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Bioengineering
Special Issues
Spinal Disorders and Spinal Surgery: Recent Advances and Future Directions
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Spinal Disorders and Spinal Surgery: Recent Advances and Future Directions

A special issue of Bioengineering (ISSN 2306-5354). This special issue belongs to the section "Regenerative Engineering".

Deadline for manuscript submissions: closed (30 September 2023) | Viewed by 4928

Special Issue Editors

Dr. Cheng-Li Lin

E-Mail Website
Guest Editor
Department of Orthopaedics, National Cheng Kung University, Tainan City 704, Taiwan
Interests: spine surgery; minimally invasive spine surgery; biomechanics; degenerative spine disease; ligamentum flavum hypertrophy; spinal fusion
Dr. Chien-Kuo Wang

E-Mail Website
Guest Editor
Department of Medical Imaging, National Cheng Kung University Hospital, Tainan, Taiwan
Interests: musculoskeletal radiology; spine imaging; computer-aided diagnosis; interventional radiology
Special Issues, Collections and Topics in MDPI journals
Dr. Ting-Yuan Tu

E-Mail Website
Guest Editor
Department of Biomedical Engineering, National Cheng Kung University Hospital, Tainan, Taiwan
Interests: 3D cell culture; circulating rare cells; In vitro tumor model; microfluidics cellular assays; tissue microenvironment

Special Issue Information

Dear Colleagues,

It is our great pleasure to introduce you to this exciting Special Issue on "Spinal Disorders and Spinal Surgery: Recent Advances and Future Directions". Spinal disorders can occur at any age, from the infant stage to old age, and lead to substantial morbidity and socioeconomic loss. Numerous efforts have been made to improve the care of patients of spinal disorders. Technological advanced afford surgeons a better understanding of the pathophysiology, diagnosis, and treatment of spinal diseases. Nevertheless, further research is still required to establish breakthrough discoveries and treatments for spinal disorders.

This Special Issue addresses spinal disorders and spinal surgery regarding recent advances and future directions. Submissions can be in the form of literature reviews, as well as original research that addresses key questions in spine care. Spinal disorders are diverse in their presentation, treatment, and outcomes, and thus, works from basic research to clinical application relating to spinal disorders will be considered.

Dr. Cheng-Li Lin
Dr. Chien-Kuo Wang
Dr. Ting-Yuan Tu
Guest Editors

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 100 words) can be sent to the Editorial Office for announcement on this website.

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. Bioengineering 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 2700 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

  • spinal disorders
  • spinal surgery
  • spine biomechanics
  • regenerative medicine
  • pathophysiology
  • spinal images

Published Papers (4 papers)

