This study was the first to research Silk Road 2, the replacement illicit marketplace to the original virtual Silk Road.
Interestingly, 73% of all vendor accounts on Silk Road 2 advertised drug items, even though drugs only constituted 19% of all items advertised. The United States is both the number one country of origin for drug sales on Silk Road 2 and the number one destination country. Of the drug items advertised, most were stimulants and hallucinogens. Of the 1834 unique items for sale, 348 were drug items sold by 145 distinct vendors shipping from 19 countries. Silk Road 2 was a much smaller marketplace than the original Silk Road. The goals of this study were to (1) compare the metrics of Silk Road 2 to the original site, and to (2) determine if there were any indications of the presence of more sophisticated drug trafficking operations.ĭata were collected from Silk Road 2 during the months of August and September 2014 using webcrawling software. Following its FBI-forced shut down in October 2013, the Silk Road enjoyed newfound fame that contributed to an increase in new users downloading and accessing the Tor Network however, with this particular marketplace out of order, Silk Road 2 was launched to fill the void. Housing an illicit, online drug retail market generating sales in the millions of USD, the Silk Road was a profitable marketplace with a growing and loyal consumer base. By leveraging technologic advancements in medical imaging, computation, and stereotactic navigation, robotics in spine surgery will continue to mature and expand in utility. However, comparatively, robotics in spine surgery remains in its infancy. Growing at a rapid rate, the second-generation spinal robotics have overcome preliminary limitations and errors. Robotics may have the added benefits of improving the surgical workflow and optimizing surgeon ergonomics. Since then, it has become a safe modality that can reproducibly place accurate pedicle screws. Integrating all these technologies, robotics in spine surgery was introduced in 2004. In combination with the advancements of stereotaxy in the late 1980s, and manipulation of volumetric and special data for 3-dimensional reconstruction in 1998, computed tomography has revolutionized neuronavigational systems. The discovery of x-rays in 1895, the development of image intensifiers in 1940, and then advancements in computational science and integration have allowed for the development of computed tomography. The synergy between medical imaging and advances in computation has allowed for stereotactic neuronavigation and its integration with robotic technology to assist in spine surgery.
Notably, patient-specific rods were used in 21 patients and were not associated with greater achievement of goal alignment for any parameter (p>0.8), with similar tendencies to undercorrect SVA and PI-LL and increase TK (p>0.6).
The proportions of patients with achieved alignment within 1 SD of goal were not significantly different for patients with a UIV above T7 vs those with a UIV at or below T7 for SVA (p=0.20), PI-LL (p=0.49) or TK (p=0.06). Surgeons achieved goal alignment (within 1 SD) for SVA, PI-LL, and TK in 74.4%, 71.4%, and 68.8% of cases, respectively. Mean (SD) offsets were: SVA=-8.5 mm (45.6 mm), PI-LL=-4.6° (14.6°), TK=7.2° (14.7°), reflecting a tendency to undercorrect SVA and PI-LL relative to goal and to increase TK relative to goal. Mean number of instrumented levels was 13.6 (SD=3.8) and 24% had a 3-column osteotomy (3CO). The 266 enrolled patients had a mean age of 61.0 yrs (SD=14.6 yrs) and 68% were women.
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