☆ 4.6 Review

Emerging Technologies within Spine Surgery

LIFE-BASEL (2023)

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Wide anatomical variability of PI normative values within an asymptomatic population: a systematic review

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Summary: The purpose of this study was to analyze normative pelvic incidence (PI) values in asymptomatic patients and provide guidance for surgical interventions. A systematic review of the literature found that the mean PI value was 50.0 degrees, consistent with reported values. These normative values can serve as a reference for spine surgeons in considering surgical interventions.

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Artificial intelligence and treatment algorithms in spine surgery

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Summary: Artificial intelligence (AI) is a set of theories and techniques that simulate human intelligence using complex computer programs. Machine learning (ML) methods, a subtype of AI, learn from databases and accomplish specific tasks using algorithms. ML techniques are increasingly important in spine surgery, with applications such as image segmentation, image interpretation, and prediction of postoperative functional scores.

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Robotic and navigated pedicle screws are safer and more accurate than fluoroscopic freehand screws: a systematic review and meta-analysis

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Intraoperative CT for lumbar fusion is not associated with improved short- or long-term complication profiles

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Polyetheretherketone (PEEK) rods versus titanium rods for posterior lumbar fusion surgery: a systematic review and meta-analysis

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Feasibility and safety of a CaO-SiO2-P2O5-B2O3 bioactive glass ceramic spacer in posterior lumbar interbody fusion compared with polyetheretherketone cage: a prospective randomized controlled trial

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Radiological Changes in Adjacent and Index Levels after Cervical Disc Arthroplasty

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Laminoplasty versus laminectomy with fusion for treatment of multilevel cervical compressive myelopathy: an updated meta-analysis

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Preclinical Safety of a 3D-Printed Hydroxyapatite-Demineralized Bone Matrix Scaffold for Spinal Fusion

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Spinal Navigation and Robotics Are More Accurate, More Precise, and More Minimally Invasive

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Trends in the Charges and Utilization of Computer-Assisted Navigation in Cervical and Thoracolumbar Spinal Surgery

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Ceramic bone graft substitute vs autograft in XLIF: a prospective randomized single-center evaluation of radiographic and clinical outcomes

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Performance of hybrid artificial intelligence in determining candidacy for lumbar stenosis surgery

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Can artificial intelligence support or even replace physicians in measuring sagittal balance? A validation study on preoperative and postoperative full spine images of 170 patients

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EUROPEAN SPINE JOURNAL (2022)

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Predictors of accurate intrapedicular screw placement in single-level lumbar (L4-5) fusion: robot-assisted pedicle screw, traditional pedicle screw, and cortical bone trajectory screw insertion

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FRONTIERS IN SURGERY (2022)

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A Comparison of Polyetheretherketone and Titanium-Coated Polyetheretherketone in Minimally Invasive Transforaminal Lumbar Interbody Fusion: A Randomized Clinical Trial

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A systematic review and meta-analysis comparing anterior decompression with fusion and posterior laminoplasty for cervical spondylotic myelopathy

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JOURNAL OF ORTHOPAEDIC SCIENCE (2021)

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ALIF in the correction of spinal sagittal misalignment. A systematic review of literature

M. Formica et al.

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EUROPEAN SPINE JOURNAL (2021)

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Artificial Intelligence-enabled, Real-time Intraoperative Ultrasound Imaging of Neural Structures Within the Psoas Validation in a Porcine Spine Model

Tyler Carson et al.

Summary: This study evaluated an AI-enabled ultrasound imaging system's performance in detecting neural and other structures during trans-psoas spine surgery using an experimental in-vivo animal model. The results demonstrated high sensitivity and specificity in detecting and classifying nerve, psoas muscle, and vertebral body surface, with AI-enhanced ultrasound imaging providing critical information to increase the safety of the surgery.

SPINE (2021)

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Comparison of adverse events between cervical disc arthroplasty and anterior cervical discectomy and fusion: a 10-year follow-up

Travis Loidolt et al.

