Seminars in Spine Surgery最新文献

Current understanding of in vivo cervical spine biomechanics and its clinical implications 当前对体内颈椎生物力学的认识及其临床意义

Seminars in Spine Surgery Pub Date : 2026-03-01 Epub Date: 2025-12-23 DOI: 10.1016/j.semss.2025.101237

Jacob Weinberg , John Bonamer , M. Zino Kuhn , Ryan Kelly , Anuj Vimawala , Kimberly Hua , Clarissa LeVasseur , Rahul Ramanathan , Christopher Gonzalez , Michael Spitnale , Richard Wawrose , Joon Y. Lee , William Anderst

{"title":"Current understanding of in vivo cervical spine biomechanics and its clinical implications","authors":"Jacob Weinberg , John Bonamer , M. Zino Kuhn , Ryan Kelly , Anuj Vimawala , Kimberly Hua , Clarissa LeVasseur , Rahul Ramanathan , Christopher Gonzalez , Michael Spitnale , Richard Wawrose , Joon Y. Lee , William Anderst","doi":"10.1016/j.semss.2025.101237","DOIUrl":"10.1016/j.semss.2025.101237","url":null,"abstract":"<div><div>Neck pain and cervical degenerative disease remain major contributors to disability worldwide, and each surgical intervention inherently alters the mechanics of cervical motion. Understanding cervical spine biomechanics is therefore essential for optimizing diagnosis, operative planning, and long-term outcomes. This review integrates contemporary anatomic, kinematic, and clinical evidence to describe how advances in <em>in vivo</em> imaging have redefined the understanding of cervical motion. Techniques such as dynamic magnetic resonance imaging and biplanar radiography now allow direct, three-dimensional quantification of vertebral translation and rotation during physiologic movement. These studies demonstrate that normal motion depends on coordinated coupling among the discs, facets, and ligamentous stabilizers, and that degenerative or postoperative conditions disrupt these interactions, leading to altered instantaneous axes of rotation and changes in load sharing. <em>In vivo</em> findings also challenge traditional explanations of adjacent segment disease, showing that postoperative adaptations reflect altered motion quality rather than excessive hypermobility. These insights provide a biomechanical rationale for motion-preserving constructs such as cervical disc arthroplasty and inform rehabilitation strategies aimed at restoring physiologic coordination. By connecting fundamental biomechanics with surgical application, this review presents an updated framework for interpreting cervical motion in both health and disease and underscores the value of dynamic imaging in guiding the next generation of motion-preserving spine care.</div></div>","PeriodicalId":39884,"journal":{"name":"Seminars in Spine Surgery","volume":"38 1","pages":"Article 101237"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146147341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Contributors to authors 作者贡献者

Seminars in Spine Surgery Pub Date : 2026-03-01 Epub Date: 2026-02-11 DOI: 10.1053/S1040-7383(26)00005-5

引用次数: 0

Biologics in the evolution of spine surgery 脊柱外科发展中的生物制剂

Seminars in Spine Surgery Pub Date : 2026-03-01 Epub Date: 2025-12-23 DOI: 10.1016/j.semss.2025.101238

Jacob Weinberg , John Bonamer , Michael Kann , Grant Guzzo , Ryan Kelly , Tyler Kallman , Christopher Gonzalez , Rahul Ramanathan , Michael Spitnale , Richard Wawrose , Joon Y. Lee , Emmett Gannon

{"title":"Biologics in the evolution of spine surgery","authors":"Jacob Weinberg , John Bonamer , Michael Kann , Grant Guzzo , Ryan Kelly , Tyler Kallman , Christopher Gonzalez , Rahul Ramanathan , Michael Spitnale , Richard Wawrose , Joon Y. Lee , Emmett Gannon","doi":"10.1016/j.semss.2025.101238","DOIUrl":"10.1016/j.semss.2025.101238","url":null,"abstract":"<div><div>Biologics have become central to modern spine surgery, providing tools to enhance fusion and promote biologic healing. Autologous bone graft remains the gold standard for its osteogenic, osteoinductive, and osteoconductive properties, while allografts and demineralized bone matrices expand graft availability and reduce morbidity, albeit with variability in biologic potency. Recombinant bone morphogenetic proteins offer potent osteoinduction and have demonstrated high fusion rates in challenging cases, though dose-related complications and cost have limited use. Advances in materials science have produced synthetic grafts and bioactive ceramics that provide consistent structure and surface-mediated biologic activity. Newer bioengineered constructs, including peptide-enhanced and nanosynthetic formulations, aim to combine osteoconductive scaffolds with molecular or cellular activation. Emerging therapies such as mesenchymal stem cell allografts and gene therapy seek to biologically stimulate bone formation and regeneration at the fusion site. Collectively, these biologics represent a shift from purely structural grafts toward integrated biologic systems that combine mechanical support with targeted molecular activity. Understanding their mechanisms, indications, and limitations is essential to optimize graft selection and advance biologically driven spine surgery.</div></div>","PeriodicalId":39884,"journal":{"name":"Seminars in Spine Surgery","volume":"38 1","pages":"Article 101238"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146147352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Biology of intervertebral disc degeneration 椎间盘退变的生物学

