From clinical outcomes to costs, here are the key discoveries in spine surgery this year:
1. A study from Plano-based Texas Back Institute found positive clinical results for patients having hybrid spine surgery. Researchers looked at a series of 305 patients having lumbar hybrid surgery (a disc replacement at one level and fusion at an adjacent level) since 2005 and measured clinical outcome data. Hybrid spine patients had statistically significant improvements in the mean values of visual analog scale scores for back pain and leg pain, and Oswestry Disability Index improved from 45.5 to 24.6.
2. Stem cell therapies can be effective for treating discogenic low back pain, according to a study published in the January 2025 issue of the International Journal of Spine Surgery. Functional outcomes in stem cell therapy patients showed significant improvement in both measures, and subgroup analysis for bone marrow aspirate concentrate showed similar improvements.
3. Anterior cervical discectomy and fusion can be done in the outpatient setting, but reimbursements vary between ASCs and hospital outpatient departments, according to a study in The Spine Journal. ACDFs at the ASC were associated with a 9.8% higher immediate procedure reimbursement, 17.2% higher patient out-of-pocket expenditures and 11.7% higher surgeon reimbursement compared to the HOPD.
4. Cervical disc replacement is a safe option across all obesity levels compared to anterior cervical discectomy and fusion, according to a study in the April 2025 issue of The Spine Journal.
5. Having a higher socioeconomic status is associated with greater rates of surgical resource usage before spinal fusions, according to a study in the April 2025 issue of The Spine Journal.
6. Patients having two-level cervical disc replacement tended to have fewer postoperative complications compared to those having two-level anterior cervical discectomy and fusion, according to a study published in the April 15 edition of Spine.
7. The first year of a bundled payment program for outpatient spine surgery was associated with lower spending compared to inpatient cases. The cohort study used Medicare claims and differences-in-differences analysis. Outpatient and inpatient back and neck except spinal fusion patients between 2013 and 2019 were included. Bundled Payments for Care Improvement Advanced was associated with a differential reduction of $1,201 in total episode spending. Return inpatient admissions were 2.2% lower compared to hospitals that didn’t participate in bundles.
8. Endoscopic spine patients were less likely to need readmission 30 days after surgery compared to traditional methods. Researchers conducted a retrospective multicenter analysis to compare 30-day readmission rates in endoscopic spinal decompression or discectomy spine patients with those who had other spine surgery techniques.
9. Semaglutide use was associated with increased rates of pseudarthrosis and dysphagia in patients having posterior cervical fusion. Researchers used data from the PearlDiver Mariner to measure outcomes in posterior cervical fusion patients between 2010 and 2022. Same-day costs and mean 90-day costs were also “significantly lower” in patients who were taking semaglutide.
10. A study from Marina del Rey, Calif.-based DISC Surgery Center evaluated 203 outpatient 360-degree lumbar spinal fusions and found strong results in safety. The 360-degree spinal fusions, also called anterior-posterior lumbar interbody fusions, in the study were completed between 2018 and 2024 at one ASC. All 203 patients were discharged within 23 hours, and there were no hospital transfers, blood transfusions or readmissions in the immediate preoperative period. The average operating time was 167 minutes.
11. Interventional pain management physicians performing sacroiliac joint fusions had no complications when supervised and trained by a spine surgeon and low complication rates without surgeon oversight, according to a study published in the November 2025 issue of The Spine Journal.
12. A study published Sept. 24 in the Journal of the American Academy of Orthopaedic Surgeons found “little differences” in surgical outcomes between orthopedic spine surgeons and spinal neurosurgeons.
13. Expandable cage designs are effective in spinal fusion, but devices that address more than just disc height alone have additional benefits, according to a study published in the October issue of the International Journal of Spine Surgery. The study included 75 patients who had navigation-assisted minimally invasive transforaminal lumbar interbody fusion with expandable cages. Thirty-five of those patients had expandable cages that only increased disc height, and 40 had cages that addressed height and lodorsis.
14. Minimally invasive robot-assisted pars fracture surgery enabled most adolescent patients to return to sports in as little as six weeks, researchers with New York City-based Hospital for Special Surgery found. The retrospective study focused on nine nine adolescent patients with lumbar spondylolysis who had robot-assisted pars repair at HSS using the single-screw technique. After surgery they were in an eight-week physical therapy program to reintroduce them to sport-specific exercises.
15. Patients living with dementia experience a higher hazard for adverse events related to elective lumbar spine surgery, according to a recent study. The study examined more than 100,000 Medicare beneficiaries to assess outcomes following elective lumbar spine surgery and found that patients with dementia were more likely to suffer adverse events including mortality and intensive postoperative interventions compared to patients without dementia.
