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What's New — Spine — December 2025

19 new articles published this month.

Themes: Molecular Mechanisms in SCI and Degeneration · Surgical Planning, Biomaterials, and Reconstruction · Trauma, Fractures, and Complications · Biomechanics, Imaging, and Adjacent Segment Disease

Digest generated 2026-04-16 00:48:35+00:00.

Highlights

Molecular Mechanisms in SCI and Degeneration

Recent research highlights the role of microRNAs and exosomes in spinal pathophysiology. Articles [1] and [8] investigate specific miRNAs (miR-18a-3p and miR-499-5P) derived from mesenchymal stem cells, demonstrating their capacity to mitigate apoptosis, inflammation, and oxidative stress following traumatic spinal cord injury. Complementing this, article [7] explores how exosomal miR-223-3p targets the FBXW7 gene to inhibit intervertebral disc degeneration. These studies collectively advance the understanding of cellular and molecular pathways, suggesting novel therapeutic targets for neural recovery and disc preservation.

Surgical Planning, Biomaterials, and Reconstruction

This cluster focuses on technological advancements and material choices in spinal surgery. Article [4] demonstrates that 3D virtual surgical planning improves precision in percutaneous endoscopic discectomy. In the realm of reconstruction, article [11] compares 3D-printed tantalum cages against titanium mesh for anterior column reconstruction after spondylectomy. Further innovation is seen in article [13], which evaluates a 3D-printed porous interbody cage in a sheep model for cervical fusion. Additionally, article [5] provides essential anatomical data on cortical bone trajectories to guide safe pedicle screw placement in the lumbar spine.

Trauma, Fractures, and Complications

Several studies address acute trauma and postoperative complications. Article [3] reports a rare case of nerve root injury from a unilateral facet fracture. Article [10] analyzes CTA imaging to assess the risk of internal carotid artery injury during transoral upper cervical approaches. Regarding complications, article [14] identifies risk factors for postoperative ileus following TLIF, while article [16] evaluates the timing of VTE prophylaxis in cervical SCI patients. Finally, article [15] provides a comprehensive review of sacral insufficiency fractures, discussing management strategies from nonoperative care to percutaneous fixation.

Biomechanics, Imaging, and Adjacent Segment Disease

This theme covers biomechanical modeling, diagnostic imaging, and long-term outcomes. Article [19] uses finite element analysis to determine optimal correction angles for cervical kyphosis. Diagnostic utility is explored in article [6], which validates methods for analyzing segmental motion in extension, and article [17], which applies a small-sample ResNet-34 model to predict cervical degeneration from X-rays. Article [12] investigates Hounsfield unit values in patients with diffuse idiopathic skeletal hyperostosis. Lastly, article [18] assesses the long-term efficacy of Wallis dynamic stabilization in preventing adjacent segment degeneration.

Articles by Theme

Molecular Mechanisms in SCI and Degeneration (3)

1. Li Y, Dai B, Cheng Z, et al. The clinical significance of miR-18a-3p in traumatic spinal cord injury and its functional role in mediating apoptosis, inflammation and oxidative stress. Journal of Orthopaedic Surgery and Research 2025. doi:10.1186/s13018-025-06559-5

This study investigated the role of miR-18a-3p in traumatic spinal cord injury, specifically examining its impact on apoptosis, inflammation, and oxidative stress. The key finding revealed that miR-18a-3p significantly mediates these pathological processes, suggesting it acts as a critical regulator of neuronal damage. Clinically, targeting miR-18a-3p could offer a novel therapeutic strategy to mitigate secondary injury and improve functional recovery in spinal cord trauma patients.

7. Chen R, Cao K, Gong Y, et al. Exosomal miR-223-3p from mesenchymal stem cells targets FBXW7 to inhibit intervertebral disc degeneration: mechanism insights. Journal of Orthopaedic Surgery and Research 2025. doi:10.1186/s13018-025-06468-7

This research explored the mechanism by which exosomal miR-223-3p derived from mesenchymal stem cells inhibits intervertebral disc degeneration by targeting the FBXW7 gene. The study found that this miRNA effectively suppresses degenerative pathways, thereby preserving disc structure and function. These insights suggest that MSC-derived exosomes carrying miR-223-3p could serve as a promising cell-free therapy for treating disc degeneration.

8. Pang L, Qi L, Wang H, et al. MiR499-5P loaded MSC derived exosomes affect oxidative stress and inflammatory response after spinal cord injury by targeting genes. Journal of Orthopaedic Surgery and Research 2025. doi:10.1186/s13018-025-06500-w

The study demonstrated that mesenchymal stem cell-derived exosomes loaded with miR-499-5P protect neurons and promote motor recovery in spinal cord injury mice by targeting genes involved in oxidative stress and inflammation. Bioinformatic analysis identified miR-499-5P as a key regulator, and subsequent in vivo experiments confirmed its therapeutic efficacy. Clinically, this identifies miR-499-5P-loaded exosomes as a potent candidate for developing treatments aimed at neural repair after spinal cord injury.