Seminars in Spine Surgery Pub Date : 2026-03-01 Epub Date: 2025-12-23 DOI: 10.1016/j.semss.2025.101233

Jacob Weinberg , John Bonamer , Rahul Ramanathan , Christopher Gonzalez , Mario Rotunno , Gwendolyn Sowa , Nam Vo , Michael Spitnale , Joon Y. Lee , Richard Wawrose

{"title":"Biology of intervertebral disc degeneration","authors":"Jacob Weinberg , John Bonamer , Rahul Ramanathan , Christopher Gonzalez , Mario Rotunno , Gwendolyn Sowa , Nam Vo , Michael Spitnale , Joon Y. Lee , Richard Wawrose","doi":"10.1016/j.semss.2025.101233","DOIUrl":"10.1016/j.semss.2025.101233","url":null,"abstract":"<div><div>Intervertebral disc degeneration (IDD) underlies a substantial portion of chronic low back pain and remains a major cause of disability worldwide. The intervertebral disc, composed of the nucleus pulposus, annulus fibrosus, and cartilaginous endplates, maintains spinal flexibility and distributes mechanical load. Degeneration disrupts this system through cellular dysfunction, loss of hydration, and matrix breakdown. Recent evidence characterizes IDD as a multifactorial biologic cascade rather than a single age-related process. Aging, inflammation, genetic predisposition, abnormal loading, postural malalignment, and lifestyle exposures interact through overlapping pathways that accelerate cellular senescence, oxidative stress, and extracellular matrix degradation. These mechanisms reinforce one another, producing progressive biochemical and structural failure of the disc. Although the sequence of events remains incompletely defined, advances in molecular biology and biomechanics have clarified key drivers of degeneration and identified therapeutic targets. Translational efforts are increasingly directed toward modifying these pathways through biologic and regenerative approaches, including stem cell and extracellular vesicle therapy, gene-based interventions, platelet-rich plasma, growth factors, and tissue-engineered scaffolds. Together, these discoveries support a growing view of IDD as a biologically modifiable disease and highlight the potential for mechanism-based interventions to restore disc function and prevent progression.</div></div>","PeriodicalId":39884,"journal":{"name":"Seminars in Spine Surgery","volume":"38 1","pages":"Article 101233"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146147336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

“Omics”: the emerging molecular basis of spine research “组学”：脊柱研究的新兴分子基础

Seminars in Spine Surgery Pub Date : 2026-03-01 Epub Date: 2025-12-23 DOI: 10.1016/j.semss.2025.101236

John Bonamer , Gwendolyn A. Sowa , Harsha Nagar , Jacob Weinberg , Caroline Lindsey , Rahul Ramanathan , Christopher Gonzalez , Michael Spitnale , Richard Wawrose , Joon Y. Lee , Pedro Baldoni

