In 2026, JSS reviewers continue to make outstanding contributions to the peer review process. They demonstrated professional effort and enthusiasm in their reviews and provided comments that genuinely help the authors to enhance their work.

Hereby, we would like to highlight some of our outstanding reviewers, with a brief interview of their thoughts and insights as a reviewer. Allow us to express our heartfelt gratitude for their tremendous effort and valuable contributions to the scientific process.

Hiroshi Kageyama, Tokushima University and Anan Medical Center, Japan

Amna Hussein, Houston Methodist Hospital, USA

Prashant V. Rajan, University Hospitals Cleveland Medical Center, USA

Woojin Cho, Osteogene Tech Corp, USA

Peter Muhareb Udby, University of Copenhagen, Denmark

Kevin G. Liu, University of Southern California, USA

Samuel Haupt, Spital Oberengadin, Switzerland

Adham M. Khalafallah, University of Miami Miller School of Medicine, USA

Hiroshi Kageyama

Dr. Hiroshi Kageyama graduated from the National Defense Medical College in 2003 and joined the Japan Ground Self-Defense Force, where he served as a medical officer. He completed his neurosurgical residency at the National Defense Medical College Hospital and became a board-certified neurosurgeon. He also received his PhD in Medicine from Juntendo University Graduate School of Medicine. He subsequently practiced primarily in spine surgery at hospitals affiliated with the National Defense Medical College. Since 2024, he has been serving as a specially appointed lecturer at the Department of Orthopedic Surgery, Tokushima University and Anan Medical Center, where he is further refining his expertise in spine surgery, particularly full-endoscopic spinal surgery.

From Dr. Kageyama’s perspective, a healthy peer-review system should be fair, constructive, and grounded in appropriate expertise. He believes that manuscripts should be evaluated based on their scientific validity and clinical relevance, with reviewers aiming not only to identify limitations but also to provide constructive suggestions. In addition, he emphasizes that transparency, ethical standards, and reasonable review timelines are essential components of an effective process.

Building on this, Dr. Kageyama notes that in spine surgery specifically, reviewers should carefully assess whether the methodology, surgical indications, and outcomes are both scientifically sound and clinically meaningful. He explains that since the ultimate goal is to improve patient care, it is important to consider whether the findings can truly inform clinical decision-making. At the same time, he stresses that reviewers should provide fair and constructive feedback that helps authors strengthen their work.

Dr. Kageyama’s commitment to this process is driven by his understanding of peer review as a system through which researchers objectively evaluate each other’s work. He believes that it is essential for improving the quality of research and advancing the field by encouraging researchers to learn from one another. Therefore, he sees his active participation in peer review as a way to contribute to the development of the scientific community, including his own work.

(by Lynette Wan, Brad Li)

Amna Hussein

Amna Hussein, MD, is a Neurosurgery Clinical Research Fellow IV at Houston Methodist Hospital. She previously completed an international neurosurgery research fellowship at the University of Arizona after serving as a neurosurgical resident in Saudi Arabia. Originally from Sudan, where she also graduated from medical school, she has been trained across diverse healthcare systems, shaping her perspective on global neurosurgical care. Her academic interests focus on spine surgery, neuromodulation, neurosurgical education, global neurosurgery, and the intersection of neurosurgery and women’s health. She has authored numerous peer-reviewed publications, book chapters, and operative videos, and serves as a reviewer for journals including Surgical Neurology International, Global Spine Journal,and Journal of Spine Surgery.Dr. Hussein also coordinated the Virtual Global Spine Conference, a global educational platform connecting neurosurgeons across continents. Her research explores improving surgical outcomes, expanding access to education, addressing disparities in neurosurgical care, and advancing interdisciplinary collaboration in women’s health. Connect with Dr. Hussein on ResearchGate and LinkedIn.

JSS: Why do we need peer review? What is so important about it?

Dr. Hussein: Peer review is the closest thing that science has to a collective conscience. Medicine progresses rapidly, but progress without verification becomes opinion rather than knowledge. Reviewers act as independent surgeons for the manuscript, identifying weak anatomy in the methodology, hidden bleeding in the statistics, and unnecessary dissection in the discussion.

More importantly, peer review indirectly protects patients. Clinical decisions are guided by published evidence; therefore, every accepted paper carries responsibility beyond the authors. A rigorous review ensures that what reaches clinicians is not only novel but trustworthy and reproducible.

