Review Article
Minimally Invasive Spine Surgery for Degenerative Lumbar Diseases: Current Advances and Future Perspectives
Zhi Liang*
Issue:
Volume 1, Issue 2, December 2026
Pages:
40-45
Received:
14 June 2026
Accepted:
10 July 2026
Published:
10 August 2026
Abstract: Degenerative lumbar diseases (DLDs), encompassing lumbar disc herniation, lumbar spinal stenosis, degenerative spondylolisthesis and degenerative lumbar scoliosis, constitute a predominant global source of chronic low back pain and radiculopathy. Such conditions markedly degrade patients’ quality of life and place a heavy socioeconomic burden on healthcare systems. Conventional open posterior lumbar surgery delivers satisfactory spinal decompression and interbody fusion, yet it is plagued by prominent drawbacks: severe paraspinal muscle injury, substantial intraoperative blood loss, intractable postoperative pain, longer hospital stays, and an increased risk of adjacent segment disease. Fueled by advances in surgical navigation, spinal endoscopy and intraoperative neuromonitoring, minimally invasive spine surgery (MISS) has achieved remarkable progress. These minimally invasive procedures retain the integrity of the posterior ligamentous complex, drastically lessen soft tissue trauma, and enable accelerated early postoperative rehabilitation. This narrative review was conducted to systematically characterize the state-of-the-art application of MISS for DLD management. High-quality peer-reviewed studies were retrieved and synthesized to summarize mainstream MISS techniques, operative workflows, perioperative clinical outcomes, surgical complications and inherent technical limitations. We further outline promising developmental directions for minimally invasive lumbar interventions. This work aims to furnish evidence-based references for clinical therapeutic decision-making and facilitate future translational research related to DLD minimally invasive treatment.
Abstract: Degenerative lumbar diseases (DLDs), encompassing lumbar disc herniation, lumbar spinal stenosis, degenerative spondylolisthesis and degenerative lumbar scoliosis, constitute a predominant global source of chronic low back pain and radiculopathy. Such conditions markedly degrade patients’ quality of life and place a heavy socioeconomic burden on he...
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Research Article
Secondary Dynamization by Ilizarov External Ring Fixator After Failure of Diaphyseal Nonunion with Intramedullary Nailing Keeping Nail in Situ
Issue:
Volume 1, Issue 2, December 2026
Pages:
46-57
Received:
28 July 2026
Accepted:
6 August 2026
Published:
22 August 2026
Abstract: Background: Diaphyseal nonunion following failed intramedullary nailing is a challenging orthopedic condition. Secondary dynamization using an Ilizarov external ring fixator while retaining the intramedullary nail may improve fracture healing and functional recovery. Objective: To evaluate the clinical and radiological outcomes of secondary dynamization using an Ilizarov external ring fixator after failure of diaphyseal nonunion with intramedullary nailing while keeping the nail in situ. Methods: This prospective study was conducted at the Department of Orthopaedic Surgery, NITOR, Dhaka, Bangladesh, from June 2024 to May 2026. Thirty patients with diaphyseal nonunion following failed intramedullary nailing were treated with secondary dynamization using an Ilizarov external ring fixator while retaining the intramedullary nail. Clinical, radiological, and functional outcomes were analyzed using SPSS version 22.0. Results: The mean age of the participants was 35.7 ± 9.2 years, and 80.0% were male. Fracture union was achieved in 93.3% of patients, with a mean union time of 18.8 ± 3.4 weeks. At final follow-up, 86.7% achieved full weight bearing, 80.0% regained full range of motion, and the mean VAS pain score improved from 7.4 ± 1.2 to 1.9 ± 0.8. Pin tract infection was the most common complication (23.3%), and infection was significantly associated with persistent nonunion (p = 0.014). Conclusion: Secondary dynamization with an Ilizarov external ring fixator while retaining the intramedullary nail is an effective and reliable treatment for diaphyseal nonunion, providing a high union rate and good functional outcome.
Abstract: Background: Diaphyseal nonunion following failed intramedullary nailing is a challenging orthopedic condition. Secondary dynamization using an Ilizarov external ring fixator while retaining the intramedullary nail may improve fracture healing and functional recovery. Objective: To evaluate the clinical and radiological outcomes of secondary dynamiz...
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Research Article
Development of a 3D Printing and Virtual Reality Workflow for Glenoid Fracture Preoperative Planning: A Scoping Review and Preliminary Survey of Surgeons
Covenant Oluwagbenga Orisabinone*,
Jane Grant,
Arpit Jariwala
Issue:
Volume 1, Issue 2, December 2026
Pages:
58-71
Received:
31 August 2026
Accepted:
8 October 2026
Published:
28 October 2026
DOI:
10.11648/j.ajot.20260102.13
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Abstract: Glenoid fractures pose a significant challenge for preoperative planning because their complex, comminuted three-dimensional anatomy is incompletely represented by conventional two-dimensional computed tomography (CT). This study aimed to (i) map the evidence on three-dimensional (3D) printing and virtual/augmented reality (VR/AR) for glenoid fracture and related shoulder surgical planning, (ii) assess the technical feasibility of an institutional CT-to-3D-print and CT-to-VR workflow, and (iii) explore preliminary surgeon perceptions. A scoping review was conducted using Joanna Briggs Institute methodology and reported according to PRISMA-ScR. PubMed, Scopus, Web of Science, IEEE Xplore, and Cochrane Library were searched for English-language studies published from 2010 to 2026. Following duplicate removal and dual-reviewer screening, 20 sources were charted narratively. An institutional workflow was also developed and piloted using anonymised DICOM data with 3D Slicer, Meshmixer, Blender, and Unity. In addition, a 25-item anonymous survey was distributed to 20 orthopaedic clinicians, with eight responses (40%); open-text responses were analysed using template analysis. The evidence comprised cadaveric experiments, case reports/series, retrospective and comparative studies, technical feasibility studies, narrative reviews, and systematic reviews, with generally low-to-moderate methodological certainty. Reported benefits included improved implant positioning, reduced planning or operative time, enhanced anatomical understanding, and educational value. The institutional workflow was technically feasible but encountered print fragility in thin, comminuted regions, and dimensional accuracy was not formally validated. Six respondents (75%) perceived improved understanding of fracture morphology, while five (62.5%) had never personally used 3D printing or VR. Qualitative responses highlighted enhanced spatial understanding, planning confidence, educational and collaborative benefits, cost and accessibility barriers, and preference for selective rather than routine use. Overall, current evidence and preliminary clinician feedback support the feasibility and perceived value of 3D printing and VR in glenoid fracture planning; however, the evidence base remains immature. Rigorous dimensional validation and adequately powered clinical outcome studies are required before routine clinical adoption can be recommended.
Abstract: Glenoid fractures pose a significant challenge for preoperative planning because their complex, comminuted three-dimensional anatomy is incompletely represented by conventional two-dimensional computed tomography (CT). This study aimed to (i) map the evidence on three-dimensional (3D) printing and virtual/augmented reality (VR/AR) for glenoid fract...
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