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Diagnostics
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Advanced Diagnostic and Surgical Techniques of Spinal Disease
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Advanced Diagnostic and Surgical Techniques of Spinal Disease

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Medical Imaging and Theranostics".

Deadline for manuscript submissions: closed (28 February 2023) | Viewed by 17349

Special Issue Editors

Dr. Hyeun Sung Kim

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Guest Editor
President, Harrison Spinartus Hospital, Seoul, Republic of Korea
Interests: minimally invasive spine surgery; endoscopic spine surgery; spine surgery
Special Issues, Collections and Topics in MDPI journals
Dr. Chien-Min Chen

E-Mail Website
Guest Editor
Division of Neurosurgery, Department of Surgery, Changhua Christian Hospital, Changhua 50006, Taiwan
Interests: endoscopic-assisted minimally-invasive neurosurgery; endoscopic spinal surgery
Prof. Dr. Koichi Sairyo

E-Mail Website
Guest Editor
Department of Orthopedics, Tokushima University, Tokushima, Japan
Interests: spine surgery; spine endoscopic surgery; deformity correction; robotic surgery; VR/AR technology

Special Issue Information

Dear Colleagues, 

As the aging population changes the medical pattern, degenerative spinal diseases will become an important part of the medicine of the future.

For this reason, there is a need for advanced diagnostic and surgical techniques for degenerative spinal diseases that are appropriate for this.

Dr. Hyeun Sung Kim
Dr. Chien-Min Chen
Prof. Dr. Koichi Sairyo
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. Diagnostics is an international peer-reviewed open access semimonthly 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 2600 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

  • advanced diagnostic techniques
  • advanced surgical techniques
  • endoscopic spinal surgery
  • minimally invasive spine surgery
  • navigation-guided spinal surgery

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Published Papers (5 papers)