Peer review also improves authors. Many of my own manuscripts become clearer only after thoughtful critique. A good review does not reject work—it refines thinking. In that sense, peer review is less about gatekeeping but more about mentorship at a global scale.

JSS: What are the limitations of the existing peer-review system? What can be done to improve it?

Dr. Hussein: The current peer-review system has several important limitations. One of the most evident is variability. Two experienced reviewers can evaluate the same manuscript and reach entirely different conclusions, reflecting differences in training, expectations, and personal bias rather than true scientific disagreement. This inconsistency can make the publication process unpredictable for authors and may shift the focus from methodological quality to subjective interpretation.

Another challenge is the invisible nature of the review process. Peer review requires significant time, concentration, and responsibility, yet it remains largely unrecognized academic labor. As submission volumes continue to grow, reviewer fatigue increasingly threatens the depth and quality of evaluations. In parallel, the system often favors novelty over reliability. Exciting or positive findings are prioritized, while replication studies and negative results, which are essential for scientific integrity, struggle to find space in the literature.

Improvement requires treating peer review as a structured academic skill rather than an informal expectation. Standardized review frameworks that prioritize methodology before conclusions can reduce subjectivity. Reviewer training, particularly for early-career physicians, would improve consistency and confidence in the process. Meaningful recognition systems, such as academic credit, citable reviews, and ORCID-linked contributions, could also sustain reviewer engagement. In appropriate contexts, transparent peer review may further increase accountability and trust, while actively encouraging replication and negative studies would strengthen the reliability of published evidence. Ultimately, peer review should evolve from a tradition we inherit into a discipline we teach.

JSS: Would you like to say a few words to encourage other reviewers who have been devoting themselves to advancing scientific progress behind the scene?

Dr. Hussein: Reviewers rarely see the impact of their work. Their names are not on the title page, yet their fingerprints remain on the final science.

Every careful comment prevents future confusion. Every statistical correction protects a future patient. Every thoughtful suggestion helps an author somewhere in the world think more clearly. Reviewing is not simply a service to a journal; it is a service to the next generation of surgeons you may never meet. Science advances because someone has chosen to read carefully when the others are tired.

So, to every reviewer: your work may be invisible, but it is not insignificant. You are part of the architecture of knowledge.

(By Lynette Wan, Masaki Lo)

Prashant V. Rajan

Dr. Prashant Rajan is an orthopaedic spine surgeon at University Hospitals Cleveland Medical Center and an Assistant Professor of Orthopaedic Surgery at Case Western Reserve University School of Medicine. He earned his medical degree from Harvard Medical School, completed combined orthopaedic and neurosurgical spine residency training at the Cleveland Clinic, and pursued fellowship training in spine surgery at Emory University under internationally recognized spine surgeons. Dr. Rajan provides comprehensive care for patients with degenerative, traumatic, neoplastic, and deformity-related spinal disorders and takes Level 1 trauma call, with particular expertise in cervical spine pathology and spinal cord injury. He is an active member of national spine societies, including the Cervical Spine Research Society and the North American Spine Society. His research focuses on cervical spine outcomes, spinal cord injury, trauma-related spine care, and evidence-based surgical decision-making. Connect with him on LinkedIn.

JSS: What role does peer review play in science?

Dr. Rajan: Peer review is fundamental to maintaining the rigor, credibility, and integrity of scientific research. It serves as a quality control mechanism that evaluates the validity of methods, accuracy of results, and appropriateness of conclusions before findings are disseminated. Beyond gatekeeping, peer review improves manuscripts by offering constructive feedback that strengthens clarity, methodology, and scientific impact.

JSS: What reviewers have to bear in mind while reviewing papers?

Dr. Rajan: Reviewers should be objective, fair, and constructive, focusing on the scientific merit rather than personal opinion. They should assess methodological rigor, ethical standards, statistical validity, and relevance to the field while acknowledging the study’s limitations. Importantly, reviewers should aim to help authors improve their work through clear, respectful, and actionable feedback.

JSS: Data sharing is prevalent in scientific writing in recent years. Do you think it is crucial for authors to share their research data? And why?

