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      Extended reality in cranial and spinal neurosurgery – a bibliometric analysis

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          Abstract

          Purpose

          This bibliometric analysis of the top 100 cited articles on extended reality (XR) in neurosurgery aimed to reveal trends in this research field. Gender differences in authorship and global distribution of the most-cited articles were also addressed.

          Methods

          A Web of Science electronic database search was conducted. The top 100 most-cited articles related to the scope of this review were retrieved and analyzed for trends in publications, journal characteristics, authorship, global distribution, study design, and focus areas. After a brief description of the top 100 publications, a comparative analysis between spinal and cranial publications was performed.

          Results

          From 2005, there was a significant increase in spinal neurosurgery publications with a focus on pedicle screw placement. Most articles were original research studies, with an emphasis on augmented reality (AR). In cranial neurosurgery, there was no notable increase in publications. There was an increase in studies assessing both AR and virtual reality (VR) research, with a notable emphasis on VR compared to AR. Education, surgical skills assessment, and surgical planning were more common themes in cranial studies compared to spinal studies. Female authorship was notably low in both groups, with no significant increase over time. The USA and Canada contributed most of the publications in the research field.

          Conclusions

          Research regarding the use of XR in neurosurgery increased significantly from 2005. Cranial research focused on VR and resident education while spinal research focused on AR and neuronavigation. Female authorship was underrepresented. North America provides most of the high-impact research in this area.

          Supplementary information

          The online version contains supplementary material available at 10.1007/s00701-024-06072-4.

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          Most cited references40

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          R: A Language and Enviroment for Statistical Computing

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            Open access publishing, article downloads, and citations: randomised controlled trial

            Objective To measure the effect of free access to the scientific literature on article downloads and citations. Design Randomised controlled trial. Setting 11 journals published by the American Physiological Society. Participants 1619 research articles and reviews. Main outcome measures Article readership (measured as downloads of full text, PDFs, and abstracts) and number of unique visitors (internet protocol addresses). Citations to articles were gathered from the Institute for Scientific Information after one year. Interventions Random assignment on online publication of articles published in 11 scientific journals to open access (treatment) or subscription access (control). Results Articles assigned to open access were associated with 89% more full text downloads (95% confidence interval 76% to 103%), 42% more PDF downloads (32% to 52%), and 23% more unique visitors (16% to 30%), but 24% fewer abstract downloads (−29% to −19%) than subscription access articles in the first six months after publication. Open access articles were no more likely to be cited than subscription access articles in the first year after publication. Fifty nine per cent of open access articles (146 of 247) were cited nine to 12 months after publication compared with 63% (859 of 1372) of subscription access articles. Logistic and negative binomial regression analysis of article citation counts confirmed no citation advantage for open access articles. Conclusions Open access publishing may reach more readers than subscription access publishing. No evidence was found of a citation advantage for open access articles in the first year after publication. The citation advantage from open access reported widely in the literature may be an artefact of other causes.
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              Augmented reality in neurosurgery: a systematic review.

              Neuronavigation has become an essential neurosurgical tool in pursuing minimal invasiveness and maximal safety, even though it has several technical limitations. Augmented reality (AR) neuronavigation is a significant advance, providing a real-time updated 3D virtual model of anatomical details, overlaid on the real surgical field. Currently, only a few AR systems have been tested in a clinical setting. The aim is to review such devices. We performed a PubMed search of reports restricted to human studies of in vivo applications of AR in any neurosurgical procedure using the search terms "Augmented reality" and "Neurosurgery." Eligibility assessment was performed independently by two reviewers in an unblinded standardized manner. The systems were qualitatively evaluated on the basis of the following: neurosurgical subspecialty of application, pathology of treated lesions and lesion locations, real data source, virtual data source, tracking modality, registration technique, visualization processing, display type, and perception location. Eighteen studies were included during the period 1996 to September 30, 2015. The AR systems were grouped by the real data source: microscope (8), hand- or head-held cameras (4), direct patient view (2), endoscope (1), and X-ray fluoroscopy (1) head-mounted display (1). A total of 195 lesions were treated: 75 (38.46 %) were neoplastic, 77 (39.48 %) neurovascular, and 1 (0.51 %) hydrocephalus, and 42 (21.53 %) were undetermined. Current literature confirms that AR is a reliable and versatile tool when performing minimally invasive approaches in a wide range of neurosurgical diseases, although prospective randomized studies are not yet available and technical improvements are needed.
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                Author and article information

                Contributors
                adrian.elmi.terander@ki.se
                Journal
                Acta Neurochir (Wien)
                Acta Neurochir (Wien)
                Acta Neurochirurgica
                Springer Vienna (Vienna )
                0001-6268
                0942-0940
                25 April 2024
                25 April 2024
                2024
                : 166
                : 1
                : 194
                Affiliations
                [1 ]Department of Clinical Neuroscience, Karolinska Institutet, ( https://ror.org/056d84691) Stockholm, Sweden
                [2 ]KTH Royal Institute of Technology, ( https://ror.org/026vcq606) Stockholm, Sweden
                [3 ]Artificial Engineering, Naples, Italy
                [4 ]Department of Orthopaedics and Hand surgery, Uppsala University hospital, ( https://ror.org/01apvbh93) Uppsala, Sweden
                [5 ]Department of Surgical Sciences, Uppsala University, ( https://ror.org/048a87296) Uppsala, Sweden
                [6 ]Division of Neurosurgery, Lehigh Valley Fleming Neuroscience Institute, Allentown, PA USA
                [7 ]Department of Neurosurgery & Brain Repair, Morsani College of Medicine, University of South Florida, ( https://ror.org/032db5x82) Tampa, FL USA
                [8 ]Capio Spine Center Stockholm, Löwenströmska Hospital, Upplands-Väsby, Sweden
                [9 ]Department of Medical Sciences, Örebro University, ( https://ror.org/05kytsw45) Örebro, Sweden
                Author information
                http://orcid.org/0009-0000-1966-7911
                http://orcid.org/0000-0001-9479-761X
                http://orcid.org/0000-0001-5634-8960
                http://orcid.org/0000-0002-3614-8782
                http://orcid.org/0000-0001-6064-5634
                http://orcid.org/0000-0003-4616-189X
                http://orcid.org/0000-0001-8061-7163
                http://orcid.org/0000-0001-6774-2066
                http://orcid.org/0000-0002-8781-1169
                http://orcid.org/0000-0002-3776-6136
                Article
                6072
                10.1007/s00701-024-06072-4
                11045579
                38662229
                8a11f499-7967-449e-aa87-b3707ce2a8cc
                © The Author(s) 2024

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                : 25 January 2024
                : 8 April 2024
                Funding
                Funded by: Karolinska Institute
                Categories
                Review Article
                Custom metadata
                © Springer-Verlag GmbH Austria, part of Springer Nature 2024

                Surgery
                extended reality,virtual reality,augmented reality,mixed reality,neurosurgery,bibliometrics
                Surgery
                extended reality, virtual reality, augmented reality, mixed reality, neurosurgery, bibliometrics

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