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Spine Surgery: Clinical Advances and Practice Updates
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Spine Surgery: Clinical Advances and Practice Updates

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

Deadline for manuscript submissions: 20 July 2026 | Viewed by 1506

Special Issue Editor

Dr. Junho Song

E-Mail Website
Guest Editor
Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
Interests: orthopaedic surgery; spine surgery; minimally invasive spine surgery; disc arthroplasty; spinal deformity; scoliosis; spinopelvic alignment

Special Issue Information

Dear Colleagues,

Rapid innovation in spine surgery, from minimally invasive and endoscopic techniques to navigation, robotics, biologics, and data-driven care pathways, is reshaping everyday decision-making. This Special Issue seeks clinically grounded work that clarifies what works, for whom, and at what cost. We welcome pragmatic trials and comparative effectiveness studies, prospective and registry-based cohort studies, systematic reviews and meta-analyses, large database analyses, and technical notes that translate advances into safer care, faster recovery, and durable function.

Priority topics include the outcomes of degenerative and deformity procedures, complications and revision surgery, perioperative optimization/ERAS, outpatient pathways, robotics, artificial intelligence, minimally invasive techniques/endoscopic spine surgery, and health services research spanning value and equity. Submissions should emphasize transparent methods aligned with EQUATOR guidance (e.g., CONSORT, STROBE, and PRISMA) and clinically meaningful endpoints such as patient-reported outcomes, complications/readmissions, and return to work/activity. Our aim is to bridge foundational surgical concepts with enabling technologies to deliver reliable, patient-centered outcomes across diverse populations.

Dr. Junho Song
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-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 surgery
  • minimally invasive spine surgery
  • endoscopic spine surgery
  • robotics
  • artificial intelligence
  • spinal deformity
  • scoliosis
  • spinal trauma

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Published Papers (2 papers)