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13 pages, 6800 KiB  
Article
Automatic Detection, Classification, and Grading of Lumbar Intervertebral Disc Degeneration Using an Artificial Neural Network Model
by Wongthawat Liawrungrueang, Pyeoungkee Kim, Vit Kotheeranurak, Khanathip Jitpakdee and Peem Sarasombath
Diagnostics 2023, 13(4), 663; https://doi.org/10.3390/diagnostics13040663 - 10 Feb 2023
Cited by 17 | Viewed by 7003
Abstract
Background and Objectives: Intervertebral disc degeneration (IDD) is a common cause of symptomatic axial low back pain. Magnetic resonance imaging (MRI) is currently the standard for the investigation and diagnosis of IDD. Deep learning artificial intelligence models represent a potential tool for rapidly [...] Read more.
Background and Objectives: Intervertebral disc degeneration (IDD) is a common cause of symptomatic axial low back pain. Magnetic resonance imaging (MRI) is currently the standard for the investigation and diagnosis of IDD. Deep learning artificial intelligence models represent a potential tool for rapidly and automatically detecting and visualizing IDD. This study investigated the use of deep convolutional neural networks (CNNs) for the detection, classification, and grading of IDD. Methods: Sagittal images of 1000 IDD T2-weighted MRI images from 515 adult patients with symptomatic low back pain were separated into 800 MRI images using annotation techniques to create a training dataset (80%) and 200 MRI images to create a test dataset (20%). The training dataset was cleaned, labeled, and annotated by a radiologist. All lumbar discs were classified for disc degeneration based on the Pfirrmann grading system. The deep learning CNN model was used for training in detecting and grading IDD. The results of the training with the CNN model were verified by testing the grading of the dataset using an automatic model. Results: The training dataset of the sagittal intervertebral disc lumbar MRI images found 220 IDDs of grade I, 530 of grade II, 170 of grade III, 160 of grade IV, and 20 of grade V. The deep CNN model was able to detect and classify lumbar IDD with an accuracy of more than 95%. Conclusion: The deep CNN model can reliably automatically grade routine T2-weighted MRIs using the Pfirrmann grading system, providing a quick and efficient method for lumbar IDD classification. Full article
(This article belongs to the Special Issue Advanced Diagnostic and Surgical Techniques of Spinal Disease)
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8 pages, 2166 KiB  
Article
Biportal Endoscopic Radiofrequency Ablation of the Sacroiliac Joint Complex in the Treatment of Chronic Low Back Pain: A Technical Note with 1-Year Follow-Up
by Chun Tseng, Kuo-Tai Chen, Yi-Chin Fong, Chung-Wei Lin, Li-Wei Sun, Chien-Min Chen and Guan-Chyuan Wang
Diagnostics 2023, 13(2), 229; https://doi.org/10.3390/diagnostics13020229 - 8 Jan 2023
Cited by 7 | Viewed by 2688
Abstract
Background: Sacroiliac joint (SIJ) pain is a common source of low back pain. Previously reported management strategies for this pain include conservative treatment, SIJ injection, radiofrequency denervation ablation, and SIJ fusion. Herein, we describe the use of biportal endoscopic radiofrequency ablation (BERA) to [...] Read more.
Background: Sacroiliac joint (SIJ) pain is a common source of low back pain. Previously reported management strategies for this pain include conservative treatment, SIJ injection, radiofrequency denervation ablation, and SIJ fusion. Herein, we describe the use of biportal endoscopic radiofrequency ablation (BERA) to treat patients with low back pain. Methods: We included 16 patients who underwent BERA from April 2018 to June 2020. We marked the S1, S2, and S3 foramina and the SIJ line under fluoroscopy. Skin entry points were positioned at 0.5 cm medial to the SIJ line and at the level of the S1 and S2 foramina. Under local anesthesia, we introduced a 30° arthroscope with a 4 mm diameter through the viewing portal; surgical instruments were inserted through another caudal working portal. We ablated the lateral branches of the S1–S3 foramina and L5 dorsal ramus, which were the sources of SIJ pain. Results: Clinically relevant improvements in both visual analog scale and Oswestry Disability Index scores were noted at 1-, 6-, and 12-month follow-up time points after surgery. The overall patient satisfaction score was 89.1%. Conclusions: BERA for SIJ pain treatment has the advantage of directly identifying and ablating the innervating nerve to the joint. Through this technique, an expanded working angle can be obtained compared with traditional single-port endoscopy. Our study demonstrated promising preliminary results. Full article
(This article belongs to the Special Issue Advanced Diagnostic and Surgical Techniques of Spinal Disease)
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11 pages, 2373 KiB  
Article
Full-Endoscopic Lumbar Foraminotomy for Foraminal Stenosis in Spondylolisthesis: Two-Year Follow-Up Results
by Do Yeon Rhee and Yong Ahn
Diagnostics 2022, 12(12), 3152; https://doi.org/10.3390/diagnostics12123152 - 13 Dec 2022
Cited by 6 | Viewed by 2797
Abstract
Full-endoscopic lumbar foraminotomy (FELF) under local anesthesia has been developed as a minimally invasive alternative for lumbar foraminal stenosis. Some authors have described this technique for treating various lumbar spondylolisthesis. However, few studies have reported the outcomes of FELF for foraminal stenosis in [...] Read more.