Dr. Rajan: Yes, data sharing is increasingly crucial. It promotes transparency, reproducibility, and trust in scientific findings while enabling independent validation and secondary analyses. When done responsibly and ethically, data sharing accelerates knowledge advancement, reduces redundancy, and maximizes the value of research contributions to the broader scientific community.

(by Lynette Wan, Masaki Lo)

Woojin Cho

Dr. Woojin Cho is an orthopedic spine surgeon with over 20 years of clinical and academic experience in adult spinal deformity, degenerative spine disease, and spinal biomechanics. He completed spine research fellowships at Twin Cities Spine Center and Washington University in St. Louis, and clinical spine fellowships at the University of Virginia and the Hospital for Special Surgery. He formerly served as Associate Professor at Albert Einstein College of Medicine and Research Director at Montefiore Spine Center. Currently, he serves as Clinical AI Consultant at Osteogene Tech Corp, where he applies generative and agentic AI to clinical workflow automation and research data structuring, bridging evidence-based spine surgery with AI-driven healthcare innovation. His scholarly contributions include over 100 peer-reviewed publications, 11 book chapters, and 250+ scientific presentations. He continues to serve as an active reviewer for multiple international spine journals, including JSS, JAAOS, and several Elsevier titles. Learn more about him here.

Dr. Cho believes that a healthy peer-review system rests on three pillars: methodological rigor, constructive dialogue, and clinical relevance. He notes that in spine surgery, where every recommendation can affect a patient's mobility and quality of life, reviewers must go beyond identifying flaws—they should help authors sharpen their reasoning and clarify the translational value of their work. The ideal system, he adds, protects scientific integrity while fostering mentorship, especially for early-career researchers. As generative AI increasingly influences manuscript preparation, Dr. Cho believes peer reviewers now carry an additional responsibility: to assess whether AI-assisted content is transparently disclosed and whether reasoning remains human-guided. A healthy system, he emphasizes, adapts to these changes without losing its core commitment to evidence, fairness, and patient benefit.

In Dr. Cho’s opinion, objectivity in peer review means evaluating a manuscript solely on its scientific merit—independent of the authors' identity, institution, or prevailing surgical dogma. He maintains objectivity through three practices. First, he separates methodological assessment from clinical preference; a study whose conclusion disagrees with his own practice still deserves a fair reading if its methodology is sound. Second, he grounds every critique in specific, verifiable evidence—citing the relevant literature or biomechanical principle rather than relying on personal authority. Third, he actively checks his reasoning against potential biases, particularly in areas where he has strong clinical convictions. In an era when AI tools can amplify both precision and bias, disciplined self-awareness is more essential than ever for objective review.

(by Lareina Lim, Brad Li)

Peter Muhareb Udby

Peter Muhareb Udby, MD, DC, PhD, is a consultant spine surgeon, chiropractor, and clinical researcher affiliated with the Spine Unit, Department of Orthopaedic Surgery, Copenhagen University Hospital – Rigshospitalet, and the University of Copenhagen, Denmark. His clinical and academic work focuses on complex degenerative spine disorders, long-term surgical outcomes, spine phenotyping, and data-driven decision support in spine surgery. He is actively involved in large-scale nationwide longitudinal studies investigating surgical trajectories following lumbar spine surgery, integrating national registry data, clinical phenotyping, imaging biomarkers including Modic changes, and artificial intelligence-based methods. Dr. Udby collaborates internationally within spine research and education and has a particular interest in the future integration of AI, predictive modelling, and personalized spine care. His work aims to bridge clinical spine surgery with translational data science to improve patient selection, counselling, and long-term outcomes in degenerative spine disease.

Dr. Udby thinks that a constructive review is objective, respectful, and focused on enhancing the scientific quality of a manuscript. Even when major methodological concerns exist, he emphasizes that reviewers should provide clear, specific suggestions to help authors strengthen both their current work and future research projects. Effective peer review should aim to improve transparency, methodology, data interpretation, and clinical relevance. In contrast, a destructive review is overly dismissive or unnecessarily harsh without offering meaningful guidance. Reviews should critically evaluate the scientific merit of the work, not discourage authors personally. Peer review functions best when it is rigorous yet collegial, fostering improvement rather than criticism.

