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Innovations in Spine Surgery: A Narrative Review of Current Integrative Technologies.

Publication ,  Journal Article
Bcharah, G; Gupta, N; Panico, N; Winspear, S; Bagley, A; Turnow, M; D'Amico, R; Ukachukwu, A-EK
Published in: World Neurosurg
April 2024

Neurosurgical technologies have become increasingly more adaptive, featuring real-time and patient-specific guidance in preoperative, intraoperative, and postoperative settings. This review offers insight into how these integrative innovations compare with conventional approaches in spine surgery, focusing on machine learning (ML), artificial intelligence, augmented reality and virtual reality, and spinal navigation systems. Data on technology applications, diagnostic and procedural accuracy, intraoperative times, radiation exposures, postoperative outcomes, and costs were extracted and compared with conventional methods to assess their advantages and limitations. Preoperatively, augmented reality and virtual reality have applications in surgical training and planning that are more immersive, case specific, and risk-free and have been shown to enhance accuracy and reduce complications. ML algorithms have demonstrated high accuracy in predicting surgical candidacy (up to 92.1%) and tailoring personalized treatments based on patient-specific variables. Intraoperatively, advantages include more accurate pedicle screw insertion (96%-99% with ML), enhanced visualization, reduced radiation exposure (49 μSv with O-arm navigation vs. 556 μSv with fluoroscopy), increased efficiency, and potential for fewer intraoperative complications compared with conventional approaches. Postoperatively, certain ML and artificial intelligence models have outperformed conventional methods in predicting all postoperative complications of >6000 patients as well as predicting variables contributing to in-hospital and 90-day mortality. However, applying these technologies comes with limitations, such as longer operative times (up to 35.6% longer) with navigation, dependency on datasets, costs, accessibility, steep learning curve, and inherent software malfunctions. As these technologies advance, continuing to assess their efficacy and limitations will be crucial to their successful integration within spine surgery.

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Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

April 2024

Volume

184

Start / End Page

127 / 136

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Surgery, Computer-Assisted
  • Spine
  • Pedicle Screws
  • Imaging, Three-Dimensional
  • Humans
  • Artificial Intelligence
  • 3209 Neurosciences
  • 3202 Clinical sciences
  • 1109 Neurosciences
 

Citation

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Bcharah, G., Gupta, N., Panico, N., Winspear, S., Bagley, A., Turnow, M., … Ukachukwu, A.-E. (2024). Innovations in Spine Surgery: A Narrative Review of Current Integrative Technologies. World Neurosurg, 184, 127–136. https://doi.org/10.1016/j.wneu.2023.12.124
Bcharah, George, Nithin Gupta, Nicholas Panico, Spencer Winspear, Austin Bagley, Morgan Turnow, Randy D’Amico, and Alvan-Emeka K. Ukachukwu. “Innovations in Spine Surgery: A Narrative Review of Current Integrative Technologies.World Neurosurg 184 (April 2024): 127–36. https://doi.org/10.1016/j.wneu.2023.12.124.
Bcharah G, Gupta N, Panico N, Winspear S, Bagley A, Turnow M, et al. Innovations in Spine Surgery: A Narrative Review of Current Integrative Technologies. World Neurosurg. 2024 Apr;184:127–36.
Bcharah, George, et al. “Innovations in Spine Surgery: A Narrative Review of Current Integrative Technologies.World Neurosurg, vol. 184, Apr. 2024, pp. 127–36. Pubmed, doi:10.1016/j.wneu.2023.12.124.
Bcharah G, Gupta N, Panico N, Winspear S, Bagley A, Turnow M, D’Amico R, Ukachukwu A-EK. Innovations in Spine Surgery: A Narrative Review of Current Integrative Technologies. World Neurosurg. 2024 Apr;184:127–136.
Journal cover image

Published In

World Neurosurg

DOI

EISSN

1878-8769

Publication Date

April 2024

Volume

184

Start / End Page

127 / 136

Location

United States

Related Subject Headings

  • Tomography, X-Ray Computed
  • Surgery, Computer-Assisted
  • Spine
  • Pedicle Screws
  • Imaging, Three-Dimensional
  • Humans
  • Artificial Intelligence
  • 3209 Neurosciences
  • 3202 Clinical sciences
  • 1109 Neurosciences