The literature on spinal pathologies can be divided into articles focusing on different types of pathological conditions affecting the spine, manuscripts regarding techniques (conservative or surgical) for treating the spinal diseases, and papers that analyze pediatric or adult pathologies. With the aging of the population and the increase of specific comorbidities and frailties on one side, and the simultaneous development of new technologies, innovative treatments and minimally invasive surgical strategies on the other, the target population needing treatment for spinal pathologies has changed.

The goal is to identify which are the old and new frailties that can influence the treatment of spinal pathologies, especially traumatic and degenerative, and what are the new devices, surgical techniques, and therapeutic algorithms, which could guarantee safe and effective treatments to those patients who in the recent past would not have had access to a resolutive treatment for their spinal disease because of their fragility.

The aims of this Special Issue are: to identify procedural algorithms addressing different treatment strategies stratifying patients according to their frailties/comorbidities; to assess what role recent surgical techniques and devices for minimally invasive and ultra-minimally invasive treatments can play for frail and elderly patients in terms of functional and radiological outcome; and to identify diagnostic methods, software, and applications that can help in choosing the most effective treatment for these patients, providing new data about their specific spinal pathology and helping to circumscribe the target of treatment, where possible, when facing multilevel degenerative diseases typical of the aging spine. Review articles and meta-analyses on the current state of the art on conservative and surgical strategies for treating degenerative and traumatic spinal pathologies in elderly patients are especially welcome. We also encourage the submission of studies evaluating the contribution of the most recent surgical techniques and devices and their future perspectives in the treatment of traumatic and degenerative spinal pathologies in patients previously considered not eligible for traditional surgical treatments due to their age/comorbidities.

Potential topics include but are not limited to the following:

• Aging spine
• Degenerative spine disease
• Spine trauma
• Imaging of the spine and software imaging tools
• Osteoporosis
• Minimally invasive spine surgery
• Functional outcomes in elderly patients
• Bone mineral density
• Targeted treatment in fragile patients
• Neurointerventional procedures
• Multilevel degenerative spine disease