There are several stand out articles in this edition of JSS. The paper by Faqeeh and Yen on facet joint denervation as an adjunct to patients undergoing posterior lumbar decompression for spinal stenosis is of particular interest to many spinal surgeons. The results of lumbar decompression for neurogenic claudication can be deemed poor by patients using subjective outcome measures such as the ODI, as relief of the claudicant symptoms can be excellent, but the ongoing mechanical back pain can present as a poor outcome, despite the goals of this surgery to provide relief of claudication and improved walking distance. Interesting however, the results of this well performed study do not support the addition of facet denervation for short-term treatment on back pain in patients undergoing lumbar laminectomy for spinal stenosis (1).

The article by Nomura et al. on quantitative analysis of indirect decompression in extreme lateral interbody fusion for lumbar spinal stenosis (2) further adds evidence of the power of distraction and restoration of disc height to achieve acceptable clinical outcomes. Reduction of canal and foraminal stenosis using this technique, without the additional risk of entering the spinal canal and nerve manipulation, has been well demonstrated with both ALIF and XLIF (3). Finally, the article by Passias et al. on behalf of the International Spine Study Group on the limited morbidity and radiographic benefit of C2 fixation as the uppermost instrumented vertebrae (4) is comforting to surgeons to provide a statement of confidence on uppermost fixation represents a huge volume of work, and the authors should be commended for their efforts on this detailed, and well researched article.

We will continue to not charge any fee for submitting articles to JSS for initial assessment, (an increasingly common practice), however upon peer review and acceptance, JSS will need to charge a relatively minor publishing fee to cover the costs of maintaining the Journal as a free-to-read publication. On behalf of the Editorial Board, I would like to thank AME Groups for ongoing publishing services to JSS, and making the Journal a success. Enjoy the current issue and please forward ideas for focused editions via email for consideration and discussion to contact the editorial office at jss@amegroups.com.

Ralph J. Mobbs
June, 2019
Sydney, Australia

References
1. Faqeeh A, Yen D. Open facet joint denervation as an adjunct in patients undergoing posterior lumbar decompression for spinal stenosis—a single blinded randomized controlled trial. J Spine Surg 2019. doi: 10.21037/jss.2019.05.06
2. Nomura H, Yamashita A, Watanabe T, Shirasawa K. Quantitative analysis of indirect decompression in extreme lateral interbody fusion and posterior spinal fusion with a percutaneous pedicle screw system for lumbar spinal stenosis. J Spine Surg 2019. doi: 10.21037/jss.2019.06.03
3. Mobbs RJ, Phan K, Malham G, Seex K, Rao PJ. Lumbar interbody fusion: techniques, indications and comparison of interbody fusion options including PLIF, TLIF, MI-TLIF, OLIF/ATP, LLIF and ALIF. J Spine Surg. 2015 Dec;1(1):2-18.doi: 10.3978/j.issn.2414-469X.2015.10.05. Review. PubMed PMID: 27683674; PubMed Central PMCID: PMC5039869.
4. Passias PG, Bortz CA, Segreto F, Horn S, Pierce KE, Alas H, Brown AE, Lafage R, Lafage V, Smith JS, Line B, Eastlack R, Sciubba DM, Klineberg EO, Soroceanu A, Burton DC, Schwab FJ, Bess S, Shaffrey CI, Ames CP; onbehalf of the International Spine Study Group (ISSG). Limitedmorbidity and possible radiographic benefit of C2 vs. subaxial cervical upper-most instrumented vertebrae. J Spine Surg 2019. doi: 10.21037/jss.2019.06.04