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Medicina
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New Frontiers in Spine Surgery and Spine Disorders
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New Frontiers in Spine Surgery and Spine Disorders

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

Deadline for manuscript submissions: 31 March 2026 | Viewed by 4703

Special Issue Editor

Prof. Dr. Shinjiro Kaneko

E-Mail Website
Guest Editor
Department of Spine and Spinal Cord Surgery, Fujita Health University, Toyoake 470-1192, Japan
Interests: spinal deformity; spinal cord injury; cervical spine diseases; lumbar spine diseases; thoracic spine diseases
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

In recent years, we have been observing great progress in the field of treatment for spine disorders.

Lateral lumbar interbody fusion (LLIF) has emerged as a novel option for lumbar interbody fusion procedures. LLIF has also been widely used in the surgical treatment of adult spinal deformity (ASD). There are various advantages of applying LLIF to the surgical treatment of ASD. Meanwhile, several new issues remain unsolved.

The main aim of this Special Issue of Medicina is to deliver new advances in the field of spine surgery and spine disorders.

This Special Issue is open to studies on surgical strategies, clinical outcomes, etiology, systematic reviews, etc.

We invite authors to submit articles related to all the areas of spine and spinal cord surgery.

The paper types can be either of original articles, review articles, technical notes, or case reports.

Dr. Shinjiro Kaneko

Prof. Dr. Shinjiro Kaneko
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. 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 disorders
  • spine surgery
  • adult spinal deformity
  • pediatric spinal deformity
  • cervical spine diseases
  • upper cervical spine diseases, lumbar spine diseases
  • thoracic spine diseases
  • spinal cord injury
  • spine and spinal cord tumor

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Published Papers (4 papers)