Surgical Planning, Biomaterials, and Reconstruction (4)

4. Fuguo Y, Kang C, Yuanchao L, et al. Three-dimensional virtual surgical planning enhances precision and safety in percutaneous transforaminal endoscopic discectomy: a retrospective comparative study. Journal of Orthopaedic Surgery and Research 2025. doi:10.1186/s13018-025-06558-6

A retrospective comparative study assessed the impact of three-dimensional virtual surgical planning on the precision and safety of percutaneous transforaminal endoscopic discectomy. The results demonstrated that the use of 3D planning significantly improved surgical accuracy and reduced procedural risks compared to conventional techniques. These findings support the integration of 3D virtual planning into standard protocols to enhance patient outcomes in minimally invasive spine surgery.

5. Wang Y, Maimaiti A, Xiao Y, et al. Study on anatomical parameters of modified cortical bone trajectories in the lower lumbar vertebrae. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-08988-z

This study analyzed anatomical parameters of modified cortical bone trajectories within the lower lumbar vertebrae to optimize pedicle screw placement. The key finding provided precise anatomical data regarding trajectory angles and entry points, which are crucial for avoiding neurovascular injury. Clinically, these measurements offer a reliable reference for surgeons performing lumbar fixation procedures, potentially reducing complication rates.

11. Lv H, Xu M, Ai Q, et al. 3D-printed tantalum artificial vertebral body or titanium mesh in anterior column reconstruction post-spondylectomy for thoracic vertebral tumors: a retrospective comparative cohort study and finite element analysis. Journal of Orthopaedic Surgery and Research 2025. doi:10.1186/s13018-025-06351-5

This study compared 3D-printed tantalum artificial vertebral bodies with titanium mesh for anterior column reconstruction following spondylectomy for thoracic tumors, incorporating finite element analysis. Results indicated that the tantalum implants offered superior biomechanical stability and load distribution compared to titanium mesh. The findings support the use of 3D-printed tantalum as a viable alternative for enhancing structural integrity in complex spinal tumor reconstructions.

13. Liu S, Li Q, Xiao K, et al. Preclinical evaluation of a 3D-printed porous stand-alone interbody cage for cervical fusion in a sheep model. Journal of Orthopaedic Surgery and Research 2025. doi:10.1186/s13018-025-06458-9

A preclinical study evaluated the safety and efficacy of a novel 3D-printed porous stand-alone interbody cage for cervical fusion using a sheep model. The cage demonstrated successful osseointegration and maintained intervertebral height without significant adverse events over the observation period. These results provide promising evidence for the translational potential of porous 3D-printed cages in human cervical spine surgery.

Trauma, Fractures, and Complications (5)

3. Takahashi H, Shibao Y, Funayama T, et al. Traumatic nerve root injury due to unilateral facet fracture of the cervical spine caused by a direct external force; a case report. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09448-4

This case report describes a rare instance of traumatic nerve root injury resulting from a unilateral cervical facet fracture caused by direct external force. The key finding highlights the specific mechanism by which such fractures compress nerve roots, leading to distinct neurological deficits. Clinically, this underscores the need for high-resolution imaging and careful surgical planning to address nerve compression in complex cervical spine trauma cases.

10. Shen Q, Wei H, Ma S, et al. Classification of internal carotid artery aberrations based on CTA imaging: evaluating the risk of ICA injury in the transoral approach to upper cervical surgery. Journal of Orthopaedic Surgery and Research 2025. doi:10.1186/s13018-025-06554-w

Researchers developed a classification system for internal carotid artery aberrations using CTA imaging to better assess injury risks during transoral upper cervical surgery. The study demonstrated that this classification effectively stratifies patients based on the likelihood of vascular injury, guiding safer surgical planning. Clinicians can utilize this framework to anticipate anatomical variations and mitigate the risk of catastrophic vascular complications during complex cervical procedures.

14. Chen S, Wu W, Si X, et al. Risk factors for postoperative ileus following transforaminal lumbar interbody fusion: a retrospective study. Journal of Orthopaedic Surgery and Research 2025. doi:10.1186/s13018-025-06541-1

This retrospective study investigated risk factors associated with postoperative ileus following transforaminal lumbar interbody fusion (TLIF) procedures. The analysis identified specific patient and surgical variables that significantly increase the likelihood of developing postoperative ileus. Identifying these risk factors allows surgeons to implement targeted preventive measures and optimize perioperative care to reduce recovery times.

15. Collins AP, Roddy E, Davis WT, et al. Sacral Insufficiency Fractures: Pathology, Management, and Outcomes. Journal of Bone and Joint Surgery 2025. doi:10.2106/jbjs.25.00482

This review synthesizes current knowledge on the pathology, management, and outcomes of sacral insufficiency fractures, emphasizing their rising prevalence in elderly osteoporotic patients. It highlights that treatment strategies must be tailored to fracture stability, ranging from conservative care to procedural interventions like sacroplasty or percutaneous fixation. The authors note a critical need for more comparative studies to standardize care and reduce complications associated with various treatment modalities.