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Research

12 pages, 336 KB  
Article
Evolution of Alignment and Clinical Outcomes During One Surgeon’s Learning Curve in L5-S1 Anterior Lumbar Interbody Fusion: A Single-Center Experience
by Maxwell Sahhar, Manjot Singh, Derrick Kang, Jinseong Kim, Rhea D. Rasquinha, Joseph E. Nassar, Michael Farias, Zvipo Chisango, Nicolas Carayannopoulos, Todd Stafford, John Czerwein, Bassel G. Diebo and Alan H. Daniels
J. Clin. Med. 2026, 15(5), 1940; https://doi.org/10.3390/jcm15051940 - 4 Mar 2026
Viewed by 368
Abstract
Background: Anterior Lumbar Interbody and Fusion (ALIF) is particularly effective for improving radiographic alignment and functional outcomes. However, it also introduces distinct technical challenges, even for surgeons who are highly experienced with other lumbar fusion approaches. This study analyzes the effect of surgeon [...] Read more.
Background: Anterior Lumbar Interbody and Fusion (ALIF) is particularly effective for improving radiographic alignment and functional outcomes. However, it also introduces distinct technical challenges, even for surgeons who are highly experienced with other lumbar fusion approaches. This study analyzes the effect of surgeon experience on clinical outcomes, radiographic parameters, and operative metrics in patients with degenerative lumbar disc disease undergoing single-level L5-S1 anterior lumbar interbody fusion. Methods: Adult patients who underwent L5-S1 ALIF with or without posterior fixation for degenerative disc disease between June 2017 and December 2024 were included. Patients were stratified into Early (from 2017 to December 2020), Middle (January 2021 to December 2022), and Recent (January 2023 to December 2024) groups. Demographics, radiographic alignment, in-hospital outcomes, and 2-year complication and reoperation rates were compared based on time of surgery. Multivariate logistic and linear regression adjusted for age, sex, BMI, comorbidities, prior fusion, and posterior instrumentation was conducted to assess the effect of accumulation of surgeon experience. Results: A total of 203 ALIFs were performed (mean age: 57.6 years; 50.7% female; mean Charlson Comorbidity Index: 2.1). Recent cases showed greater PT reduction (Early = 0.9°, Middle = −1.5°, Recent = −2.2°, p = 0.039), improved PI-LL mismatch correction (−0.4°, −4.8°, −5.4°, p = 0.007), higher L5-S1 lordotic correction (6.7°, 8.4°, 11.4°, p = 0.003), lower estimated blood loss (21.9 mL, 13.8 mL, 10.0 mL, p = 0.006), shorter OR time (107.4 min, 86.6 min, 75.2 min, p < 0.001), and fewer mechanical complications (39.3% vs. 13.7%, p < 0.001) and reoperations (10.7% vs. 2.1%, p = 0.023). Regression showed that each additional year of experience predicted improved alignment, lower blood loss and OR time, and reduced odds of complications (OR = 0.54, p < 0.001) and reoperations (OR = 0.49, p = 0.015). Conclusions: In this single-surgeon, single-center cohort, increasing ALIF-specific experience over time was associated with improvements in sagittal alignment, operative efficiency, and lower complication and reoperation rates. These findings describe the longitudinal learning curve of one surgeon and should be interpreted within this context. Full article
(This article belongs to the Special Issue Spine Surgery: Clinical Advances and Practice Updates)
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9 pages, 434 KB  
Article
Vertebral Ankylosis Is Associated with Reduced Cervical Extensor Muscle Bulk and Increased Fatty Degeneration
by Junho Song, Austen D. Katz, Alex Ngan, Andrew C. Hecht, Sheeraz A. Qureshi and Sohrab Virk
J. Clin. Med. 2026, 15(1), 119; https://doi.org/10.3390/jcm15010119 - 24 Dec 2025
Viewed by 801
Abstract
Background/Objectives: Ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis produce long-segment spinal ankylosis, altered biomechanics, and high fracture risk in the cervical spine. Paraspinal muscle degeneration (“spine-specific sarcopenia”) has been linked to pain, disability, and worse outcomes after cervical spine surgery, but the relationship [...] Read more.
Background/Objectives: Ankylosing spondylitis and diffuse idiopathic skeletal hyperostosis produce long-segment spinal ankylosis, altered biomechanics, and high fracture risk in the cervical spine. Paraspinal muscle degeneration (“spine-specific sarcopenia”) has been linked to pain, disability, and worse outcomes after cervical spine surgery, but the relationship between vertebral ankylosis and cervical paraspinal muscle health is unknown. We aimed to evaluate the association between vertebral ankylosis and cervical paraspinal muscle health using MRI-based measures of muscle quantity and quality. Methods: Adult patients with cervical vertebral ankylosis and available cervical MRI were identified at a single academic center and propensity score-matched 1:1 to patients without ankylosing conditions based on age, sex, body mass index, American Society of Anesthesiologists class, and comorbidity index. Axial T2-weighted images at C2-3 through C7-T1 were used to manually trace bilateral deep extensor and deep flexor muscles to obtain bilateral cross-sectional areas (CSAs) at each level. Extensor fatty infiltration was graded using the Goutallier classification. CSAs and Goutallier grades were compared between the matched groups. Results: Compared with matched controls, patients with vertebral ankylosis demonstrated significantly smaller deep extensor CSA at multiple cervical levels and higher Goutallier grades in the lower cervical spine and at the cervicothoracic junction. Deep flexor CSA tended to be smaller in the ankylosis group, but differences did not reach statistical significance. Conclusions: Vertebral ankylosis is associated with poorer cervical paraspinal muscle health, characterized by reduced extensor muscle bulk and increased fatty degeneration. These findings support conceptualizing ankylosing spinal conditions as disorders of both bone and muscle and highlight the cervicothoracic extensors as a potential target for risk stratification and rehabilitation strategies. Full article
(This article belongs to the Special Issue Spine Surgery: Clinical Advances and Practice Updates)
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