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Spinal Disorders: Current Treatment and Future Opportunities: Third Edition
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Spinal Disorders: Current Treatment and Future Opportunities: Third Edition

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

Deadline for manuscript submissions: closed (15 May 2026) | Viewed by 2302

Editor

Dr. Alan H Daniels

E-Mail Website
Guest Editor
Department of Orthopedics, Division of Spine Surgery, Warren Alpert Medical School of Brown University, Providence, RI, USA
Interests: spine disorders; spine surgery; spinal cord injury; spine-abnormities and deformities
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Spinal disorders are common and can lead to substantial morbidity and loss of productivity in society. Spinal disorders can be due to congenital, degenerative, traumatic, or oncological causes. As diagnostic advances such as bone density measurements, MRI/MRA, CT/CT myelography, EMG, laboratory testing, and health-related quality of life outcomes/patient-reported outcome measures have become more commonplace, research advances in these techniques have led to improvements in the care of spinal disorders. Similarly, surgical technology and procedures have advanced rapidly over the last generation, making spinal surgery safer and more effective. Only with ongoing research can we continue advancing the field of spine care and spinal surgery.

This is Edition III of the Special Issue “Spinal Disorders: Current Treatment and Future Opportunities”: https://www.mdpi.com/journal/jcm/special_issues/Spinal_Disorders_Current_Treatment_Future_Opportunities. In this Special Issue, we invite submissions that focus on spinal injuries, spinal disorders and spinal surgery. Submissions can be in the form of literature reviews providing insight into current knowledge and technical know-how, as well as original research that addresses key questions in spine care. Spinal disorders are diverse in their presentation, treatment, and outcomes; thus, any submission related to spinal disorders will be considered.

We look forward to receiving your submission.

Dr. Alan H Daniels
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 250 words) can be sent to the Editorial Office for assessment.

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-anonymized 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
  • spine surgery
  • spondylolisthesis
  • scoliosis
  • cervical myelopathy
  • spine surgery training
  • disc replacement
  • spine trauma
  • spine infection
  • spine fracture
  • spinal epidural abscess

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Related Special Issue

Published Papers (3 papers)

