Smartphone apps for spinal surgery: is technology good or evil?

Abstract

The increased utilization of smartphones together with their downloadable applications (apps) provides opportunity for doctors, including spinal surgeons, to integrate such technology into clinical practice. However, the clinical reliability of the medical app sector remains questionable. We reviewed available apps themed specifically towards spinal surgery and related conditions and assessed the level of medical professional involvement in their design and content. The most popular smartphone app stores (Android, Apple, Blackberry, Windows, Samsung, Nokia) were searched for spinal surgery-themed apps, using the disease terms Spinal Surgery, Back Surgery, Spine, Disc Prolapse, Sciatica, Radiculopathy, Spinal Stenosis, Scoliosis, Spinal Fracture and Spondylolisthesis. A total of 78 individual spinal surgery themed apps were identified, of which there were six duplicates (N=72). According to app store classifications, there were 57 (79%) medical themed apps, 11 (15%) health and fitness themed apps, 1 (1%) business and 3 (4%) education themed apps. Forty-five (63%) apps were available for download free of charge. For those that charged access, the prices ranged from £0.62 to £47.99. Only 44% of spinal surgery apps had customer satisfaction ratings and 56% had named medical professional involvement in their development or content. This is the first study to specifically address the characteristics of apps related to spinal surgery. We found that nearly half of spinal surgery apps had no named medical professional involvement, raising concerns over app content and evidence base for their use. We recommend increased regulation of spinal surgical apps to improve the accountability of app content.