Interest in the use of artificial intelligence (AI) and machine learning (ML) in medicine has grown exponentially over the last few years. With its ability to enhance speed, precision, and efficiency, AI has immense potential, especially in the field of surgery. This article aims to provide a comprehensive literature review of artificial intelligence as it applies to surgery and discuss practical examples, current applications, and challenges to the adoption of this technology. Furthermore, we elaborate on the utility of natural language processing and computer vision in improving surgical outcomes, research, and patient care.

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Background Neurosurgery Awareness Month (August) was initiated by the American Association of Neurological Surgeons with the aim of bringing neurological conditions to the forefront and educating the public about these conditions. Digital media is an important tool for disseminating information and connecting with influencers, general public, and other stakeholders. Hence, it is crucial to understand the impact of awareness campaigns such as Neurosurgery Awareness Month to optimize resource allocation, quantify the efficiency and reach of these initiatives, and identify areas for improvement. Objective The purpose of our study was to examine the digital impact of Neurosurgery Awareness Month globally and identify areas for further improvement. Methods We used 4 social media (Twitter) assessment tools (Sprout Social, SocioViz, Sentiment Viz, and Symplur) and Google Trends to extract data using various search queries. Using regression analysis, trends were studied in the total number of tweets posted in August between 2014 and 2022. Two search queries were used in this analysis: one specifically targeting tweets related to Neurosurgery Awareness Month and the other isolating all neurosurgery-related posts. Total impressions and top influencers for #neurosurgery were calculated using Symplur’s machine learning algorithm. To study the context of the tweets, we used SocioViz to isolate the top 100 popular hashtags, keywords, and collaborations between influencers. Network analysis was performed to illustrate the interactions and connections within the digital media environment using ForceAtlas2 model. Sentiment analysis was done to study the underlying emotion of the tweets. Google Trends was used to study the global search interest by studying relative search volume data. Results A total of 10,007 users were identified as tweeting about neurosurgery during Neurosurgery Awareness Month using the “#neurosurgery” hashtag. These tweets generated over 29.14 million impressions globally. Of the top 10 most influential users, 5 were faculty neurosurgeons at US university hospitals. Other influential users included notable organizations and journals in the field of neurosurgery. The network analysis of the top 100 influencers showed a collaboration rate of 81%. However, only 1.6% of the total neurosurgery tweets were advocating about neurosurgery awareness during Neurosurgery Awareness Month, and only 13 tweets were posted by verified users using the #neurosurgeryawarenessmonth hashtag. The sentiment analysis revealed that the majority of the tweets about Neurosurgery Awareness Month were pleasant with subdued emotion. Conclusions The global digital impact of Neurosurgery Awareness Month is nascent, and support from other international organizations and neurosurgical influencers is needed to yield a significant digital reach. Increasing collaboration and involvement from underrepresented communities may help to increase the global reach. By better understanding the digital impact of Neurosurgery Awareness Month, future health care awareness campaigns can be optimized to increase global awareness of neurosurgery and the challenges facing the field.

Study Design : Retrospective Chart Review. Objectives Incidental durotomies (IDs) are common spine surgery complications. In this study, we present a review on the most commonly utilized management strategies, report our institutional experience with case examples, and describe a stepwise management algorithm. Methods A retrospective review was performed of the electronic medical records of all patients who underwent a thoracolumbar or lumbar spine surgery between March 2017 and September 2019. Additionally, a literature review of the current management approaches to treat IDs and persistent postoperative CSF leaks following lumbar spine surgeries was performed. Results We looked at 1133 patients that underwent posterior thoracolumbar spine surgery. There was intraoperative evidence of ID in 116 cases. Based on our cohort and the current literature, we developed a progressive treatment algorithm for IDs that begins with a primary repair, which can be bolstered by dural sealants or a muscle patch. If this fails, the primary repair can be followed by a paraspinal muscle flap, as well as a lumbar drain. If the patient cannot be weaned from temporary CSF diversion, the final step in controlling postoperative leak is longterm CSF diversion via a lumboperitoneal shunt. In our experience, these shunts can be weaned once the patient has no further clinical or radiographic signs of CSF leak. Conclusions There is no standardized management approach of IDs and CSF leaks in the literature. This article intends to provide a progressive treatment algorithm and contribute to the development process of a treatment consensus.

Differences between same-day and staged (circumferential) fusion surgery in adult spinal deformity.

