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 2981

Special Issue Editor


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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
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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

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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 (3 papers)

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Research

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 526
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 636
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 1358
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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