Full-endoscopic lumbar foraminotomy (FELF) under local anesthesia has been developed as a minimally invasive alternative for lumbar foraminal stenosis. Some authors have described this technique for treating various lumbar spondylolisthesis. However, few studies have reported the outcomes of FELF for foraminal stenosis in patients with stable spondylolisthesis. This study aimed to demonstrate the specific technique and clinical outcomes of FELF for foraminal stenosis in patients with spondylolisthesis. Twenty-three consecutive patients with foraminal stenosis and stable spondylolisthesis were treated with FELF. Among them, 21 patients were followed up for 2 years. Full-endoscopic foraminal decompression via the transforaminal approach was performed by a senior surgeon. Clinical outcomes were evaluated using the visual analog pain score (VAS), Oswestry Disability Index (ODI), and modified MacNab criteria. The VAS and ODI scores significantly improved at the two-year follow-up. The global effects were excellent in six patients (28.6%), good in 13 (61.9%), and fair in two (9.5%). Therefore, all patients showed clinical improvement, with a success (excellent/good) rate of 90.5%. No significant surgical complications or signs of further instability were observed. FELF can be used for foraminal stenosis in patients with stable spondylolisthesis. A specialized surgical technique is required for foraminal decompression of spondylolisthesis. Full article
(This article belongs to the Special Issue Advanced Diagnostic and Surgical Techniques of Spinal Disease)
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9 pages, 945 KiB  
Article
“Double Cross Sign” Could Be an Indicator of an Adequate Amount of Bone Cement in Kyphoplasty with the SpineJack System: A Retrospective Study
by Chao-Jui Chang, Chih-Kai Hong and Che-Chia Hsu
Diagnostics 2022, 12(12), 3068; https://doi.org/10.3390/diagnostics12123068 - 6 Dec 2022
Cited by 1 | Viewed by 2099
Abstract
Kyphoplasty with the SpineJack system was able to restore vertebral height and stabilize the vertebra with an injection of bone cement. The goal of this study was to seek a reliable assessing method during the surgery in determining the minimum amount of bone [...] Read more.
Kyphoplasty with the SpineJack system was able to restore vertebral height and stabilize the vertebra with an injection of bone cement. The goal of this study was to seek a reliable assessing method during the surgery in determining the minimum amount of bone cement required for the SpineJack system to restore vertebral height and stabilize the vertebra. We defined the “double cross sign” as bone cement that expanded vertically along the bilateral SpineJack system, and spread across the midline of the vertebral body as viewed in the anteroposterior (AP) view of the radiographic image. Sixty-five patients aged 74.5 ± 8.5 years with vertebral compression fracture were included in the study. Patients with a positive double cross sign had better ODI score than those without the double cross sign (20.0 ± 6.9 vs. 32.3 ± 8.2; p < 0.001). Postoperative regional kyphotic and local kyphotic angle were significantly better in the positive double cross sign group (11 ± 8.8 degrees vs. 5.3 ± 3.2 degrees; p = 0.001/11.7 ± 6.2 degrees vs. 6.6 ± 4.1 degrees; p = 0.001, respectively). The more stable construct was built once the double cross sign was achieved during surgery. In this study, a convenient and intuitive method in identifying the minimum but sufficient quantity of injected cement during the SpineJack procedure was developed. Full article
(This article belongs to the Special Issue Advanced Diagnostic and Surgical Techniques of Spinal Disease)
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8 pages, 1239 KiB  
Case Report
Aggressive Pyogenic Spondylitis Caused by S. constellatus: A Case Report
by Nenad Koruga, Alen Rončević, Anamarija Soldo Koruga, Dario Sabadi, Domagoj Drenjančević, Ana Prica, Tatjana Rotim, Tajana Turk and Domagoj Kretić
Diagnostics 2022, 12(11), 2686; https://doi.org/10.3390/diagnostics12112686 - 4 Nov 2022
Cited by 4 | Viewed by 1576
Abstract
Streptococcus constellatus (SC) is a species of Streptococcus belonging to the Streptococcus anginosus group, along with Streptococcus anginosus and Streptococcus intermedius. Despite its commensal nature, underlying risk factors and medical conditions might lead to various anatomic site infections caused by this opportunistic [...] Read more.
Streptococcus constellatus (SC) is a species of Streptococcus belonging to the Streptococcus anginosus group, along with Streptococcus anginosus and Streptococcus intermedius. Despite its commensal nature, underlying risk factors and medical conditions might lead to various anatomic site infections caused by this opportunistic pathogen. Although SC infections have mostly been associated with bacteremia, some case reports of abscess and empyema formation have been documented. Herein, we report a case of a middle-aged female patient who initially presented with radiculopathy symptoms. Subsequent neurologic imaging revealed a pyogenic abscess along paravertebral muscles, which was found to be caused by SC. The patient was successfully treated with abscess drainage from the lumbar zone and antibiotics, and the symptoms of radiculopathy have completely resolved. Full article
(This article belongs to the Special Issue Advanced Diagnostic and Surgical Techniques of Spinal Disease)
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