Editorial: Highlights in spine conditions

Spine disorders are one of the leading causes of disability worldwide, with lumbar spine conditions such as chronic low back pain (CLBP) and lumbar spinal stenosis among the most common. Despite a substantial body or research, clinical care for these patients has seen little advancement and associated healthcare costs are exorbitant. To better serve both patients and healthcare systems, some posit that new treatments rooted in cutting-edge science are urgently needed. In the meantime, how can we refine our diagnostics strategies and care delivery models to optimize patient outcomes and reduce healthcare utilization? This Research Topic, “Highlights in Spine Disorders,” presents glimpses into efforts to address these critical challenges.

Dougherty and Beehler present a theory-driven approach to CLBP management, conceptualizing chronic pain as a biopsychosocial syndrome. Their practical program leverages a shared workspace within the electronic medical record to facilitate coordinated care between chiropractic and behavioral health practitioners. The initiative, titled “Joining Forces” is described by the authors as an efficient model for delivering multidisciplinary care grounded in chronic pain theory, using existing clinical resources. As the authors highlight, effective CLBP management necessitates addressing both pathoanatomic and psychosocial contributors to pain and disability.

Effective management of certain spinal disorders such as lumbar spinal stenosis, degenerative spondylolisthesis, and osteoporotic compression fractures, has traditionally focused on their pathoanatomic roots. Several articles in this compendium focus on these conditions. Martin et al. report on the results of implementing a novel, systematic patient goal-setting program for individuals undergoing spine surgery. Through the collaboration of multiple stakeholders—neurosurgeons, advanced practice providers, informaticists, clinical application specialists, and the director of quality improvement—they created an electronic dashboard that enables automatic tracking of patient-derived goals from the pre-operative phase through post-operative recovery and beyond. This work exemplifies the need for patient-centered care. Kun et al. present outcomes from a retrospective data analysis comparing outcomes of two endoscopic lumbar fusion techniques for single-segment spondylolisthesis. As open surgical techniques can be associated with significant cost and morbidity, their work provides valuable insights into safer and more cost-effective care. Kann et al. report the results of a systematic review and meta-analysis comparing outcomes of thoracic vs. lumbar kyphoplasty for osteoporotic compression fractures. Their findings underscore the importance of diagnostic specificity when evaluating the efficacy of interventions, reinforcing the need for precision in clinical decision-making.

The existing literature has long characterized CLBP as a largely a non-specific condition, with most interventions yielding only in modest improvements. This highlights the critical need for greater diagnostic specificity, a theme explored by Soota et al. They apply machine learning to identify phenotypes of individuals with CLBP who do—or do not—respond to mindfulness meditation, thus identifying specific combinations of clinical and psychosocial factors that when present together in a single person, predict treatment response or lack thereof.

Npochinto Moumeni et al. examined CLBP management in rural Cameroon by comparing osteopathic care, physiotherapy, while using the “unique practitioner syndrome” as a theoretical framework to interpret local care-seeking and treatment patterns. By generating rare, context-specific evidence from an underserved setting, the work provides valuable insight into feasible, culturally grounded care models that could inform scalable interventions in low-resource regions. Stay et al., compared the incidence, imaging characteristics, and clinical presentation of intradural spinal arachnoid cysts and spinal arachnoid webs, two rare extramedullary spinal lesions with overlapping symptoms. By clarifying distinguishing imaging features, the work contributes to improving diagnostic differentiation and supports more informed decision-making for these uncommon but clinically significant conditions.

Lastly, Surapuchong and Pongpirul brief research report evaluated whether radiological parameters measured on standing whole-spine radiographs (e.g., sagittal vertical axis, SVA) are associated with MRI-defined severity of lumbar disc herniation. While SVA showed an association with severe canal compromised, its limited accuracy suggests that it should not be used as exclusive screening tool but may still offer supportive information for referral decisions in resource-limited settings.

As editors, we hope the novel approaches presented in these papers will inspire others to think outside the box in ways that challenge existing paradigms and improve outcomes for the countess individuals who continue to suffer from spinal disorders, as well as the healthcare systems that deliver their care.

Generative AI statement

The author(s) declared that generative AI was used in the creation of this manuscript. Generative AI was used to improve readability.

Any alternative text (alt text) provided alongside figures in this article has been generated by Frontiers with the support of artificial intelligence and reasonable efforts have been made to ensure accuracy, including review by the authors wherever possible. If you identify any issues, please contact us.

Publisher's note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

Footnotes

Edited and Reviewed by: Annamaria Iagnocco, University of Turin, Italy