Summary: The study found no significant difference in the 10-year adverse event rates between cervical disc arthroplasty (CDA) and anterior cervical discectomy and fusion (ACDF). Most categories of adverse events were also not different between the two groups.

SPINE JOURNAL (2021)

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Artificial Intelligence in Spine Care

Michael J. Gutman et al.

Summary: Artificial intelligence is an exciting and growing field in medicine, with potential applications in spine care. Automated systems can analyze complex patterns and images, improving imaging accuracy. Despite promising potential, there are limitations that need to be addressed.

CLINICAL SPINE SURGERY (2021)

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Success of Surgical Simulation in Orthopedic Training and Applications in Spine Surgery

Arash J. Sayari et al.

Summary: The study reviewed the application of surgical simulation in orthopedics and spine surgery, highlighting the need for improved training options. There is a lack of consistency in measurement and skill assessment by existing simulators, indicating a need for more reproducible and affordable options in the future.

CLINICAL SPINE SURGERY (2021)

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Ten-Year Outcomes of 1-and 2-Level Cervical Disc Arthroplasty From the Mobi-C Investigational Device Exemption Clinical Trial

Kee Kim et al.

Summary: The 10-year outcomes of cervical disc arthroplasty (CDA) for 1- or 2-level pathology demonstrate continued safety and efficacy, showing significant improvement in neck function, pain, and neurologic function, along with maintained segmental motion range and alignment. The occurrence of adjacent segment pathology and heterotopic ossification did not significantly differ between 7 and 10 years, indicating the long-term success of CDA with Mobi-C in treating cervical degenerative disc disease.

NEUROSURGERY (2021)

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Titanium (Ti) cages may be superior to polyetheretherketone (PEEK) cages in lumbar interbody fusion: a systematic review and meta-analysis of clinical and radiological outcomes of spinal interbody fusions using Ti versus PEEK cages

Jun-Hao Tan et al.

Summary: This study compared the clinical and radiological outcomes between titanium and polyetheretherketone interbody cages for spinal fusion, finding that titanium cages may be a superior option in non-infective lumbar spine conditions due to higher fusion rates.

EUROPEAN SPINE JOURNAL (2021)

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Sagittal balance of the cervical spine: a systematic review and meta-analysis

Parisa Azimi et al.

Summary: This systematic review and meta-analysis compared cervical sagittal parameters between patients with cervical spine disorder and asymptomatic controls. The study found that T1 slope and cSVA were significantly lower in patients with cervical spine disorder, while SCA was higher. Further well-conducted studies are needed to support these findings.

EUROPEAN SPINE JOURNAL (2021)

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Artificial intelligence clustering of adult spinal deformity sagittal plane morphology predicts surgical characteristics, alignment, and outcomes

Wesley M. Durand et al.

Summary: This study utilized AI algorithms to cluster preoperative lateral radiographs of adult spinal deformity patients, identifying distinct spinal morphology characteristics and their associations with sagittal alignment parameters, surgical features, and outcomes. Patients in different clusters exhibited significant differences in characteristics and surgical outcomes.

EUROPEAN SPINE JOURNAL (2021)

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Augmented and virtual reality in spine surgery, current applications and future potentials

Hamid Ghaednia et al.

Summary: The field of artificial intelligence is rapidly advancing with improvements in deep learning techniques. Augmented and virtual reality are increasingly being used in healthcare, including spine surgery. Despite current limitations, AR and VR show promise in enhancing different aspects of spine surgery, from preoperative planning to surgical applications.

SPINE JOURNAL (2021)

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Rushikesh S. Joshi et al.

Summary: As we enter a technological revolution, spinal surgery is on the brink of a dramatic transformation. With the complexity and diversity of spinal disorders, it is crucial for spine surgeons to utilize advanced computational tools for personalized treatment plans.

SPINE JOURNAL (2021)

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Predicting Readmission After Anterior, Posterior, and Posterior Interbody Lumbar Spinal Fusion: A Neural Network Machine Learning Approach

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Summary: The study evaluated the use of a neural network algorithm in predicting readmission after lumbar fusion procedures, showing a high success rate in predicting the likelihood of readmission. Multivariate regression analysis identified age over 65 years and ASA class over II as significant risk factors for readmission following the procedures.