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Research

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16 pages, 11985 KiB  
Article
Effectiveness of Toothbrushing Technique for Biofilm Removal and Postoperative Infection Control after Spinal Fusion Surgery: A Retrospective Study
by Sung-ryul Choi, Ji-Won Kwon, Kyung-Soo Suk, Hak-Sun Kim, Seong-Hwan Moon, Si-Young Park, Seung-Eon Moon and Byung-Ho Lee
Bioengineering 2023, 10(10), 1143; https://doi.org/10.3390/bioengineering10101143 - 28 Sep 2023
Viewed by 835
Abstract
This retrospective study was designed to investigate the effectiveness of using a toothbrush, which is commonly used in our daily life, for biofilm removal and infection control in the treatment of spinal infections occurring after spinal fusion surgery. Currently, a biofilm is thought [...] Read more.
This retrospective study was designed to investigate the effectiveness of using a toothbrush, which is commonly used in our daily life, for biofilm removal and infection control in the treatment of spinal infections occurring after spinal fusion surgery. Currently, a biofilm is thought to form on the surface of the metal inserted during spine fusion surgery. We aim to determine the differences in clinical outcomes between using and not using a toothbrush to remove biofilm while performing conventional drainage, curettage, and debridement. A total of 1081 patients who underwent anterior or posterior spinal fusion surgery between November 2018 and October 2022 were screened. The study included 60 patients who developed surgical site infection and underwent incision and drainage surgery either with a toothbrush (n = 20) or without a toothbrush (n = 40). Failure of infection control that requires revision surgery occurred in 2 patients (10%) in the Toothbrush group and in 14 patients (35%) in the No-Toothbrush group (p = 0.039). Thus, the rate of additional surgery was significantly lower in the Toothbrush group. Additionally, normalization of c-reactive protein levels occurred significantly faster in the Toothbrush group (p = 0.044). Therefore, using a toothbrush to treat spinal infections following spinal fusion surgery appears to have beneficial mechanical debridement effects, resulting in improved clinical results, which were also confirmed based on the electron microscopic images. Full article
(This article belongs to the Special Issue Spinal Disorders and Spinal Surgery: Recent Advances and Future Directions)
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13 pages, 3794 KiB  
Article
Revisional Endoscopic Foraminal Decompression via Modified Interlaminar Approach at L5-S1 after Failed Posterior Instrumented Lumbar Fusion in Elderly Patients
by Zheng Cao, Zhenzhou Li, Hongliang Zhao, Jinchang Wang and Shuxun Hou
Bioengineering 2023, 10(9), 1097; https://doi.org/10.3390/bioengineering10091097 - 19 Sep 2023
Viewed by 916
Abstract
Elderly people usually have poorer surgical tolerance and a higher incidence of complications when undergoing revision surgery after posterior instrumented lumbar fusion (PILF). Full-endoscopic transforaminal surgery is a safe and effective option, but sometimes, it is difficult to revise L5-S1 foraminal stenosis (FS) [...] Read more.
Elderly people usually have poorer surgical tolerance and a higher incidence of complications when undergoing revision surgery after posterior instrumented lumbar fusion (PILF). Full-endoscopic transforaminal surgery is a safe and effective option, but sometimes, it is difficult to revise L5-S1 foraminal stenosis (FS) after PILF. Therefore, we developed full-endoscopic lumbar decompression (FELD) at the arthrodesis level via a modified interlaminar approach under local anesthesia. This study aimed to describe the technical note and clinical efficacy of the technique. Eleven patients with unilateral lower limb radiculopathy after PILF underwent selective nerve root block and then underwent FELD. Magnetic resonance imaging (MRI) and computer tomography (CT) were performed on the second postoperative day. Their clinical outcomes were evaluated with a Visual analog scale (VAS) of low back pain and sciatica pain, Oswestry disability index (ODI), and the MacNab score. Complete decompression was achieved in every case with FELD without serious complications. Postoperative VAS of sciatica pain and ODI at each time point and VAS of low back pain and ODI after three months postoperatively were significantly improved compared with those preoperative (p < 0.05). According to the MacNab criteria, seven patients (63.6%) had excellent results at the two-year follow-up, and four patients (36.4%) had good results. No patients required further revision surgery. FELD, via a modified interlaminar approach, is effective for treating unilateral L5-S1 FS after PILF in elderly people. Full article
(This article belongs to the Special Issue Spinal Disorders and Spinal Surgery: Recent Advances and Future Directions)
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11 pages, 2454 KiB  
Article
Automated Detection and Measurement of Dural Sack Cross-Sectional Area in Lumbar Spine MRI Using Deep Learning
by Babak Saravi, Alisia Zink, Sara Ülkümen, Sebastien Couillard-Despres, Jakob Wollborn, Gernot Lang and Frank Hassel
Bioengineering 2023, 10(9), 1072; https://doi.org/10.3390/bioengineering10091072 - 10 Sep 2023
Cited by 1 | Viewed by 954
Abstract
Lumbar spine magnetic resonance imaging (MRI) is a critical diagnostic tool for the assessment of various spinal pathologies, including degenerative disc disease, spinal stenosis, and spondylolisthesis. The accurate identification and quantification of the dural sack cross-sectional area are essential for the evaluation of [...] Read more.
Lumbar spine magnetic resonance imaging (MRI) is a critical diagnostic tool for the assessment of various spinal pathologies, including degenerative disc disease, spinal stenosis, and spondylolisthesis. The accurate identification and quantification of the dural sack cross-sectional area are essential for the evaluation of these conditions. Current manual measurement methods are time-consuming and prone to inter-observer variability. Our study developed and validated deep learning models, specifically U-Net, Attention U-Net, and MultiResUNet, for the automated detection and measurement of the dural sack area in lumbar spine MRI, using a dataset of 515 patients with symptomatic back pain and externally validating the results based on 50 patient scans. The U-Net model achieved an accuracy of 0.9990 and 0.9987 on the initial and external validation datasets, respectively. The Attention U-Net model reported an accuracy of 0.9992 and 0.9989, while the MultiResUNet model displayed a remarkable accuracy of 0.9996 and 0.9995, respectively. All models showed promising precision, recall, and F1-score metrics, along with reduced mean absolute errors compared to the ground truth manual method. In conclusion, our study demonstrates the potential of these deep learning models for the automated detection and measurement of the dural sack cross-sectional area in lumbar spine MRI. The proposed models achieve high-performance metrics in both the initial and external validation datasets, indicating their potential utility as valuable clinical tools for the evaluation of lumbar spine pathologies. Future studies with larger sample sizes and multicenter data are warranted to validate the generalizability of the model further and to explore the potential integration of this approach into routine clinical practice. Full article
(This article belongs to the Special Issue Spinal Disorders and Spinal Surgery: Recent Advances and Future Directions)
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Review

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12 pages, 2589 KiB  
Review
Future of Endoscopic Spine Surgery: Insights from Cutting-Edge Technology in the Industrial Field
by Woon-Tak Yuh, You-Sang Lee, Jong-Hyeok Jeon and Il Choi
Bioengineering 2023, 10(12), 1363; https://doi.org/10.3390/bioengineering10121363 - 27 Nov 2023
Cited by 1 | Viewed by 1408
Abstract
In the evolving landscape of spinal surgery, technological advancements play a pivotal role in enhancing surgical outcomes and patient experiences. This paper delves into the cutting-edge technologies underpinning endoscopic spine surgery (ESS), specifically highlighting the innovations in scope cameras, RF equipment, and drills. [...] Read more.
In the evolving landscape of spinal surgery, technological advancements play a pivotal role in enhancing surgical outcomes and patient experiences. This paper delves into the cutting-edge technologies underpinning endoscopic spine surgery (ESS), specifically highlighting the innovations in scope cameras, RF equipment, and drills. The modern scope camera, with its capability for high-resolution imaging, offers surgeons unparalleled visualization, enabling precise interventions. Radiofrequency (RF) equipment has emerged as a crucial tool, providing efficient energy delivery for tissue modulation without significant collateral damage. Drills, with their enhanced torque and adaptability, allow for meticulous bone work, ensuring structural integrity. As minimally invasive spine surgery (MISS) becomes the standard, the integration and optimization of these technologies are paramount. This review captures the current state of these tools and anticipates their continued evolution, setting the stage for the next frontier in spinal surgery. Full article
(This article belongs to the Special Issue Spinal Disorders and Spinal Surgery: Recent Advances and Future Directions)
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