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Medicina
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Spinal Surgery: Advances and Concerns
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Spinal Surgery: Advances and Concerns

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Neurology".

Deadline for manuscript submissions: 31 December 2026 | Viewed by 2102

Special Issue Editors

Prof. Dr. Filippo Migliorini

E-Mail Website
Guest Editor
1. Department of Trauma and Reconstructive Surgery, University Hospital in Halle, Martin-Luther University Halle-Wittenberg, Halle, Germany
2. Department of Life Sciences, Health, and Health Professions, Link Campus University, Rome, Italy
3. Department of Orthopaedic and Trauma Surgery, Academic Hospital of Bolzano, Bolzano, Italy
Interests: orthopaedic surgery; trauma surgery; knee; hip; spine; ankle; arthroplasty; arthroscopy; sports medicine; regenerative medicine, medical statistics
Dr. Gaetano Pappalardo

E-Mail Website
Guest Editor Assistant
Department of Spine Surgery, Pineta Grande Hospital, 81030 Castel Volturno, Italy
Interests: spine

Special Issue Information

Dear Colleagues,

We are delighted to announce the launch of this Special Issue, entitled "Spinal Surgery: Advances and Concerns”, in Medicina, a multidisciplinary, open access, and peer-reviewed journal that publishes high-quality articles (https://www.mdpi.com/journal/medicina). The current impact factor of this journal is 2.4.

This Special Issue aims to explore the rapidly evolving landscape of spinal surgery, where technological innovation meets clinical practice. We invite the submission of research, clinical studies, and review articles highlighting cutting-edge developments in minimally invasive techniques, robotic-assisted surgery, artificial intelligence applications, and advanced imaging methods transforming surgical precision and patient outcomes. This Special Issue aims to address the critical concerns facing the field, including the balance between technological advancement and economic sustainability, the learning curve associated with novel techniques, radiation exposure reduction, and the long-term efficacy validation of emerging therapies. We welcome the submission of research focused on endoscopic approaches, 3D-printed implants, neuromodulation, biologics, and stem cell applications. Contributions examining patient-specific challenges, outcome measurements, and proper patient selection are particularly encouraged. With this Special Issue, we hope to create a platform that offers spine surgeons and scientists worldwide an opportunity to share innovations that bridge the gap between technological promise and clinical reality, ultimately advancing our collective goal of improved patient care through evidence-based spinal surgery.

Dr. Filippo Migliorini
Guest Editor

Dr. Gaetano Pappalardo
Guest Editor Assistant

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. Medicina is an international peer-reviewed open access monthly 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 2200 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
  • deformity
  • motion preservation
  • oncology
  • infections
  • trauma
  • complications
  • instrumentation
  • outcomes

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Further information on MDPI's Special Issue policies can be found here.

Published Papers (2 papers)

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Research

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9 pages, 951 KB  
Article
Clinical Outcomes of Transdiscal Screws for Thoracolumbar Spinal Fractures with Marked Anterior Distraction Gap Accompanied by Diffuse Idiopathic Skeletal Hyperostosis
by Ryo Ugawa, Yoshihiro Fujiwara and Toshiyuki Matsumoto
Medicina 2025, 61(10), 1874; https://doi.org/10.3390/medicina61101874 - 19 Oct 2025
Viewed by 990
Abstract
Background and Objectives: Diffuse idiopathic skeletal hyperostosis (DISH)-related spinal fractures with marked anterior distraction are highly unstable and pose substantial surgical challenges. The transdiscal screw for diffuse idiopathic skeletal hyperostosis (TSD) technique has been proposed to enhance fixation strength by penetrating adjacent [...] Read more.
Background and Objectives: Diffuse idiopathic skeletal hyperostosis (DISH)-related spinal fractures with marked anterior distraction are highly unstable and pose substantial surgical challenges. The transdiscal screw for diffuse idiopathic skeletal hyperostosis (TSD) technique has been proposed to enhance fixation strength by penetrating adjacent vertebral endplates; however, its clinical utility in large-displacement cases remained unclear. Materials and Methods: In this retrospective study, we reviewed 21 patients with thoracolumbar DISH-related fractures and an anterior fracture gap ≥ 15 mm, who underwent posterior fixation between 2010 and 2024. 11 patients underwent TSD fixation (TSD group), and 10 underwent conventional fixation without bilateral TSD (control group). Results: The mean number of fused segments did not differ significantly between the groups (5.0 ± 1.4 vs. 5.0 ± 1.3, p = 0.43). Operative time was comparable (164 ± 57 vs. 168 ± 60 min, p = 0.90). Blood loss tended to be lower in the TSD group (306 ± 334 vs. 528 ± 658 mL, p = 0.33). For fracture-gap reduction, the TSD group improved from 17.4 ± 2.3 mm preoperatively to 13.8 ± 4.4 mm postoperatively and 2.0 ± 3.6 mm at final follow-up, while the control group showed less reduction (16.8 ± 2.2, 15.4 ± 1.4, and 7.0 ± 9.1 mm, respectively). Screw loosening occurred in three TSD patients and six controls (p = 0.13). All patients in the TSD group achieved bone union without reoperation, whereas four controls experienced implant backout, three required reoperation, and two failed to achieve bone union (p = 0.035). Conclusions: Posterior fixation using TSD provided reliable stability, maintained reduction, and reduced the risk of implant failure compared with conventional fixation in highly unstable DISH-related fractures with anterior distraction. Although larger prospective studies are needed, TSD may represent a valuable surgical option for this challenging patient population. Full article
(This article belongs to the Special Issue Spinal Surgery: Advances and Concerns)
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Review