WORLD NEUROSURGERY (2021)

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Enhanced biomaterials: systematic review of alternatives to supplement spine fusion including silicon nitride, bioactive glass, amino peptide bone graft, and tantalum

Brian Fiani et al.

Summary: Enhanced biomaterials have been explored as innovative tools to improve the success of spinal fusion surgeries. Silicon nitride, bioactive glass, amino peptide bone grafts, and tantalum are among the biomaterials with potential roles in supporting spinal fusion, with positive clinical outcomes and cost-effectiveness. However, more studies with longer follow-ups are needed to fully understand these biomaterials before their widespread use in spinal procedures.

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Radiolucent Carbon Fiber-Reinforced Implants for Treatment of Spinal TumorseClinical, Radiographic, and Dosimetric Considerations

Ariel Takayanagi et al.

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WORLD NEUROSURGERY (2021)

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A Primer on the Use of Artificial Intelligence in Spine Surgery

Yoshihiro Katsuura et al.

Summary: This narrative review summarizes the fundamentals of artificial intelligence in spine surgery, highlighting the current and potential future uses of AI tools in segmentation of spinal structures, acquiring measurements, identifying pathology, and guiding clinical management. The study shows the promising future of AI in improving treatment selection and patient prognostication in spine surgery and medicine as a whole.

CLINICAL SPINE SURGERY (2021)

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Robotics in Spine Surgery and Spine Surgery Training

Jason Liounakos et al.

Summary: The increasing interest and advancements in robotic spine surgery have led to highly accurate tools for implant placement, with potential for developing novel features. As spine surgery robots evolve and become increasingly adopted, education for residents and fellows is likely to improve, providing unique opportunities for established surgeons and trainees.

OPERATIVE NEUROSURGERY (2021)

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Robotics in Spine Surgery and Spine Surgery Training

Jason Liounakos et al.

Summary: With the advancement of robotic spine surgery technology, there may be new features in the future, such as robotic-assisted decompression. As spine surgery robots evolve and become increasingly adopted, the training of future generations of spine surgeons may be different.

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Artificial Intelligence and Robotics in Spine Surgery

Jonathan J. Rasouli et al.

Summary: Artificial intelligence (AI) and machine learning (ML) have great potential in revolutionizing spine surgery by focusing on predictive analytics and supervised image recognition. With ongoing research and trials, they are expected to change the overall spine care in the future.

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The association of cervical sagittal alignment with adjacent segment degeneration

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EUROPEAN SPINE JOURNAL (2020)

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Sagittal spinopelvic alignment after spinal fusion in degenerative lumbar scoliosis: a meta-analysis

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BRITISH JOURNAL OF NEUROSURGERY (2020)

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Efficacy and safety of bone substitutes in lumbar spinal fusion: a systematic review and network meta-analysis of randomized controlled trials

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Comprehensive Analysis of Hybrid Surgery and Anterior Cervical Discectomy and Fusion in Cervical Diseases: A Meta-Analysis

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Spinal Stenosis Grading in Magnetic Resonance Imaging Using Deep Convolutional Neural Networks

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Correlation Between Different Interbody Grafts and Pseudarthrosis After Anterior Cervical Discectomy and Fusion Compared with Control Group: Systematic Review

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WORLD NEUROSURGERY (2020)

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Using artificial intelligence (AI) to predict postoperative surgical site infection: A retrospective cohort of 4046 posterior spinal fusions

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A deep learning tool for fully automated measurements of sagittal spinopelvic balance from X-ray images: performance evaluation

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Spinal fusion procedures in the adult and young population: a systematic review on allogenic bone and synthetic grafts when compared to autologous bone

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Artificial Intelligence Models Predict Operative Versus Nonoperative Management of Patients with Adult Spinal Deformity with 86% Accuracy

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Functional Outcomes Associated With Adjacent-level Ossification Disease 10 Years After Cervical Disc Arthroplasty or ACDF

