Abstract
In recent years, spine surgery has undergone remarkable advancements, revolutionized the field, and transformed patient care. This special issue of the Journal of Orthopedics provides the best possible knowledge for its readers about the current trends and recent innovations in the field of spine surgery and supports clinicians and surgeons in their daily practice and decision-making process. It covers various topics like artificial intelligence in spine surgery, 3D printing, minimally invasive spine surgery. It also provides needed information on modic changes, management of eary onset scoliosis and recent trends in spinal cord injury management.
Keywords: Spine, Fractures, Spinal deformity, Artificial intelligence, 3D printing, Scoliosis, Robotics
Editorial
In the last two decades, the field of spine surgery has seen a number of recent developments and technological innovations that have led to considerable improvements in patient outcomes. These new inventions and technologies have been a path provider for achieving surgical goals of reducing morbidity and mortality.
This special issue of the Journal of Orthopaedics (JOO) aims to bridge the prevailing gap between readers and the recent advancement in spine surgery. It begins with a narrative review of modic change by Prof. Rajasekaran providing the readers the in-depth knowledge of its pathophysiology, clinical significance, and role in chronic low back.
The domain of artificial intelligence (AI) is seeing rapid progress, particularly due to recent advancements in deep learning (DL) techniques. Augmented (AR) and virtual reality (VR) are finding their place in healthcare, and spine surgery is no exception.1 The narrative review by Andrea Luca and his team provides spine surgeons and clinical researchers with general information about the current applications, future potentials, and accessibility of AR and VR systems in spine surgery. In spine surgery, there are three main areas in which 3-D printing is being used: anatomic haptic models for preoperative planning; surgical guides for the placement of pedicle screws; and patient-specific titanium implants for spinal column reconstruction.2 The narrative review by Bhavuk Garg and his team has explained in detail the current application of 3D printing in spine surgery.
Ultrasonic bone devices, bone scalpels in particular, would be interesting and informative for any spine surgeon who is a novice in this field. This special issue of JOO presents a comprehensive review of the various ultrasonic bone devices available including their physical, technologic, and clinical aspects in spine surgery written by Ajoy Shetty and his team.
Image-guided navigation has progressed considerably and has the potential to reduce complications and improve outcomes in all areas of spinal surgery, such as minimally invasive spinal surgery (MISS), deformity correction, tumor resection, and revision surgery. However, the field of robotic spine surgery is still in its infancy and requires more development before it can be widely adopted for use in challenging procedures.3 The narrative review on Robotics and Navigation in spine surgery by Chhabra explains the utility of these modern developments to the spine society.
Convolutional neural network (CNN) is a universal technology, which has achieved remarkable performance in multiple MRI assessment tasks, including pathology identification, key-point detection, and anatomical segmentation.4, 5, 6 The study by Jason Cheung and his team predicted the development of endplate defects over a span of 5 years using an unbalanced data set and a convolutional neural network.
Spine surgery has been transformed significantly by the growth of minimally invasive surgery (MIS) procedures. Minimally invasive spine (MIS) surgery can result in a decrease in visualization, however, using computer-assisted navigation technologies enables greater visualization through smaller MIS incisions as compared to open surgical procedures.7 In this special issue, we have discussed in detail the different endoscopic techniques and its implication in spine surgery. Lokande et al. have explained the tips and tricks of full endoscopic spine surgery in detail. Although MISS techniques have recently gained popularity to decrease surgical morbidity after open surgery, there are definitely limitations, especially in restoring severe sagittal malalignment patients. Lateral Access Minimally Invasive Spine Surgery is designed to fill this vacuum. Written by Tanaka et al. on the topic, it will be an excellent resource for both beginning and experienced surgeons.
The treatments for early-onset scoliosis (EOS) remain great challenges for spine surgeons. The role of vertebral body tethering (VBT) and grow rods in early onset scoliosis is imperative in skeletally immature patients. The narrative review on growth rods by Jwalanth Mehta explores the various types of growing rod options that are currently available. Alice Baroncini has given an overview of the current applications of VBT, along with imaging and comments derived from the clinical experience which will be a valuable asset to the young budding spine surgeon.
In particular, Professor Michael Fehlings's chapter on "Current insights into the management of spinal cord injury" deserves to be brought to the reader's attention where he explores the management of SCI through early decompressive surgery, optimizing mean arterial pressure, steroid therapy, and focused rehabilitation. In addition, the literature regarding emerging research that aims to repair the spinal cord following the primary injury mechanism is also explored.
Finally, we would like to personally thank all the contributing authors for their excellent research and the reviewers who critically reviewed all the manuscripts.
Contributor Information
Ajoy Prasad Shetty, Email: ajoyshetty@gmail.com.
Dilip Chand Raja, Email: dilipdino@gmail.com.
References
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