central or centrolateral calcified thoracic disc herniation. When executed with a precise microsurgical technique, it offers safe decompression with favourable short-term outcomes. Full article
(This article belongs to the Special Issue Surgical Management of Complex Spinal Pathologies: Challenges and Innovations)
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