Dr. Udby indicates that disclosing conflicts of interest (COI) is essential for scientific transparency and maintaining trust in the research community. A disclosed COI does not automatically invalidate a study, but it enables readers, reviewers, and editors to interpret findings within the appropriate context. Financial relationships, industry involvement, or intellectual interests may consciously or unconsciously influence study design, data interpretation, or reporting. Transparent COI disclosure is crucial to upholding the credibility and integrity of scientific publishing.

“I review for JSS because the journal publishes highly clinically relevant and scientifically important research within spine surgery and spinal disorders. I appreciate the journal’s international perspective and its focus on both clinical and research-oriented topics. Reviewing also allows me to stay up to date on emerging research, contribute to the scientific community, and support the development of high-quality publications. Finally, I would like to thank JSS for the opportunity and honour of participating in this interview. I also warmly welcome spine clinicians and researchers with an interest in visiting Copenhagen, exchanging ideas, or exploring future academic and research collaborations to reach out. International collaboration and knowledge sharing remain essential to advancing the spine field and improving patient care,” says Dr. Udby.

(by Lareina Lim, Brad Li)

Kevin G. Liu

Kevin G. Liu is a fourth-year medical student at the Keck School of Medicine, University of Southern California. His primary research interests focus on postoperative spine biomechanics and the application of synthetic materials in spine surgery. He has also led clinical studies in other neurosurgical subspecialties, including skull base surgery. Currently, he is engaged in research on surgical cervical spine anatomy and postoperative spinopelvic motion.

Mr. Liu believes that a qualified reviewer should show empathy toward manuscript authors. He points out that it is often easy to spot flaws and criticize others’ work without providing constructive suggestions. A thoughtful reviewer should recognize that everyone was once an inexperienced author still learning academic writing. Just as every researcher would hope for supportive feedback in their early career, reviewers ought to deliver specific, actionable comments to help authors improve and contribute more effectively to collective scientific knowledge.

In Mr. Liu’s opinion, the current peer-review system tends to require reviewers to be strict field experts. While this standard helps ensure review quality, it also narrows the reviewer pool and discourages many capable researchers from participating. He references the Dunning-Kruger effect: as expertise grows, individuals often become more aware of the limits of their own knowledge and hesitate to volunteer as reviewers. He suggests journals rephrase calls for “expert reviewers” into invitations for researchers with relevant field experience and academic writing background, which could encourage more qualified scholars to join the reviewer pool.

Mr. Liu notes that following reporting guidelines (e.g., STROBE, CONSORT) can be tedious, yet they are essential for maintaining high standards in scientific literature. These standards give reviewers confidence in the studies they evaluate and reassure them that any new knowledge they apply to patient care is based on trustworthy evidence. He also recommends that authors consult relevant reporting guidelines early in the study design phase, rather than retroactively adjusting completed manuscripts to meet checklist requirements.

(by Lareina Lim, Brad Li)

Samuel Haupt

Dr. Samuel Haupt is a Swiss board-certified surgeon specializing in orthopaedic surgery, traumatology, and general trauma surgery. He currently serves as Head of Surgery and Orthopaedics at Spital Oberengadin and is a Fellow of the European Board of Surgery (FEBS). His clinical and academic interests focus on musculoskeletal trauma, fracture management, and the biomechanical aspects of orthopedic and spine surgery. He received his training at the Cantonal Hospital of Graubünden and Balgrist University Hospital, and has published extensively in journals including The Spine Journal, Journal of Biomechanics, and Archives of Orthopaedic and Trauma Surgery. His recent research covers randomized controlled trials in spine surgery, cervical fracture reduction techniques, and clinical outcomes of proximal femoral fractures. Beyond research, he is actively engaged in surgical education as AO Faculty and an ATLS instructor, and serves on the foundation board of GO STAR, which supports trauma surgery training programs in Ethiopia. Connect with him on LinkedIn.

Dr. Haupt believes that constructive peer review should center on helping authors strengthen their work scientifically and clinically, with the ultimate goal of enhancing research quality, transparency, and clinical relevance. He points out that the rapid growth in scientific publications has led to widespread reviewer fatigue, prolonged publication delays, and inconsistent review quality—especially in highly specialized disciplines. Peer review is generally unpaid and completed alongside heavy clinical and academic workloads. In his view, a key improvement lies in fostering stronger reciprocity within the scientific community. Researchers who submit manuscripts should also take responsibility for reviewing papers in the same field. Maintaining scientific integrity is a collective duty, and the peer-review system can only operate sustainably with active participation from the research community.

