Clinical Advances in Spine Surgery

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

Deadline for manuscript submissions: 31 July 2025 | Viewed by 1644

Special Issue Editors


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Guest Editor
1. Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970473, Taiwan
2. School of Medicine, Tzu Chi University, Hualien 970374, Taiwan
Interests: spinal surgery and research; minimal invasive spine surgery; general orthopedic surgery and research; cervical spine disease, trauma, and surgery
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Co-Guest Editor
Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 970, Taiwan
Interests: trauma and fracture management; osteoarthritis and spinal disease diagnosis and research; hand and wrist surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are pleased to announce a Special Issue of Medicina focused on "Clinical Advances in Spine Surgery". As a Guest Editor, I warmly invite you to contribute your cutting-edge research, comprehensive reviews, and insightful case studies to this timely and important collection.

This Special Issue aims to showcase the latest developments and innovations in spine surgery, encompassing a wide range of topics that reflect the rapidly evolving field. We welcome submissions that address, but are not limited to, the following areas:

  1. Minimally invasive spine surgery techniques and outcomes.
  2. Advanced imaging and navigation in spine surgery.
  3. Robotic-assisted spine procedures.
  4. Biologics and regenerative approaches in spine treatment.
  5. Management of complex spinal deformities.
  6. Advances in spinal fusion technologies.
  7. Treatment strategies for degenerative spine conditions.
  8. Trauma and spinal cord injury management.
  9. Oncological spine surgery advancements.
  10. Pediatric spine surgery innovations.
  11. Artificial disc replacement and motion preservation techniques.
  12. Complication prevention and management in spine surgery.
  13. Cost-effectiveness and value-based care in spine surgery .
  14. Patient-reported outcomes in spine interventions.
  15. Emerging technologies in spine surgery (e.g., augmented reality, 3D printing).

We welcome various types of submissions, including original research articles, systematic reviews and meta-analyses, state-of-the-art review articles, case reports of novel techniques or challenging cases, and technical notes on innovative surgical approaches.

We encourage you to submit your best work and join us in advancing the field of spine surgery. Your contributions will play a crucial role in shaping the future of patient care and surgical techniques in this dynamic specialty.

Dr. Wen-Tien Wu
Dr. Kuang-Ting Yeh
Guest Editors

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Keywords

  • spine surgery
  • minimal invasive spine surgery
  • trauma and fracture
  • spinal disease diagnosis and research
  • orthopedic surgery

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Published Papers (2 papers)

