Introduction Minimally invasive spinal surgeries rely heavily on imaging for localization of key anatomical structures. Current established modalities either do not provide adequate visualization of soft-tissue structures or do so in an indirect manner. Real-time integrated soft-tissue imaging will allow surgeons to accurately differentiate nerves, muscle, vasculature, and bone while simultaneously preventing excessive dissection of tissue and risk to patients. Areas Covered SonoVision™ is a novel imaging device able to meet the needs of intraoperative anatomical visualization. This review explains the mechanism of the device and summarizes the empirical support for its use. Multiple animal, cadaver, and human studies have been used to compile machine-learning training data and validate the system’s accuracy and usability through actual and simulated surgical scenarios. Expert Opinion SonoVision™ represents a significant improvement over current intraoperative imaging technology in terms of accuracy, efficiency, and ease of use. This system provides vital anatomical information that would otherwise be unavailable in an intuitive, real-time format. SonoVision™ may play an important role in improving outcomes in lateral approach spine surgery as well as making minimally invasive techniques more accessible to a wider range of surgeons. Article Highlights • The direct lateral transpsoas approach for lumbar fusion has distinct advantages, but is associated with various complications, many of which are related to inadequate intraoperative imaging. • There is a significant unmet need for real-time intraoperative soft-tissue imaging in spine surgery. • The SonoVision™ ultrasound system utilizes machine-learning algorithms to provide real-time soft tissue imaging and differentiation for use during spine procedures. • Early trials are promising with regard to SonoVision’s™ ability to meet needs for intraoperative soft-tissue imaging in lateral approach spine surgery.
Within the last few decades, there has been a shift in routine spine procedures from the inpatient to outpatient setting. In response to the transition, a surge in ambulatory surgery centers (ASCs) has closely followed (1). The reason for the movement is considered to be two-fold: (I) the advent of minimally invasive techniques and (II) financial incentives for surgeons to operate and own ASCs.
Mr. Munns is Medical Student and Research Associate, Dr. Park is Resident, and Dr. Singh is Assistant Professor, Department of Orthopaedic Surgery, Rush University Medical Center, 1725 West Harrison Street, POB 1063, Chicago, IL 60612; E-mail: [email protected]. Mr. Munns and Dr. Park have disclosed that they have no significant relationships with or financial interests in any commercial organizations pertaining to this educational activity. Dr. Singh has disclosed that he is/was a consultant to Stryker Spine and Pioneer Spine. All staff in a position to control the content of this CME activity have disclosed that they have no financial relationships with, or financial interests in, any commercial companies pertaining to this educational activity. Lippincott CME Institute, Inc., has identified and resolved all faculty and staff conflicts of interest regarding this educational activity. This continuing education activity is intended for orthopedic and neurologic surgeons and other physicians with an interest in spine surgery.
Literature review.To discern which social media outlets contribute most to spine surgery literature dissemination and to investigate how popular articles compare to articles with most citations.Scientific literature is increasingly disseminated through social media. The Altmetric Attention Score (AAS) is defined as an automated, weighted score calculation from counts of all online attention received by various research outputs. Increasing AAS values indicate more online attention. For example, the overall top 100 Altmetric spine surgery peer-reviewed articles since 2010 had an AAS range from 78 to 1537. Among all spine surgery literature reviewed since 2010, the mean AAS was 5.3 with a median of 1.0.We performed an Altmetric database search of nine spine surgery journals from January 2010 to October 2019. Mean AAS was summarized alongside metrics including citation count and impact factor. We assessed correlations between AAS and online sources, readers, and citations. Journals were grouped by impact factor, and analysis-of-variance compared mean AAS. The 100 highest AAS articles were compared to the most cited.13,601 articles were included. The mean AAS was 5.3, with Twitter contributing the most. The three highest associations were news (P < 0.001), Twitter (P < 0.001), and Facebook (P < 0.001). There was no significant association between impact factor and AAS. Compared with the most cited articles, the top 100 AAS articles had significantly more article types, more prospective studies, fewer retrospective studies, fewer reviews, and fewer systematic reviews (P < 0.001 for all). Spine contributed the most articles in both top 100 sets.Our evaluation revealed Twitter, newsfeeds, and Facebook were the most significant social media outlets. Compared to articles with the most citations, the most popular articles are prospective and encompass broader study designs. Social media plays an integral role in dissemination, both within spine literature and the public sphere.3.