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Research

13 pages, 11628 KB  
Article
Unilateral Posterior Stabilization in Adult Spinal Pathologies: Comparative Clinical, Radiological, and Complication Outcomes of Dynamic Versus Rigid Systems
by Uzay Erdogan, Ege Anil Ucar, Feride Bulgur Balay, Gurkan Berikol, Ibrahim Taha Albas, Mehmet Yigit Akgun, Tunc Oktenoglu, Ali Fahir Ozer and Ozkan Ates
Medicina 2025, 61(11), 1958; https://doi.org/10.3390/medicina61111958 - 31 Oct 2025
Viewed by 424
Abstract
Background and Objectives: Unilateral spinal stabilization has emerged as a less invasive alternative to bilateral fixation in the management of lateralized spinal pathologies. While both rigid and dynamic systems are utilized, comparative data regarding their clinical efficacy, radiological outcomes, and complication profiles—particularly [...] Read more.
Background and Objectives: Unilateral spinal stabilization has emerged as a less invasive alternative to bilateral fixation in the management of lateralized spinal pathologies. While both rigid and dynamic systems are utilized, comparative data regarding their clinical efficacy, radiological outcomes, and complication profiles—particularly in multilevel applications—remain limited. Materials and Methods: A retrospective, two-center analysis was conducted on 113 patients who underwent unilateral posterior spinal stabilization between 2019 and 2023. Patients were divided into unilateral rigid stabilization (URS, n = 41) and unilateral dynamic stabilization (UDS, n = 72) groups. Pathologies of the patients include disc herniations, foraminal and spinal stenosis, tumoral lesions and spondylolisthesis. Clinical outcomes were assessed using the Visual Analogue Scale (VAS) over a 24-month follow-up. Radiological parameters included fusion status, superior adjacent disc height, and foraminal height index. Complication rates, including adjacent segment degeneration (ASD), pseudoarthrosis, and screw loosening, were analyzed according to type-of-stabilization and construct length (two, three, or four levels). Results: Both URS and UDS groups demonstrated significant VAS improvement at final follow-up, with no significant differences between groups (p < 0.001). Fusion rates were significantly higher in the URS group (85.37% vs. 27.78%, p < 0.001), while pseudoarthrosis (39.02% vs. 16.62%, p = 0.081) were more frequent in URS. No cases of rod fracture or infection were observed. Complication rates, particularly ASD, increased with longer constructs (6.56%, 21.21%, vs. 31.58% p = 0.01), independent of stabilization type. Conclusions: Unilateral stabilization—whether rigid or dynamic—offers effective symptom relief with reduced surgical morbidity. However, dynamic systems may provide biomechanical advantages by preserving motion and minimizing adjacent segment stress. While rigid constructs yield higher fusion rates, they are associated with increased complications. These findings support the use of dynamic stabilization, particularly in multilevel constructs, and highlight the need for patient-specific surgical strategies to optimize outcomes and mitigate long-term complications. Full article
(This article belongs to the Special Issue New Frontiers in Spine Surgery and Spine Disorders)
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11 pages, 843 KB  
Article
Association of CT HU Values with Adjacent Vertebral Fractures After Balloon Kyphoplasty
by Hiromitsu Takano, Hidetoshi Nojiri, Shota Tamagawa, Arihisa Shimura, Juri Teramoto, Hisashi Ishibashi, Yuta Sugawara, Kazuki Nakai and Muneaki Ishijima
Medicina 2025, 61(9), 1517; https://doi.org/10.3390/medicina61091517 - 23 Aug 2025
Viewed by 789
Abstract
Background and Objectives: Although adjacent vertebral fractures (AVF) frequently occur after balloon kyphoplasty (BKP), their risk factors remain unclear. This retrospective study aimed to identify risk factors for AVF and evaluate the utility of Hounsfield unit (HU) values on preoperative vertebral computed [...] Read more.
Background and Objectives: Although adjacent vertebral fractures (AVF) frequently occur after balloon kyphoplasty (BKP), their risk factors remain unclear. This retrospective study aimed to identify risk factors for AVF and evaluate the utility of Hounsfield unit (HU) values on preoperative vertebral computed tomography (CT) scans as predictors of its occurrence. Materials and Methods: We retrospectively evaluated 180 patients (46 male and 134 female individuals; mean age: 80.3 years; range: 60–94 years) who underwent BKP for osteoporotic vertebral fractures (OVFs) between 2021 and 2023 with at least 6 months of follow-up. The patients were categorized into the AVF (n = 31) and non-AVF (n = 149) groups. Analyzed variables included patient characteristics, fracture level, prior fractures, posterior wall injury, intravertebral cleft, vacuum phenomenon in adjacent intervertebral discs, injury-to-surgery interval, cement volume, kyphosis angles, wedge ratios, and HU values. HU values were measured at three levels on preoperative CT scans in the vertebrae above and below the treated segment. Cutoff HU values predictive of AVF were determined using receiver operating characteristic (ROC) curve analysis. Results: AVF incidence was 17.2% (31/180), with 71.0% occurring in the vertebrae above the treated level. HU values in all measured slices were significantly lower in the AVF group. The mean HU values in the upper vertebra were 61.1 ± 6.03 (AVF) and 84.7 ± 2.75 (non-AVF), and in the lower vertebra, 51.5 ± 8.44 and 81.0 ± 3.85, respectively. ROC analysis showed cutoff HU values of 79.3 and 61.0 for the upper and lower vertebrae, respectively. HU values were identified as independent AVF risk factors. Conclusions: Preoperative vertebral HU values are independent AVF predictors. Values below 79.3 in the upper or 61.0 in the lower vertebrae were linked to higher AVF risk, suggesting HU measurement is a simple, useful tool for preoperative risk assessment. Full article