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21 pages, 980 KB  
Review
Current Perspective on Orthobiology Applications for the Treatment of Intervertebral Disc Degeneration (IDD)—A Narrative Review
by Gianluca Conza, Maria Consiglia Trotta, Chiara Mastronardi, Alfonso Nocera, Annalisa Itro, Gabriele Martin, Gabriella Toro, Caterina Claudia Lepre, Marina Russo and Giuseppe Toro
Medicina 2026, 62(4), 758; https://doi.org/10.3390/medicina62040758 - 15 Apr 2026
Viewed by 654
Abstract
Background and Objectives: Low back pain (LBP) is a leading cause of disability worldwide and is frequently associated with intervertebral disc degeneration (IVDD). Current therapeutic strategies are primarily symptomatic and do not restore native disc biology, largely due to the avascular nature [...] Read more.
Background and Objectives: Low back pain (LBP) is a leading cause of disability worldwide and is frequently associated with intervertebral disc degeneration (IVDD). Current therapeutic strategies are primarily symptomatic and do not restore native disc biology, largely due to the avascular nature of the intervertebral disc and the hostile inflammatory and mechanical microenvironment that characterizes degeneration. The aim of this study is to provide an updated and clinically oriented overview of the pathophysiology of IVDD and to evaluate the current evidence on mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP)-based therapies. Materials and Methods: A focused narrative literature review was performed to evaluate current evidence on MSC- and PRP-based therapies for intervertebral disc degeneration (IVDD). The search was conducted in PubMed. Only studies in English were considered eligible. Results: Mesenchymal stem cells (MSCs) demonstrated regenerative and immunomodulatory effects primarily through paracrine mechanisms, enhancing extracellular matrix synthesis and reducing inflammation and apoptosis. MSC-derived extracellular vesicles emerged as a promising cell-free alternative, potentially overcoming limitations related to cell survival and safety. Platelet-rich plasma (PRP) showed anabolic and anti-inflammatory properties, promoting disc cell proliferation and matrix production, particularly in early-stage degeneration. Clinical studies, including randomized trials, reported significant improvements in pain and function for both MSC and PRP therapies, with favourable safety profiles. However, heterogeneity in treatment protocols and limited long-term data remain significant limitations. Orthobiologic therapies represent a minimally invasive option for patients with discogenic low back pain refractory to conservative treatment. Patient selection is crucial and should consider degeneration stage, disc viability, and clinical presentation. PRP is primarily indicated in early-stage degeneration (Pfirrmann II–III), whereas MSC-based therapies may be considered in selected patients with more advanced but still viable discs. Based on current evidence, a stepwise approach is proposed, progressing from conservative management to PRP, MSCs, and ultimately surgery. Orthobiologics should be integrated within a multimodal strategy including rehabilitation. Conclusions: MSCs and PRP represent a promising and, eventually, complementary orthobiologic therapies for IVDD. PRP is primarily effective in early degenerative stages as a biologic stimulator, whereas MSCs may provide regenerative benefits in more advanced but still viable discs. Further studies are necessary to standardize protocols and confirm long-term efficacy and safety. Full article
(This article belongs to the Special Issue Spinal Surgery: Advances and Concerns)
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