{"title":"“Omics”: the emerging molecular basis of spine research","authors":"John Bonamer , Gwendolyn A. Sowa , Harsha Nagar , Jacob Weinberg , Caroline Lindsey , Rahul Ramanathan , Christopher Gonzalez , Michael Spitnale , Richard Wawrose , Joon Y. Lee , Pedro Baldoni","doi":"10.1016/j.semss.2025.101236","DOIUrl":"10.1016/j.semss.2025.101236","url":null,"abstract":"<div><div>Omics technologies have transformed spine research by enabling comprehensive molecular characterization of genetic, epigenetic, transcriptomic, proteomic, and microbial factors that contribute to spinal disease. The purpose of this review is to synthesize current applications of omics in elucidating the mechanisms of spinal pathology and to highlight how integrated multi-omics strategies are advancing precision spine medicine. Genomic and epigenomic studies have clarified hereditary and regulatory influences on spine morphology and disease susceptibility, while transcriptomic and proteomic analyses reveal dynamic changes in gene and protein expression that mediate cellular stress, extracellular matrix remodeling, and pain signaling. Microbiomic research has identified potential microbial contributions to disc degeneration and chronic pain. Multi-omics integration now connects these molecular layers to uncover interacting pathways that underlie complex conditions including intervertebral disc degeneration, scoliosis, and ankylosing spondylitis. These advances are accelerating biomarker discovery and the identification of therapeutic targets, fostering mechanism-based, patient-specific interventions. Ongoing challenges include data harmonization, cohort heterogeneity, and the integration of omic datasets with biobanking and electronic health records. As computational modeling and machine learning converge with longitudinal omic datasets, spine research is poised to move from descriptive molecular mapping to actionable, personalized diagnostic and therapeutic strategies.</div></div>","PeriodicalId":39884,"journal":{"name":"Seminars in Spine Surgery","volume":"38 1","pages":"Article 101236"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146147340","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Small Animal Models in Translational Spine Surgery Research 翻译脊柱外科研究中的小动物模型

Seminars in Spine Surgery Pub Date : 2026-03-01 Epub Date: 2025-12-23 DOI: 10.1016/j.semss.2025.101235

John Bonamer , Robert Bilodeau , Jacob Weinberg , Timothy Edwards , Rahul Ramanathan , Christopher Gonzalez , Michael Spitnale , Joon Y. Lee , Richard Wawrose

{"title":"Small Animal Models in Translational Spine Surgery Research","authors":"John Bonamer , Robert Bilodeau , Jacob Weinberg , Timothy Edwards , Rahul Ramanathan , Christopher Gonzalez , Michael Spitnale , Joon Y. Lee , Richard Wawrose","doi":"10.1016/j.semss.2025.101235","DOIUrl":"10.1016/j.semss.2025.101235","url":null,"abstract":"<div><div>Small animal models are foundational to translational spine surgery research, enabling the investigation of disease mechanisms and the preclinical evaluation of therapeutic strategies prior to human application. This narrative review synthesizes current knowledge of mouse, rat, and rabbit models used to study major spinal pathologies, including intervertebral disc degeneration, spinal fusion, spinal cord injury, scoliosis, and osteoporotic vertebral disease. For each application, key experimental methods, principal outcome measures, and the the elements of human pathology most faithfully reproduced by these models are summarized.</div><div>While these models have driven significant advances in spine research, several key considerations influence their clinical translation. Quadrupedal biomechanics, persistent notochordal cells, and technical scale limitations may affect degeneration, implant performance, and regenerative capacity compared with humans. Additionally, methodologic variability and inconsistent reporting can limit reproducibility and exaggerate perceived treatment effects.</div><div>Emerging approaches including genetic engineering, bioelectronic monitoring, and artificial intelligence–enabled analytics are rapidly improving model fidelity and data quality, thereby positioning small animal research to better support translational decision-making. Continued refinement of biological relevance, standardization of methodological rigor, and ethical stewardship will be essential to maximize the value of these systems in advancing future innovations in spine surgery.</div></div>","PeriodicalId":39884,"journal":{"name":"Seminars in Spine Surgery","volume":"38 1","pages":"Article 101235"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146147338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ligamentum Flavum Hypertrophy: Pathophysiology, Patient Presentation, Management, and Translational Therapeutic Research 黄韧带肥大：病理生理学、患者表现、管理和转化治疗研究

Seminars in Spine Surgery Pub Date : 2026-03-01 Epub Date: 2025-12-23 DOI: 10.1016/j.semss.2025.101234

John Bonamer , Jacob Weinberg , Sridula Kallakuri , Rahul Ramanathan , Christopher Gonzalez , Richard Wawrose , Michael Spitnale , Peter Alexander , Joon Y. Lee