Background Adult spinal deformity (ASD) is a deformity in the curvature of the adult spine. ASD includes a range of pathology that leads to decreased quality of life for patients as well as debilitating morbidities. Treatment can range from nonoperative management to long-segment surgical corrections and depends greatly on the deformity and patient profiles. If surgical treatment is indicated, circumferential (a combined anterior and posterior approach) fusion is one of the tools in the spine surgeon’s armamentarium. Depending on the complexity, the procedure is either completed on the same day or staged. Determining whether to perform a circumferential surgery in a staged fashion is based largely on the surgeon’s preference and perception of the individual case complexity; at present, there is no high-quality evidence that can be used to support that decision. Objective This paper presents the protocol for a systematic review that aims to investigate the differences between same-day versus staged circumferential fusion surgery in ASD both in patient selection and in outcomes. Methods Searches will be performed on MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, Web of Science, and Scopus. Gray literature and the reference lists of articles included in the full-text screening will also be screened for inclusion. Results will be exported to Covidence. Data will be collected on demographics, type of procedures performed, surgery levels, blood loss, total operation time, length of stay, disposition, readmissions (30 days and 90 days), and perioperative complications. Patient-reported outcomes will also be assessed. Data quality assessment of randomized controlled trials will be performed using the Cochrane Collaboration’s tool for assessing risk of bias in randomized trials, and nonrandomized studies will be assessed with the ROBINS-I (Risk of Bias in Non-randomized Studies of Interventions) tool. All screening, quality assessment, and data extraction will be done by 2 independent reviewers. A descriptive synthesis will be performed, and data will be evaluated for further analysis. Results This study is currently in the screening phase. There are no results yet. The search strategy has been developed and documented. Information has been exported to Covidence. Upon conclusion of the critical appraisal stage, screening and extraction, as well as a synthesis of the results, will be performed. Conclusions The intended review will summarize the differences in perioperative outcomes and complications between same-day and staged (circumferential) fusion surgery in adult spinal deformity. It will also describe the patients selected for such procedures based on their demographics and pathology. Identified gaps in knowledge will provide insight into current limitations and guide further studies on this topic. Trial Registration PROSPERO CRD42022339764; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=339764 International Registered Report Identifier (IRRID) PRR1-10.2196/42331

BACKGROUND Neurosurgery Awareness Month (NAM) was initiated by the American Association of Neurological Surgeons. Bringing neurological conditions to the forefront and sharing knowledge to enlighten the public is the goal of NAM. Digital media is key disseminating information, connecting with influencers and sharing opinions. It is crucial to understand the impact of awareness months to quantify their efficiency, global reach and to optimize resource allocation. OBJECTIVE The purpose of our study was to examine the digital impact of Neurosurgery Awareness Month to inform future Healthcare Awareness Campaigns. METHODS We used four social media assessment tools (Sprout Social, SocioViz, Symplur, and SentimentViz) and Google Trends to obtain data about the total tweets, global impressions, and sentiment from countries worldwide about NAM. RESULTS 10,007 users were identified during NAM using the ‘#neurosurgery’ that fetched over 29.14 million impressions globally. Five of the top 10 most influential users were faculty neurosurgeons at US-university hospitals. Others included notable organizations and journals. Network analysis of the top 100 influencers, showed a collaboration rate of 81 percent. Only 1.6% of the total neurosurgery tweets were advocating about neurosurgery awareness during NAM. Only 13 tweets were posted by verified users using the #neurosurgeryawarenessmonth. CONCLUSIONS The global digital impact of neurosurgery awareness month is nascent and support from other international organizations and neurosurgical influencers is needed to yield a significant digital reach.

BACKGROUND Adult spinal deformity (ASD) is a deformity in the curvature of the adult spine. Possible treatments of ASD include conservative and surgical management. If surgical treatment is indicated, (circumferential) fusion surgery is one of the procedures that may be performed. Depending on the complexity, the procedure is either done on the same day (SD) or staged (STA). OBJECTIVE This is a protocol of a systematic review that aims to investigate the differences between SD and STA (circumferential) fusion surgery in ASD. METHODS Searches have been performed on MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL). Results have been exported to Covidence. All screening, quality assessment, and data extraction will be done by two independent reviewers. A descriptive synthesis will be performed and data will be evaluated for further analysis. RESULTS This study is currently in the screening phase. There are no results yet. Search strategy has been developed and initiated. Information has been exported to Covidence. After conclusion of the critical appraisal stage, screening and extraction, synthesis of results will be performed. CONCLUSIONS The intended review will summarize the differences in perioperative outcomes and complications between same-day and staged (circumferential) fusion surgery in adult spinal deformity. Identified gaps in knowledge will provide insight into current limitations and guide further studies on this topic. CLINICALTRIAL PROSPERO CRD42022339764