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26 pages, 5082 KB  
Technical Note
Single-Position Minimally Invasive Retropleural Asymmetric Vertebral Column Resection and Percutaneous Pedicle Screw Fixation in the Lateral Position for Congenital Kyphoscoliosis
by Piotr Kowalski, Gergely Bodon, Michael A. Galgano, Justyna Walczak, Michał Grabala, Krzysztof Zakrzewski and Paweł Grabala
J. Clin. Med. 2026, 15(15), 5861; https://doi.org/10.3390/jcm15155861 - 27 Jul 2026
Viewed by 331
Abstract
Background: Congenital thoracic kyphoscoliosis caused by vertebral malformations is a challenging condition that may progress during skeletal growth, leading to spinal imbalance, pain, cosmetic deformity, and neurological compromise. Conventional correction often requires extensive anterior, posterior, or combined approaches associated with substantial surgical morbidity. [...] Read more.
Background: Congenital thoracic kyphoscoliosis caused by vertebral malformations is a challenging condition that may progress during skeletal growth, leading to spinal imbalance, pain, cosmetic deformity, and neurological compromise. Conventional correction often requires extensive anterior, posterior, or combined approaches associated with substantial surgical morbidity. We describe a single-position surgical technique combining a lateral retropleural asymmetric vertebral resection with percutaneous posterior instrumentation performed entirely in the lateral decubitus position. Methods: A 15-year-old boy with progressive congenital thoracic kyphoscoliosis secondary to a T10 butterfly vertebra underwent surgical correction after failure of conservative treatment. The procedure was performed entirely in the left lateral decubitus position under multimodal intraoperative neurophysiological monitoring. Bilateral percutaneous pedicle screws were inserted from T7 to L1 under fluoroscopic guidance without repositioning the patient. A muscle-sparing lateral retropleural approach was then used to perform T10 asymmetric vertebral column resection, anterior column reconstruction with an expandable cage, and definitive deformity correction using posterior rod compression. The technical rationale, operative workflow, and reconstruction strategy are described. Results: The procedure was completed without intraoperative neurological deterioration or the need for patient repositioning. Postoperative imaging demonstrated satisfactory restoration of coronal and sagittal alignment, appropriate implant positioning, and spinal canal decompression. The patient experienced marked improvement in pain, shoulder balance, rib hump deformity, and overall posture while maintaining normal neurological function. The main thoracic curve improved from 32° to 6°, thoracic kyphosis from 78° to 63°, VAS from 5 to 0, ODI from 42 to 5, and SRS-22R from 3.85 to 4.85. Solid fusion was confirmed at 3 years. A postoperative pneumothorax, attributed to pleural violation during exposure, represented the only complication and resolved completely following pleural drainage. At 36-month follow-up, radiographs and computed tomography confirmed maintenance of deformity correction, stable instrumentation, and solid anterior and posterior fusion without implant failure or loss of correction. Conclusions: Single-position lateral retropleural asymmetric vertebral resection combined with percutaneous pedicle screw fixation is a technically feasible option for selected patients with congenital thoracic kyphoscoliosis. Avoiding intraoperative repositioning while combining anterior reconstruction and posterior stabilization through a reduced-access retropleural approach may simplify the surgical workflow and minimize soft-tissue disruption without compromising deformity correction. Further clinical experience is required to establish its reproducibility and comparative advantages. Full article
(This article belongs to the Special Issue Spinal Disorders: Current Treatment and Future Opportunities: Third Edition)
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25 pages, 37727 KB  
Technical Note
Decision-Making in the Surgical Management of Rigid Congenital Spinal Deformities: The Role of Vertebral Column Resection and Less Invasive Alternatives
by Piotr Kowalski, Justyna Walczak, Krzysztof Zakrzewski and Paweł Grabala
J. Clin. Med. 2026, 15(12), 4633; https://doi.org/10.3390/jcm15124633 - 15 Jun 2026
Cited by 1 | Viewed by 600
Abstract
Background: Vertebral column resection (VCR) has historically been recognized as the most efficacious corrective intervention for severe rigid spinal deformities. Nevertheless, advancements in preoperative optimization, staged corrective methodologies, osteotomies, and contemporary instrumentation have broadened the spectrum of therapeutic options available. The definitive role [...] Read more.
Background: Vertebral column resection (VCR) has historically been recognized as the most efficacious corrective intervention for severe rigid spinal deformities. Nevertheless, advancements in preoperative optimization, staged corrective methodologies, osteotomies, and contemporary instrumentation have broadened the spectrum of therapeutic options available. The definitive role of VCR in the modern management of rigid congenital spinal deformities remains a topic of ongoing scholarly discourse. Methods: This study presents two illustrative cases of severe congenital spinal deformities that were addressed employing various surgical methodologies, alongside a comprehensive review of the current literature pertaining to VCR and less invasive alternatives, including halo-gravity traction (HGT), temporary internal distraction techniques, pedicle subtraction osteotomy (PSO), asymmetric pedicle subtraction osteotomy (APSO), and multi-rod constructs. Results: The cases elucidated herein underscore the necessity for treatment strategies to be tailored specifically to the characteristics of the deformity, its flexibility, the neurological risks involved, and the individual patient’s specific attributes. In one case, significant deformity correction achieved via preoperative HGT facilitated successful management through multilevel Ponte osteotomies and posterior spinal fusion, thereby obviating the need for VCR. In other patient suffering from severe rigid congenital kyphotic deformity with pronounced anterior column deficiencies, VCR was deemed essential to realize adequate correction and neural decompression. All patients exhibited substantial radiographic correction, enhancements in health-related quality-of-life metrics, diminished disability and pain, while maintaining correction without neurological complications or implant failure at the final follow-up evaluation. Conclusions: VCR continues to be a vital element within the surgical repertoire for the treatment of severe rigid spinal deformities; however, it should not be deemed obligatory in every instance. Diligent preoperative evaluation, staged correction methodologies, and less invasive osteotomy techniques may permit satisfactory correction while mitigating surgical morbidity in suitably selected patients. Treatment approaches should be customized, favoring the least invasive procedure capable of achieving safe and lasting correction whenever practicable. Full article
(This article belongs to the Special Issue Spinal Disorders: Current Treatment and Future Opportunities: Third Edition)
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22 pages, 28243 KB  
Technical Note
Surgical Correction of Thoracolumbar Kyphosis in Achondroplasia: Complications, Pitfalls, and Reflections on the Pursuit of Maximal Realignment in View of Correction Leading to Functional Disability
by Justyna Walczak, Emilia Nowosławska, Krzysztof Zakrzewski and Paweł Grabala
J. Clin. Med. 2026, 15(8), 3142; https://doi.org/10.3390/jcm15083142 - 20 Apr 2026
Cited by 2 | Viewed by 760
Abstract
Background: Achondroplasia, the most common genetic dwarfism caused by the FGFR3 mutation (autosomal dominant, 80% de novo), results in a disproportionately short stature. Thoracolumbar kyphosis (TLK), combined with characteristic spinal canal stenosis, increases the risk of symptomatic compression, yet the literature lacks clear [...] Read more.
Background: Achondroplasia, the most common genetic dwarfism caused by the FGFR3 mutation (autosomal dominant, 80% de novo), results in a disproportionately short stature. Thoracolumbar kyphosis (TLK), combined with characteristic spinal canal stenosis, increases the risk of symptomatic compression, yet the literature lacks clear thresholds for symptom onset or progressive deformity angles. Methods: A 16-year-old female with achondroplasia presented with rapidly progressive kyphosis despite conservative management (bracing and therapy). Over six months, she developed neurogenic claudication; bilateral leg pain; weakness; and paresthesia that worsened with standing/walking, which was relieved by flexion/sitting. Imaging demonstrated surgical-threshold kyphosis with progressive spinal misalignment. Her symptoms indicated compressive myeloradiculopathy from lumbar stenosis, critical given achondroplasia’s congenitally narrowed canal and heightened neurologic vulnerability. Results: Staged surgery planned: Posterior fusion T6-L4 with pedicle screws and then extensive decompression (laminectomy/foraminotomy T11-L3), L1 corpectomy with expandable titanium cage, and Ponte osteotomies. Intraoperative complications included a malpositioned left T10 screw breaching the anterior/lateral cortex near the aorta, requiring urgent revision. Postoperatively: Neurogenic bladder, wound leakage, and E. coli urinary tract infection (UTI) with fever (treated with IV antibiotics). After infection resolution, definitive surgery removed the malpositioned screw and completed decompression, corpectomy, cage placement, bone grafting, and osteotomies, successfully resolving neurological symptoms. However, 13 cm trunk lengthening caused severe functional impairment—disproportionately short arms prevented independent toileting and dressing. Left arm lengthening via external fixation restored partial function. At 2.5-year follow-up, there was solid fusion, no neurological deficits, and improved quality of life. Conclusions: Surgery addresses severe TLK, vertebral wedging, and neurogenic claudication in achondroplasia. Vertebral column resection effectively corrects TLK and neurological deficits but carries a high complication risk. This should be reserved for severe TLK with hypoplastic vertebrae, performed by experienced surgeons. Critically, correction magnitude must preserve limb–trunk proportions to prevent functional disability, as excessive lengthening may necessitate additional limb procedures for independence restoration. Full article
(This article belongs to the Special Issue Spinal Disorders: Current Treatment and Future Opportunities: Third Edition)
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