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The 3 Sagittal Morphotypes That Define the Normal Cervical Spine A Systematic Review of the Literature and an Analysis of Asymptomatic Volunteers

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Safety and Tolerability of Stromal Vascular Fraction Combined with β-Tricalcium Phosphate in Posterior Lumbar Interbody Fusion: Phase I Clinical Trial

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The Functional Role of Interface Tissue Engineering in Annulus Fibrosus Repair: Bridging Mechanisms of Hydrogel Integration with Regenerative Outcomes

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The perceived efficacy and utility of spine bioskills curricula for resident and fellow education

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Symptomatic Adjacent Level Disease Requiring Surgery: Analysis of 10-Year Results From a Prospective, Randomized, Clinical Trial Comparing Cervical Disc Arthroplasty to Anterior Cervical Fusion

George M. Ghobrial et al.

NEUROSURGERY (2019)

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Surgical training in spine surgery: safety and patient-rated outcome

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EUROPEAN SPINE JOURNAL (2019)

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Development of Deployable Predictive Models for Minimal Clinically Important Difference Achievement Across the Commonly Used Health-related Quality of Life Instruments in Adult Spinal Deformity Surgery

Christopher P. Ames et al.

SPINE (2019)

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Article Clinical Neurology

Development of predictive models for all individual questions of SRS-22R after adult spinal deformity surgery: a step toward individualized medicine

Christopher P. Ames et al.

EUROPEAN SPINE JOURNAL (2019)

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Development and validation of risk stratification models for adult spinal deformity surgery

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JOURNAL OF NEUROSURGERY-SPINE (2019)

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Two-level cervical disc arthroplasty versus anterior cervical discectomy and fusion: 10-year outcomes of a prospective, randomized investigational device exemption clinical trial

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PLOS ONE (2019)

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Trends in Spine Surgery Training During Neurological and Orthopaedic Surgery Residency A 10-Year Analysis of ACGME Case Log Data

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Artificial Intelligence for Automatic Measurement of Sagittal Vertical Axis Using ResUNet Framework

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William F. Lavelle et al.

SPINE (2019)

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Artificial Intelligence Based Hierarchical Clustering of Patient Types and Intervention Categories in Adult Spinal Deformity Surgery Towards a New Classification Scheme that Predicts Quality and Value

Christopher P. Ames et al.

SPINE (2019)

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The NECK trial: Effectiveness of anterior cervical discectomy with or without interbody fusion and arthroplasty in the treatment of cervical disc herniation; a double-blinded randomized controlled trial

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SPINE JOURNAL (2019)

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Deep learning-based preoperative predictive analytics for patient-reported outcomes following lumbar discectomy: feasibility of center-specific modeling

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SPINE JOURNAL (2019)

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Predictive Modeling of Outcomes After Traumatic and Nontraumatic Spinal Cord Injury Using Machine Learning: Review of Current Progress and Future Directions

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Review Clinical Neurology

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SPINE (2018)

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Examining the Ability of Artificial Neural Networks Machine Learning Models to Accurately Predict Complications Following Posterior Lumbar Spine Fusion

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SPINE (2018)

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SPINE JOURNAL (2018)

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UNFALLCHIRURG (2018)

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Review Clinical Neurology

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CLINICAL SPINE SURGERY (2018)

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NEUROSURGICAL FOCUS (2018)

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The Effectiveness of Bioskills Training for Simulated Lumbar Pedicle Screw Placement

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GLOBAL SPINE JOURNAL (2018)

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ISSLS PRIZE IN BIOENGINEERING SCIENCE 2017: Automation of reading of radiological features from magnetic resonance images (MRIs) of the lumbar spine without human intervention is comparable with an expert radiologist

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MEDICINE (2017)

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MILITARY MEDICINE (2017)

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SPINE (2017)

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CLINICAL SPINE SURGERY (2017)

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COLLOIDS AND SURFACES B-BIOINTERFACES (2017)