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Research

13 pages, 2071 KiB  
Article
Exploratory Cluster-Based Radiographic Phenotyping of Degenerative Cervical Disorder: A Retrospective Study
by Si-Hyung Lew, Ye-Jin Jeong, Ye-Ri Roh and Dong-Ho Kang
Medicina 2025, 61(5), 916; https://doi.org/10.3390/medicina61050916 - 19 May 2025
Viewed by 460
Abstract
Background and Objectives: Degenerative cervical myelopathy (DCM), a major subtype of degenerative cervical disorders, presents with diverse sagittal alignment patterns. However, radiography-based phenotyping remains underexplored. This study aimed to identify distinct cervical alignment subgroups using unsupervised clustering analysis and to explore their [...] Read more.
Background and Objectives: Degenerative cervical myelopathy (DCM), a major subtype of degenerative cervical disorders, presents with diverse sagittal alignment patterns. However, radiography-based phenotyping remains underexplored. This study aimed to identify distinct cervical alignment subgroups using unsupervised clustering analysis and to explore their potential clinical relevance. Materials and Methods: We analyzed 1371 lateral cervical radiographs of patients with DCM. C3–C7 sagittal vertical axis (SVA), lordosis, vertical length, and curved length were determined. K-means clustering was applied, and the optimal cluster number was determined using the elbow method and silhouette analysis. Clustering validity was assessed using the Calinski–Harabasz and Davies–Bouldin indices. Results: The final clustering solution was validated with a high Calinski–Harabasz index (1171.70) and an acceptable Davies–Bouldin index (0.99) at k = 3, confirming the stability and robustness of the classification. Cluster 1 (forward-head type) exhibited low lordosis (8.3° ± 4.7°), moderate SVA (95.9 ± 60.2 mm), and a compact cervical structure, consistent with kyphotic alignment and forward-head displacement. Cluster 2 (normal) showed the highest lordosis (24.1° ± 6.8°), moderate SVA (70.6 ± 50.2 mm), and balanced sagittal alignment, indicating a biomechanically stable cervical posture. Cluster 3 (long-neck type) displayed the highest SVA (135.6 ± 76.7 mm), the longest vertical and curved lengths, and moderate lordosis, suggesting a structurally elongated cervical spine with anterior head displacement. Significant differences (p < 0.01) were observed across all clusters, confirming distinct phenotypic patterns in cervical sagittal alignment. Conclusions: This exploratory clustering analysis identified three distinct radiographic phenotypes of DCM, reflecting biomechanical heterogeneity. Although prospective studies linking these phenotypes to clinical outcomes are warranted, our findings provide a framework for personalized spinal care in the future. Full article
(This article belongs to the Special Issue Clinical Advances in Spine Surgery)
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21 pages, 2915 KiB  
Article
Malnutrition and Disability: A Retrospective Study on 2258 Adult Patients Undergoing Elective Spine Surgery
by Matteo Briguglio, Andrea Campagner, Francesco Langella, Riccardo Cecchinato, Marco Damilano, Pablo Bellosta-López, Tiziano Crespi, Elena De Vecchi, Marialetizia Latella, Giuseppe Barone, Laura Scaramuzzo, Roberto Bassani, Andrea Luca, Marco Brayda-Bruno, Thomas W. Wainwright, Robert G. Middleton, Giovanni Lombardi, Federico Cabitza, Giuseppe Banfi and Pedro Berjano
Medicina 2025, 61(3), 413; https://doi.org/10.3390/medicina61030413 - 26 Feb 2025
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Abstract
Background and Objectives: Malnutrition’s prevalence and its relationship with functional ability in patients with end-stage spine pathologies, i.e., any disease of the vertebral bodies, intervertebral discs, and associated joints requiring surgical intervention, are yet to be explored. This retrospective study aimed to [...] Read more.
Background and Objectives: Malnutrition’s prevalence and its relationship with functional ability in patients with end-stage spine pathologies, i.e., any disease of the vertebral bodies, intervertebral discs, and associated joints requiring surgical intervention, are yet to be explored. This retrospective study aimed to investigate the association between malnutrition, disability, and physical health in patients undergoing elective spine surgery in our Italian hospital. Materials and Methods: Data between 2016 and 2019, recorded at pre-admission visits, were extracted from our institutional spine registry (ClinicalTrials.gov number: NCT03644407), excluding minor patients or those undergoing emergency or oncological surgery. The measures were the Oswestry disability index (ODI) and the physical health (PH) summary of the 36-item Short-Form Health Survey. Clinical data were linked to nine laboratory parameters from pre-operative routine blood tests, and equations to ascertain the risk of malnutrition and its diagnosis were attributed. Results: The study sample included 2258 spine patients (58.15% females) who underwent surgery in our Italian hospital. The ODI and PH significantly varied across body weight difference (BWd) strata in younger adults (adjusted-p = 0.046, η2 = 0.04; adjusted-p = 0.036, η2 = 0.06) and adults (adjusted-p = 0.001, η2 = 0.02; adjusted-p = 0.004, η2 = 0.02). Protein malnutrition with acute/chronic inflammation (PMAC) in both adults (adjusted-p < 0.001, η2 = 0.04; adjusted-p < 0.001, η2 = 0.04) and older adults (adjusted-p = 0.010, η2 = 0.04; adjusted-p = 0.009, η2 = 0.05) had also a discernible impact in determining the ODI and PH. In older adults, the ODI was associated with iron deficit malnutrition (IDM) (adjusted-p = 0.005, η2 = 0.06) and both the ODI and PH were associated with vitamin B deficit (VBD) (adjusted-p = 0.037, η2 = 0.01; adjusted-p = 0.049, η2 = 0.01). Trend monotonicity was diagnosis- and sex-specific, with meaningful ordered patterns being observed mostly in young males and older females. Conclusions: Functional ability showed an association with malnutrition in younger adults and adults when using BWd, in adults and older adults when using PMAC, and in older adults when using IDM and VBD. The authors advocate for the inclusion of nutritional management in the pre-operative evaluation to potentially enhance recovery after spine surgery. Full article
(This article belongs to the Special Issue Clinical Advances in Spine Surgery)
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