(This article belongs to the Special Issue New Frontiers in Spine Surgery and Spine Disorders)
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11 pages, 943 KB  
Article
Comparing Frailty Status Among Clusters Identified Based on EQ-5D-5L Dimensions in Older Patients with Chronic Low Back Pain
by Hee Jung Kim, Hyeon Chang Kim, Jisung Hwang and Shin Hyung Kim
Medicina 2025, 61(7), 1217; https://doi.org/10.3390/medicina61071217 - 3 Jul 2025
Cited by 1 | Viewed by 934
Abstract
Background and Objectives: In the present study, distinct subgroups of older adults with chronic low back pain (LBP) were identified using cluster analysis based on the five dimensions of the EQ-5D-5L. Using detailed profiles of how chronic LBP affects various facets of [...] Read more.
Background and Objectives: In the present study, distinct subgroups of older adults with chronic low back pain (LBP) were identified using cluster analysis based on the five dimensions of the EQ-5D-5L. Using detailed profiles of how chronic LBP affects various facets of health-related quality of life (HRQoL), differences in frailty levels across these subgroups were investigated in this study. Materials and Methods: This retrospective study included patients ≥ 60 years of age who visited the pain clinic at a tertiary hospital between March 2022 and February 2023. HRQoL was assessed using the EQ-5D-5L, and frailty was evaluated via the Frailty Phenotype Questionnaire. Hierarchical cluster analysis using the WARD method with squared Euclidean distance was conducted on the EQ-5D-5L dimensions to identify subgroups. Differences in frailty, demographics, and clinical data across clusters were analyzed. Results: Among 837 older adults with chronic LBP, four distinct clusters were identified based on a cluster analysis of the EQ-5D-5L dimensions. Cluster 1 exhibited high levels of pain/discomfort and anxiety/depression, and cluster 2 had severe mobility limitations and pain/discomfort but low anxiety/depression. Cluster 3 showed balanced scores across all dimensions, and cluster 4 had severe pain/discomfort but good mobility. Significant differences were observed among the clusters in pain intensity, EQ Visual Analogue Scale (EQ-VAS) and EQ-5D-5L index scores, and frailty status. Cluster 1 had the highest pain scores and lowest EQ-VAS, and frailty was most prevalent in cluster 2 (28.5%) and least in cluster 4 (13.3%). Conclusions: The results of the present study emphasize the complexity of chronic LBP in older adults by identifying distinct clusters. Cluster analysis identified four unique profiles, with significant frailty differences across the clusters. These findings emphasize the importance of personalized management strategies tailored to specific patient profiles to enhance treatment effectiveness and improve frailty status. Full article
(This article belongs to the Special Issue New Frontiers in Spine Surgery and Spine Disorders)
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10 pages, 3278 KB  
Article
Augmented Reality in Scoliosis Correction Surgery: Efficiency and Accuracy in Pedicle Screw Instrumentation
by Chia-Ning Chang, Chi-Ruei Li, Sian-Siang Liao, Chiung-Chyi Shen, Kai-Yuan Chen, Chung-Hsin Lee and Meng-Yin Yang
Medicina 2025, 61(4), 576; https://doi.org/10.3390/medicina61040576 - 24 Mar 2025
Cited by 2 | Viewed by 1975
Abstract
Background and Objectives: Recent advancements in spinal navigation methodologies, particularly augmented reality (AR) techniques, have significantly enhanced the precision of spinal instrumentation procedures. This study aimed to evaluate the efficacy of AR-assisted navigation in spinal instrumentation surgery for thoracolumbar scoliosis. Materials and [...] Read more.
Background and Objectives: Recent advancements in spinal navigation methodologies, particularly augmented reality (AR) techniques, have significantly enhanced the precision of spinal instrumentation procedures. This study aimed to evaluate the efficacy of AR-assisted navigation in spinal instrumentation surgery for thoracolumbar scoliosis. Materials and Methods: This retrospective observational study included 10 patients with thoracolumbar scoliosis who met specific inclusion criteria and were recruited at a single medical center. Two neurosurgeons and one neuroradiologist used the Gertzbein–Robbins scale (GRS) for radiological evaluation. Preoperative and postoperative Cobb angles were measured to assess the correction of scoliosis. Overall, 257 screws were placed using the AR-assisted navigation system during thoracic and lumbar spinal deformity surgeries. Results: Among the 257 screws, 197 were placed in the thoracic spine and 60 in the lumbar spine, achieving an overall instrumentation accuracy of 98%. The preoperative Cobb angle of 69.5 ± 22.2° significantly improved to 10.1 ± 4.1° postoperatively. Regarding first-attempt screw placement accuracy, 97.4% of the screws in the thoracic spine (graded as GRS A or B) and 100% in the lumbar spine were placed with precision. Five grade C thoracic screws were identified, one of which required re-instrumentation. Conclusions: The AR navigation technique substantially improved the precision of spinal deformity surgery, with a high screw placement accuracy rate and significant scoliosis correction. The benefits of reduced attention diversion and an intuitive surgical experience suggest that AR technology could significantly improve spinal surgery practices and training programs, indicating potential for broader applicability in the future. Full article
(This article belongs to the Special Issue New Frontiers in Spine Surgery and Spine Disorders)
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