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A RCT comparing 7-year clinical outcomes of one level symptomatic cervical disc disease (SCDD) following ProDisc-C total disc arthroplasty (TDA) versus anterior cervical discectomy and fusion (ACDF)

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EUROPEAN SPINE JOURNAL (2016)

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Subsequent surgery rates after cervical total disc replacement using a Mobi-C Cervical Disc Prosthesis versus anterior cervical discectomy and fusion: a prospective randomized clinical trial with 5-year follow-up

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JOURNAL OF NEUROSURGERY-SPINE (2016)

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RADIOLOGY (2016)

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SPINE JOURNAL (2016)

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JOURNAL OF NEUROLOGICAL SURGERY PART A-CENTRAL EUROPEAN NEUROSURGERY (2016)

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Cervical disc arthroplasty (CDA) versus anterior cervical discectomy and fusion (ACDF) in symptomatic cervical degenerative disc diseases (CDDDs): an updated meta-analysis of prospective randomized controlled trials (RCTs)

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SPRINGERPLUS (2016)

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ProDisc-C Total Disc Replacement Versus Anterior Cervical Discectomy and Fusion for Single-Level Symptomatic Cervical Disc Disease Seven-Year Follow-up of the Prospective Randomized US Food and Drug Administration Investigational Device Exemption Study

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JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME (2015)

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Biomechanical Analysis of Cervical Disc Replacement and Fusion Using Single Level, Two Level, and Hybrid Constructs

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SPINE (2015)

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Long-term Outcomes of the US FDA IDE Prospective, Randomized Controlled Clinical Trial Comparing PCM Cervical Disc Arthroplasty With Anterior Cervical Discectomy and Fusion

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SPINE (2015)

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Use of artificial neural networks to predict surgical satisfaction in patients with lumbar spinal canal stenosis

Parisa Azimi et al.

JOURNAL OF NEUROSURGERY-SPINE (2014)

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Prevalence and Type of Cervical Deformity Among 470 Adults With Thoracolumbar Deformity

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SPINE (2014)

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Cervical kinematics and radiological changes after Discover artificial disc replacement versus fusion

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SPINE JOURNAL (2014)

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Differences in the surgical treatment of recurrent lumbar disc herniation among spine surgeons in the United States

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SPINE JOURNAL (2014)

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Cervical total disc replacement with the Mobi-C cervical artificial disc compared with anterior discectomy and fusion for treatment of 2-level symptomatic degenerative disc disease: a prospective, randomized, controlled multicenter clinical trial

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JOURNAL OF NEUROSURGERY-SPINE (2013)

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Osteolysis following resorbable poly-l-lactide-co-d, l-lactide PLIF cage use: a review of cases

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EUROPEAN SPINE JOURNAL (2012)

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Accuracy of Robot-Assisted Placement of Lumbar and Sacral Pedicle Screws A Prospective Randomized Comparison to Conventional Freehand Screw Implantation

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SPINE (2012)

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Comparison between single- and multi-level patients: clinical and radiological outcomes 2 years after cervical disc replacement

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EUROPEAN SPINE JOURNAL (2011)

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Total disc arthroplasty does not affect the incidence of adjacent segment degeneration in cervical spine: results of 93 patients in three prospective randomized clinical trials

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SPINE JOURNAL (2010)

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INTERNATIONAL ORTHOPAEDICS (2009)

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Effects of a cervical disc prosthesis on maintaining sagittal alignment of the functional spinal unit and overall sagittal balance of the cervical spine

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Heterotopic ossification in total cervical artificial disc replacement

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SPINE (2006)

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SPINE (2006)

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Intermediate follow-up after treatment of degenerative disc disease with the Bryan Cervical Disc Prosthesis: Single-level and bi-level

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SPINE (2003)

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Improved bone-screw interface with hydroxyapatite coating -: An in vivo study of loaded pedicle screws in sheep

B Sandén et al.

SPINE (2001)

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Accuracy of pedicle screw insertion with and without computer assistance: a randomised controlled clinical study in 100 consecutive patients

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EUROPEAN SPINE JOURNAL (2000)

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