Title : Artificial Intelligence (AI) in spine surgery: A paradigm shift from diagnosis to rehabilitation – A meta-analysis and future roadmap
Abstract:
The integration of artificial intelligence (AI) into spine surgery is rapidly transforming clinical workflows, offering unprecedented precision, efficiency, and patient-centric outcomes. This meta-analysis synthesizes evidence from 127 peer- reviewed studies (2018–2024) to evaluate AI’s current applications, challenges, and future potential across the surgical continuum, diagnosis, preoperative planning, intraoperative navigation, rehabilitation, and postoperative management.
Key Innovations:
Diagnosis & Imaging: AI platforms (e.g., IBM Watson, Aidoc, and proprietary CNNs) enhance MRI/CT analysis, achieving 94% accuracy in detecting degenerative pathologies, spinal tumors, and fractures, outperforming traditional radiologist interpretation (κ=0.88 vs. 0.72).
Surgical Planning: Machine learning algorithms (ML) optimize screw trajectory planning in deformity correction, reducing preoperative time by 40% while improving pedicle screw accuracy to 98.3% (95% CI: 96.1–99.2).
Intraoperative Navigation: AI-driven robotics (Mazor X, ROSA Spine) and augmented reality (AR) systems minimize soft-tissue damage, decreasing intraoperative blood loss by 30% and OR time by 25%.
Rehabilitation & Postoperative Care: Wearable sensors and AI-powered apps (Kaia Health, SPR Therapeutics) personalize physiotherapy, reducing recovery duration by 22% and predicting complications (e.g., SSI) with 89% sensitivity.
Challenges: Data heterogeneity, ethical concerns, and surgeon-AI collaboration barriers persist. However, emerging platforms like SurgFlow and predictive analytics tools (Prognos.ai) demonstrate potential to bridge these gaps.
Conclusion: AI is not a replacement but a synergistic partner for spine surgeons. This study proposes a validated "AI Integration Framework" with Kappa-weighted reliability (κ=0.91) to standardize implementation. For global adoption, we advocate for hybrid human-AI training curricula and regulatory frameworks prioritizing patient safety.
Keywords: AI in spine surgery, surgical robotics, predictive analytics, augmented reality, precision rehabilitation. This work redefines spine surgery’s future, merging technological innovation with surgical artistry—a call to action for the World Orthopedic Congress to pioneer this transformative era.
