Study Design: Narrative Review Objective: To review and highlight the historical and recent advances of imaging in spine surgery and to discuss current applications and future directions Methods: A PubMed review of the current literature was performed on all relevant articles that examined historical and recent imaging techniques used in spine surgery. Studies were examined for their thoroughness in description of various modalities and applications in current and future management. Results: We reviewed 97 articles that discussed past, present, and future applications for imaging in spine surgery. Although most historical approaches relied heavily upon basic radiography, more recent advances have begun to expand upon advanced modalities, including the integration of more sophisticated equipment and artificial intelligence. Conclusion: Since the days of conventional radiography, various modalities have emerged and become integral components of the spinal surgeon's diagnostic armamentarium. As such, it behooves the practitioner to remain informed on the current trends and potential developments in spinal imaging, as rapid adoption and interpretation of new techniques may make significant differences in patient management and outcomes. Future directions will likely become increasingly sophisticated as the implementation of machine learning, and artificial intelligence has become more commonplace in clinical practice.

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Background: YouTube has become a popular source for patient education, though there are concerns regarding the quality and reliability of videos related to orthopaedic and neurosurgical procedures. This study aims to evaluate the credibility and educational content of videos on YouTube related to cervical fusion. Secondarily, the study aims to identify factors predictive of higher or lower quality videos.Methods: A YouTube query using the search terms ''cervical fusion'' was performed, and the first 50 videos were included for analysis. Reliability was assessed using the Journal of the American Medical Association (JAMA) criteria. Educational quality was assessed using the Global Quality Score (GQS) and the Cervical Fusion Content Score (CFCS). Videos were stratified by content and source, and differences in JAMA, GQS, and CFCS scores were assessed. Multivariable linear regression was used to identify predictors of higher or lower JAMA, GQS, and CFCS scores. Statistical significance was established at P , 0.05.Results: Total number of views was 6 221 816 with a mean of 124 436.32 6 412 883.32 views per video. Physicians, academic, and medical sources had significantly higher mean JAMA scores (P ¼ 0.042). Exercise training and nonsurgical management videos had significantly higher mean CFCS scores (P ¼ 0.018). Videos by physicians (b ¼ 0.616; P ¼ 0.025) were independently associated with higher JAMA scores. Advertisements were significant predictors of worse CFCS (b ¼À3.978; P ¼ 0.030), and videos by commercial sources predicted significantly lower JAMA scores (b ¼ À1.326; P ¼ 0.006).Conclusions: While videos related to cervical fusion amassed a large viewership, they were poor in both quality and reliability. Videos by physicians were associated with higher reliability scores relative to other sources, whereas commercial sources and advertisements had significantly lower reliability and educational content scores. Currently, YouTube seems to be an unreliable source of information on cervical fusion for patients.Level of Evidence: 4. Clinical Relevance: The results of this study aid surgeons in counseling patients interested in cervical fusion, and suggest that publicly available videos regarding cervical fusion may not be an adequate tool for patient education at this time.

Background: The COVID-19 pandemic has impacted spine care around the globe. Much uncertainty remains regarding the immediate and long-term future of spine care and education in this COVID-19 era. Study design: Cross-sectional, international study of spine surgeons. Methods: A multi-dimensional survey was distributed to spine surgeons around the world. A total of 73 questions were asked regarding demographics, COVID-19 observations, personal impact, effect on education, adoption of telemedicine, and anticipated challenges moving forward. Multivariate analysis was performed to assess factors related to likelihood of future conference attendance, future online education, and changes in surgical indications. Results: A total of 902 spine surgeons from seven global regions completed the survey. Respondents reported a mean level of overall concern of 3.7 on a scale of one to five. 84.0% reported a decrease in clinical duties, and 67.0% reported a loss in personal income. The 82.5% reported being interested in continuing a high level of online education moving forward. Respondents who personally knew someone who tested positive for COVID-19 were more likely to be unwilling to attend a medical conference 1 year from now (OR: 0.61, 95% CI: [0.39, 0.95], P = .029). The 20.0% reported they plan to pursue an increased degree of nonoperative measures prior to surgery 1 year from now, and respondents with a spouse at home (OR: 3.55, 95% CI: [1.14, 11.08], P = .029) or who spend a large percentage of their time teaching (OR: