Justin S. Smith (USA)	Praveen V. Mummaneni (USA)	Virginie Lafage (USA)
Christopher Ames (USA)	Shay Bess (USA)	Jang W. Yoon (USA)

Yoon Ha (Korea)	Seung-Jae Hyun (Korea)
Kyung Hyun Kim (Korea)	Takashi Yurube (Japan)

Special Issue Information

Dear Colleagues,

We are pleased to propose a special issue in Neurospine dedicated to “Collective Intelligence in Spine Surgery: The Future of Outcome Measurement, Alignment Assessment, and Multicultural Collaboration.” This Special Issue is targeted for publication in January 2027.

Adult spinal deformity represents one of the most complex areas of spine surgery. Patients frequently present with substantial heterogeneity in spinal alignment, frailty, medical comorbidities, symptom burden, functional limitation, and treatment goals. Surgical planning must therefore account not only for the magnitude of deformity, but also for patient-specific risk, physiologic reserve, alignment objectives, and the likelihood of achieving a meaningful clinical benefit.

The International Spine Study Group (ISSG) research efforts have hinged on large, prospective, multicenter studies generating high quality data and high-level evidence research. By bringing together high-volume centers and experienced investigators, ISSG studies have helped clarify the relationships among spinal alignment, health-related quality of life, surgical invasiveness, complications, mechanical failure, and long-term outcomes. These collaborative investigations have advanced the field beyond isolated institutional experience and established a foundation for evidence-based decision-making in adult spinal deformity.

Large, prospectively collected, multi-institutional databases have been central to this progress. The ability to evaluate diverse patient populations across multiple centers has allowed investigators to identify clinically relevant alignment parameters, examine age- and patient-specific alignment targets, characterize compensatory mechanisms, and better understand the consequences of both under-correction and over-correction. This collective body of work has reshaped how deformity is assessed and how operative goals are defined.

This Special issue will highlight the evolution and future direction of collaborative adult spinal deformity research. Particular emphasis will be placed on spinal alignment assessment, radiographic classification, patient-specific correction targets, mechanical complications, revision risk, and the integration of regional and global alignment into surgical planning. Contributions will also examine how emerging imaging technologies and automated analytical methods may improve the accuracy, reproducibility, and efficiency of alignment assessment.

Another major focus will be preoperative optimization and risk stratification. Multicenter research has increasingly shown that outcomes are influenced by factors extending beyond radiographic deformity, including frailty, bone quality, nutritional status, body composition, medical comorbidities, and prior surgical history. Understanding these variables is essential for identifying modifiable risk factors, counseling patients, selecting appropriate surgical strategies, and reducing perioperative and long-term complications.

The growing scale of collaborative databases also creates important opportunities for predictive analytics. Big-data approaches, machine learning, and artificial intelligence may allow investigators to integrate demographic, clinical, radiographic, operative, and longitudinal outcome data to estimate individualized risks and benefits. These tools have the potential to support shared decision-making, improve patient selection, anticipate complications, and guide more personalized treatment strategies.

This issue will further explore how collective intelligence can extend beyond individual institutions and national boundaries. Differences in patient populations, surgical practice, healthcare delivery, cultural expectations, and resource availability provide both challenges and opportunities for international research. Harmonizing data definitions, radiographic measurements, outcome instruments, and analytical methods will be essential for creating models that remain accurate and relevant across diverse healthcare environments.

This Special issue stems from the collaborative efforts of the ISSG, whose multi-institutional research has contributed substantially to the modern understanding of adult spinal deformity. The collaboration between ISSG and Neurospine provides an important platform to summarize this body of work while defining the next generation of research in alignment, optimization, outcome prediction, and globally applicable spine care.

By gathering original research and authoritative expert perspectives, this special issue aims to advance the use of collaborative databases and collective intelligence to improve the evaluation and treatment of adult spinal deformity. Future outcome assessment may also increasingly incorporate objective functional measures, digital health technologies, and real-world mobility data alongside traditional radiographic and patient-reported outcomes, providing a more comprehensive understanding of recovery.

This Special Issue will be published in Neurospine, and we are currently inviting submissions of original research articles, authoritative review papers, and scholarly commentaries for peer review and potential publication.

We look forward to your valuable contributions.

Justin S. Smith, USA
Praveen V. Mummaneni, USA
Virginie Lafage, USA
Christopher Ames, USA
Shay Bess, USA
Jang W. Yoon, USA
Yoon Ha, Korea
Seung-Jae Hyun, Korea
Kyung Hyun Kim, Korea
Takashi Yurube, Japan

Suggested Keywords
International Spine Study Group; Adult spinal deformity; Collective intelligence; Multicenter research; Spinal alignment; Patient-specific alignment; Preoperative optimization; Frailty Mechanical complications; Predictive analytics; Big data; Artificial intelligence; Outcome prediction; Multicultural collaboration; Objective functional outcomes

Manuscript Submission Information
Manuscripts should be submitted online at https://submit.e-neurospine.org/ by registering and logging in to the website of Neurospine. After registration, the corresponding author(s) can access the submission form directly. Manuscripts can be submitted until the deadline, and all submissions that pass the initial pre-check will proceed to peer review. Accepted papers will be published in the Neurospine journal and featured on the Special Issue webpage.

We welcome submissions of original research articles, narrative as well as systematic review and meta-analysis articles, and authoritative commentaries.

Please note the following guidelines:

• • Submitted manuscripts should not have been published previously or be under consideration for publication elsewhere (except in the conference proceedings).
• • All manuscripts will undergo a rigorous double-blind peer-review process. Please note that an invitation does not guarantee publication; manuscripts that do not meet our strict scientific standards are subject to rejection.
• • Detailed submission guidelines, including formatting requirements and other essential information, can be found on the website for the Instructions for authors.
• • The deadline for submission is October 31, 2026.