In Dr. Haupt’s opinion, an objective review focuses on scientific rigor, methodological integrity, reporting transparency, and clinical relevance. It carefully evaluates whether research conclusions are adequately supported by empirical data and whether study limitations are honestly acknowledged. To preserve objectivity, he adheres to established reporting guidelines such as CONSORT, STROBE, and PRISMA whenever applicable, and assesses manuscripts based on standardized methodological criteria. He also maintains balance in his feedback by recognizing both the strengths and weaknesses of each study.

Dr. Haupt thinks that industry collaboration is often essential for innovation and implant development in orthopaedics and trauma surgery, making Conflicts of Interest (COIs) common and not inherently problematic. Full transparency through proper COI disclosure is critical to preserving public and academic trust in the scientific process. Clear disclosure allows readers to evaluate research based on methodological quality while fairly acknowledging potential sources of bias.

(by Lareina Lim, Brad Li)

Adham M. Khalafallah

Adham M. Khalafallah, MD, is a PGY-5 neurosurgery resident at the Department of Neurological Surgery, University of Miami Miller School of Medicine and Jackson Memorial Hospitals. He previously completed a postdoctoral research fellowship in Neurosurgical Oncology at Johns Hopkins University, where he served as Co-Director of the Neuro-Oncology Surgical Outcomes Laboratory. His academic interests cover spine surgery, minimally invasive and endoscopic techniques, spinal oncology, spinal vascular disorders, and peripheral nerve surgery, as well as neurosurgical education. Dr. Khalafallah has authored over 200 peer-reviewed publications, with a primary focus on clinical outcomes, surgical innovation and resident training. His recent research has investigated awake endoscopic spine surgery, artificial intelligence applications in spinal oncology, spinal dural arteriovenous fistulas, and modern approaches to neurosurgical training. He stays actively engaged with national neurosurgical societies, peer review, academic mentorship and collaborative multicenter research projects. Connect with him on LinkedIn.

JSS: What are the limitations of the existing peer-review system?

Dr. Khalafallah: Reviewer fatigue stands out as a major limitation of today’s peer-review system. Most reviewers are practicing clinicians and researchers who manage heavy clinical workloads, research tasks, teaching duties, administrative work and personal responsibilities concurrently. As manuscript submissions keep rising, the workload borne by a limited group of regular reviewers has grown considerably. This leads to prolonged review cycles, inconsistent evaluation quality and delays in obtaining expert feedback. To address these issues, peer review should be recognized as a valuable academic contribution instead of an unacknowledged duty. Journals and institutions need to establish formal measures to recognize and reward high-quality review work. Launching mentorship and training programs for residents, fellows and early-career faculty can expand the reviewer pool while upholding rigorous standards. Furthermore, standardized editorial guidelines and structured review frameworks can cut down redundant work and enhance consistency. Ultimately, peer review operates most effectively within a collaborative, constructive academic culture that respects reviewers’ time and expertise.

JSS: What do you regard as a constructive/destructive review?

Dr. Khalafallah: A constructive review objectively assesses a manuscript’s strengths and weaknesses, and delivers practical suggestions for improvement. Professional reviewers clearly articulate their concerns and focus on enhancing the study’s scientific rigor, readability and clinical value. Excellent reviews pinpoint methodological issues and offer feasible solutions accordingly. By contrast, a destructive review is dismissive, ambiguous or overly confrontational. Criticism without proper explanation, or comments intended to discourage authors rather than refine the work, serve no academic purpose. Scientific advancement relies on open scholarly exchange, and peer review should always aim to lift research quality rather than demotivate researchers. Strong reviewers evaluate manuscripts with fairness and modesty, united by the common goal of driving progress across the discipline.

JSS: Data sharing is prevalent in scientific writing in recent years. Do you think it is crucial for authors to share their research data?

Dr. Khalafallah: Data sharing improves transparency, reproducibility, and trust in published findings. It allows other investigators to validate results, perform secondary analyses, and build upon prior work more efficiently. In rapidly evolving fields such as neurosurgery and spine surgery, collaborative data sharing can accelerate innovation and improve patient care by facilitating multicenter validation and broader generalizability of findings.

(by Lareina Lim, Brad Li)