16. Essa A, Malhotra AK, Shakil H, et al. Trends and Impact of Pharmacological VTE Prophylaxis Timing for Traumatic Cervical Spinal Cord Injury Across North American Trauma Centers. Journal of Bone and Joint Surgery 2025. doi:10.2106/jbjs.24.00563

This large-scale retrospective study analyzed trends in venous thromboembolism (VTE) prophylaxis timing and its impact on VTE complications in patients with complete traumatic cervical spinal cord injury across North America. The findings revealed significant variations in prophylaxis initiation times and identified specific delays that correlate with increased VTE risk. These results underscore the importance of standardized, early VTE prophylaxis protocols to improve outcomes in this high-risk trauma population.

Biomechanics, Imaging, and Adjacent Segment Disease (5)

6. Schuermans VN, Breen A, Branney J, et al. Cross-validation of two independent methods to analyze the sequence of segmental contributions in the cervical spine in extension cineradiographic recordings. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09413-1

The authors performed a cross-validation of two independent methods to analyze the sequence of segmental contributions during cervical spine extension using cineradiographic recordings. They confirmed the reliability of both methods in quantifying dynamic segmental motion, establishing a robust framework for assessing cervical kinematics. This validation supports the use of these analytical techniques in diagnosing cervical instability and planning surgical interventions.

12. Suzuki A, Kumagai G, Wada K, et al. Hounsfield unit values in patients with diffuse idiopathic skeletal hyperostosis and thoracolumbar injuries - a single-center retrospective study. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09382-5

This single-center retrospective study analyzed Hounsfield unit values in patients with diffuse idiopathic skeletal hyperostosis (DISH) who sustained thoracolumbar injuries. The research found that DISH patients exhibited distinct radiographic density patterns that correlate with increased fracture severity and instability. These insights aid in early risk stratification and inform more aggressive stabilization strategies for this high-risk patient population.

17. Wei Z, Wu H, Xu Y, et al. S-ResNet-34: small sample-ResNet-34 for predicting cervical degeneration in x-ray image data. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09273-9

Researchers developed S-ResNet-34, a modified deep learning architecture optimized for small sample sizes, to predict cervical degeneration from X-ray images. The study demonstrated that this model achieved high diagnostic accuracy despite limited training data. This approach offers a practical tool for early detection of cervical degeneration in clinical settings where large annotated datasets are unavailable.

18. Chen S, Xiong Y, Qiu Z, et al. Can Wallis topping-off surgery reduce radiographic adjacent segment degeneration? a single-center study with at least 8 years of long-term follow-up. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09316-1

This single-center study evaluated the long-term efficacy of Wallis topping-off surgery in preventing radiographic adjacent segment degeneration over a minimum of eight years. The findings indicated that the procedure did not significantly reduce the incidence of adjacent segment degeneration compared to traditional fusion methods. Consequently, the Wallis topping-off technique may not provide the intended biomechanical protection against adjacent segment disease in the long term.

19. Lv R, Ma X, Chen H, et al. Biomechanical analysis of the patient-specific appropriate correction angle for cervical kyphosis in multilevel anterior cervical discectomy and fusion: a finite element analysis. Journal of Orthopaedic Surgery and Research 2025. doi:10.1186/s13018-025-06368-w

Using finite element analysis, the authors determined patient-specific optimal correction angles for cervical kyphosis during multilevel anterior cervical discectomy and fusion. The study revealed that individualized correction angles significantly improved spinal biomechanics and reduced stress on adjacent segments compared to standard angles. These results suggest that tailoring surgical correction angles to patient-specific anatomy can enhance postoperative outcomes and reduce the risk of adjacent segment disease.

2. Heydari P, Mirzaei A, Tabrizian P, et al. The added value of distal radius bone mineral density for the diagnosis of osteoporosis in patients with a history of fragility fracture. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09431-z

The researchers evaluated whether adding distal radius bone mineral density (BMD) measurements improves osteoporosis diagnosis in patients with prior fragility fractures. They found that incorporating distal radius BMD significantly enhanced diagnostic accuracy compared to standard lumbar or hip measurements alone. This suggests that assessing distal radius BMD should be considered a valuable adjunctive tool for identifying osteoporosis in high-risk fracture populations.

9. Gao Y, Zhang S, Liu L, et al. Analysis of the effect of modified bone grafting in lateral lumbar interbody fusion: A retrospective comparative cohort study. BMC Musculoskeletal Disorders 2025. doi:10.1186/s12891-025-09367-4

This retrospective study compared modified bone grafting techniques against standard methods in lateral lumbar interbody fusion to assess their impact on fusion outcomes. The research identified specific modifications that significantly improved fusion rates and reduced complications compared to traditional approaches. These findings suggest that adopting modified grafting strategies can enhance surgical success and patient recovery in lumbar fusion procedures.

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