What’s New in Spine Surgery 2026

New findings in spine surgery are covered in the latest JBJS Specialty Update, What’s New in Spine Surgery. Here, we spotlight the 5 most compelling studies, as selected by author Jason Pui Yin Cheung, MBBS, MMedSc, MS, PDipMDPath, MD, MEd.

Surgical Site Infections (SSIs)

Researchers investigated the effect of vancomycin powder mixed with autogenous bone graft and bone substitute on the rate of deep SSIs within 90 days after posterior decompression and instrumented fusion for a degenerative lumbar condition. Patients were randomized to vancomycin (n = 357) and control (n = 348) groups. The vancomycin group had a lower rate of deep SSI (0% vs. 1.4%; p = 0.029), the primary outcome, but a higher rate of superficial SSI (2% vs. 0.9%)¹.

Pediatric Scoliosis

Nighttime hypercorrective bracing and full-time bracing were compared in a secondary analysis of 89 patients treated for moderate adolescent idiopathic scoliosis (AIS). The mean follow-up was 94 months. Nighttime bracing demonstrated no clear advantage, with similar effectiveness in curve progression prevention and a tendency toward a higher risk of surgery compared with full-time bracing ².

A single-center study reported a 36.7% rate of pulmonary complications among 60 patients (51 female) who underwent vertebral body tethering for AIS. Pneumothorax was the most common of these complications (30.4%)³. “The findings indicated that perioperative complications, especially pulmonary ones, are more frequent than previously reported and that surgical extent, location, and correction magnitude are important risk factors,” writes Specialty Update author Prof. Cheung.

Spinal Degeneration

Using data from 1,962,069 individuals, researchers established 962 independent genetic associations for osteoarthritis across different joints, including 4 signals for spinal osteoarthritis, and identified signal enrichment in embryonic skeletal development cell types. The researchers also identified opportunities for drug repurposing⁴. As noted by Prof. Cheung, the study findings suggest that “early-life processes in bone and cartilage formation set the stage for later spinal degeneration” and that “several biological pathways…are now directly implicated in spine osteoarthritis pathogenesis.”

An MRI-based analysis of 2,114 patients (95 with degenerative cervical myelopathy and 2,019 from the general population) was performed to define multilevel, developmental cervical spinal stenosis and to determine its prevalence and predictive ability. Multilevel narrowing (≥3 levels) was strongly predictive of the development of degenerative cervical myelopathy requiring surgery. The criteria proposed in this study may help to identify at-risk individuals early in order to prevent spinal cord injury⁵.

What’s New in Spine Surgery is freely available at JBJS.org.

What’s New by Subspecialty

Each month, JBJS publishes a review of the most pertinent studies from the orthopaedic literature in a select subspecialty. To read the reports, visit the What’s New by Subspecialty collection at JBJS.org.

Recent OrthoBuzz posts include: What’s New in Sports Medicine, What’s New in Foot and Ankle Surgery, and What’s New in Biologics.

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References

1. Wang ST, Lin HH, Yao YC, Huang N, Hsiung W, Chang MC, Liu CL, Chou PH. Vancomycin powder mixed with autogenous bone graft and bone substitute may decrease the deep surgical site infections in elective lumbar instrumented fusion surgery for degenerative disorders: a prospective randomized study. Spine J. 2025 Sep;25(9):1866-76.
2. Charalampidis A, Diarbakerli E, Jalalpour K, Ohlin A, Ahl AA, Möller H, Abbott A, Gerdhem P; CONTRAIS study group. Effectiveness of nighttime vs full-time bracing in the treatment of moderate-grade adolescent idiopathic scoliosis: a secondary analysis of the CONTRAIS trial. Acta Orthop. 2025 Jun 9;96:437-42.
3. Chan KCA, Cheung CCG, Tse KYE, Cheung JPY, Cheung PWH. The perioperative complications of vertebral body tethering: prevalence and predictive factors. Bone Joint J. 2025 Jul 1;107-B(7):736-43.
4. Hatzikotoulas K, Southam L, Stefansdottir L, Boer CG, McDonald ML, Pett JP, Park YC, Tuerlings M, Mulders R, Barysenka A, Arruda AL, Tragante V, Rocco A, Bittner N, Chen S, Horn S, Srinivasasainagendra V, To K, Katsoula G, Kreitmaier P, Tenghe AMM, Gilly A, Arbeeva L, Chen LG, de Pins AM, Dochtermann D, Henkel C, Höijer J, Ito S, Lind PA, Lukusa-Sawalena B, Minn AKK, Mola-Caminal M, Narita A, Nguyen C, Reimann E, Silberstein MD, Skogholt AH, Tiwari HK, Yau MS, Yue M, Zhao W, Zhou JJ, Alexiadis G, Banasik K, Brunak S, Campbell A, Cheung JTS, Dowsett J, Faquih T, Faul JD, Fei L, Fenstad AM, Funayama T, Gabrielsen ME, Gocho C, Gromov K, Hansen T, Hudjashov G, Ingvarsson T, Johnson JS, Jonsson H, Kakehi S, Karjalainen J, Kasbohm E, Lemmelä S, Lin K, Liu X, Loef M, Mangino M, McCartney D, Millwood IY, Richman J, Roberts MB, Ryan KA, Samartzis D, Shivakumar M, Skou ST, Sugimoto S, Suzuki K, Takuwa H, Teder-Laving M, Thomas L, Tomizuka K, Turman C, Weiss S, Wu TT, Zengini E, Zhang Y, Ferreira MAR, Babis G, Baras A, Barker T, Carey DJ, Cheah KSE, Chen Z, Cheung JP, Daly M, de Mutsert R, Eaton CB, Erikstrup C, Furnes ON, Golightly YM, Gudbjartsson DF, Hailer NP, Hayward C, Hochberg MC, Homuth G, Huckins LM, Hveem K, Ikegawa S, Ishijima M, Isomura M, Jones M, Kang JH, Kardia SLR, Kloppenburg M, Kraft P, Kumahashi N, Kuwata S, Lee MTM, Lee PH, Lerner R, Li L, Lietman SA, Lotta L, Lupton MK, Mägi R, Martin NG, McAlindon TE, Medland SE, Michaëlsson K, Mitchell BD, Mook-Kanamori DO, Morris AP, Nabika T, Nagami F, Nelson AE, Ostrowski SR, Palotie A, Pedersen OB, Rosendaal FR, Sakurai-Yageta M, Schmidt CO, Sham PC, Singh JA, Smelser DT, Smith JA, Song YQ, Sørensen E, Tamiya G, Tamura Y, Terao C, Thorleifsson G, Troelsen A, Tsezou A, Uchio Y, Uitterlinden AG, Ullum H, Valdes AM, van Heel DA, Walters RG, Weir DR, Wilkinson JM, Winsvold BS, Yamamoto M, Zwart JA, Stefansson K, Meulenbelt I, Teichmann SA, van Meurs JBJ, Styrkarsdottir U, Zeggini E; arcOGEN Consortium; ARGO Consortium; DBDS Genomic Consortium; Estonian Biobank Research Team; FinnGen; Genes & Health Research Team; HUNT All-In Pain; Million Veteran Program; Regeneron Genetics Center. Translational genomics of osteoarthritis in 1,962,069 individuals. 2025 May;641(8065):1217-24.
5. Cheung PWH, Leung JHM, Lee VWY, Cheung JPY. Defining multilevel developmental cervical spinal stenosis using MRI. Bone Joint J. 2024 Nov 1;106-B(11):1333-41.