{"title":"Ligamentum Flavum Hypertrophy: Pathophysiology, Patient Presentation, Management, and Translational Therapeutic Research","authors":"John Bonamer , Jacob Weinberg , Sridula Kallakuri , Rahul Ramanathan , Christopher Gonzalez , Richard Wawrose , Michael Spitnale , Peter Alexander , Joon Y. Lee","doi":"10.1016/j.semss.2025.101234","DOIUrl":"10.1016/j.semss.2025.101234","url":null,"abstract":"<div><div>Ligamentum flavum hypertrophy (LFH) is a key driver of lumbar spinal stenosis (LSS). This narrative review summarizes the current understanding of LFH pathophysiology, highlighting key structural and cellular features including loss of elastin, accumulation of dense collagen, chronic inflammatory signaling, and fibroblast-to-myofibroblast transition. Classic clinical presentation and diagnostic evaluation of associated stenosis are reviewed and contemporary nonoperative and operative management strategies are outlined. Although LFH and LSS are leading causes of spine associated morbidity, management remains largely binary: nonoperative vs. operative. Nonoperative therapy may provide short-term symptomatic relief, whereas surgical decompression, despite its efficacy, is resource intensive and associated with meaningful complication and reoperation rates. Due to the limited treatment options, there exists a pressing need for the development of preventative, disease modifying, and curative therapeutics targeted at the biological mechanisms driving LFH. Advances in molecular profiling, targeted modulation of microRNAs, and refinement of biologically relevant experimental models are beginning to strengthen translational progress. Early work suggests that regulators such as miR-29a may influence core fibrotic pathways, and preliminary results from a novel rat model offer improved biological fidelity for evaluating therapeutic candidates. Continued integration of mechanistic biology and validated translational frameworks will be essential to develop novel therapies capable of altering and/or preventing the natural history of LFH and associated LSS.</div></div>","PeriodicalId":39884,"journal":{"name":"Seminars in Spine Surgery","volume":"38 1","pages":"Article 101234"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146147337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Implications and utility of artificial intelligence in clinical spine surgical practice 人工智能在脊柱外科临床实践中的意义和应用

Seminars in Spine Surgery Pub Date : 2026-03-01 Epub Date: 2025-12-23 DOI: 10.1016/j.semss.2025.101239

Jacob Weinberg , John Bonamer , Nicolas Kelhofer , Mohamed Ali Jawad-Makki , Ryan Zuckerbraun , Christopher Gonzalez , Rahul Ramanathan , Joon Y. Lee , Michael Spitnale , Richard Wawrose

{"title":"Implications and utility of artificial intelligence in clinical spine surgical practice","authors":"Jacob Weinberg , John Bonamer , Nicolas Kelhofer , Mohamed Ali Jawad-Makki , Ryan Zuckerbraun , Christopher Gonzalez , Rahul Ramanathan , Joon Y. Lee , Michael Spitnale , Richard Wawrose","doi":"10.1016/j.semss.2025.101239","DOIUrl":"10.1016/j.semss.2025.101239","url":null,"abstract":"<div><div>Artificial intelligence (AI) is rapidly reshaping modern healthcare, and spine surgery represents one of its most promising frontiers. This narrative review synthesizes current evidence on how AI technologies are being applied throughout the perioperative continuum of spine surgery, from diagnosis and preoperative planning to intraoperative guidance and postoperative care. Machine learning, deep learning, natural language processing, and computer vision have demonstrated strong performance in preoperative applications, such as automating imaging interpretation, identifying surgical candidates, optimizing implant selection, and predicting complications. Intraoperatively, AI supports navigation accuracy, augmented and mixed reality visualization, and adaptive robotic systems that respond to real-time anatomic variation. Postoperatively, predictive models forecast outcomes and complications with greater precision than traditional risk tools, while wearable sensors and telehealth platforms enable continuous monitoring and personalized recovery.</div><div>While early results are promising, key challenges remain regarding data privacy, model bias, generalizability, and clinician acceptance. Ongoing efforts to validate, regulate, and ethically implement AI systems will determine their readiness for clinical translation. Ultimately, AI holds the potential to make spine surgery more predictive, precise, and patient-centered, bridging data science with surgical expertise to advance quality and safety in care delivery.</div></div>","PeriodicalId":39884,"journal":{"name":"Seminars in Spine Surgery","volume":"38 1","pages":"Article 101239"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146147339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Perioperative blood loss management 围手术期失血处理

Seminars in Spine Surgery Pub Date : 2025-12-01 Epub Date: 2025-10-10 DOI: 10.1016/j.semss.2025.101212

Abdullah AlDuwaisan , Firoz Miyanji

引用次数: 0

Anterior non-fusion treatment for scoliosis 脊柱侧凸的前路非融合治疗

Seminars in Spine Surgery Pub Date : 2025-12-01 Epub Date: 2025-10-04 DOI: 10.1016/j.semss.2025.101219

Vivek P. Gupta , Joshua M. Pahys , Steven W. Hwang , Amer F. Samdani

引用次数: 0