Becker's ASC Review

23 THOUGHT LEADERSHIP AI is 'an essential part of spine': 3 surgeon insights By Carly Behm Artificial intelligence in healthcare has made great strides despite some concerns about the technology. Three spine surgeons discuss the long-term reputation of AI in spine surgery. Note: Responses were lightly edited for clarity. Question: Will artificial intelligence in spine and orthopedics be considered a mistake or success in 10 years? Timur Urakov, MD. University of Miami (Fla.): Artificial intelligence in spine surgery will absolutely be a success over time. It will help with efficiency of day-to-day practice as well as complex analysis of vast data on patient outcomes. AI's ability to integrate large amounts of information will be both a blessing and a curse. The false sense of trust and reliability will make us more reliant on AI for quick answers. "Hallucinations" is a well known phenomenon with current AI platforms. Whenever a piece of information is missing within an AI's database, the machine learning aspect of the program generates a novel fact that could be dangerously erroneous. We will need a safe method to keep track of this phenomenon while building all the useful applications for artificial intelligence. Vijay Yanamadala, MD. Hartford (Conn.) HealthCare: Artificial intelligence has proven to be an essential part of spine and orthopedic care. Within the realm of surgery, navigation has proven to be an immense tool with growing utilization. The utilization of robotics has also grown, although not at the same pace as navigation. We also increasingly see the utilization of AI for surgical planning. Surgimap was probably one of the earliest iterations of this, but there are now an array of surgical planning tools that help surgeons achieve the correct alignment and meet the surgical goals for a case more precisely than we were able to do even 10 years ago. Outside of the operating room, we also see tools being used for decision support and triage. Importantly, in the nonsurgical arena, we are also seeing AI being used for the delivery of care, including digital physical therapy. These tools have vastly improved access to care for millions of Americans and people around the world. No doubt, AI has been a tremendous success already and it will continue to be viewed that way with even more innovation in 10 years. Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): The current use will expand as many faceted components of neurological disease, including CVAs, neurogenerative diseases and complex spinal management integrate the use of AI in diagnosis and treatment. Growing reliance on this technology will finely hone these informational sets as applications continue. n What will the orthopedic industry look like in 50 years? By Riz Hatton The orthopedic industry is ripe for change. Kushagra Verma, MD, orthopedic spine surgeon at DISC Sports & Spine Center in Marina del Rey, Calif., connected with Becker's to answer, "What will the orthopedic industry look like 50 years from now?" Editor's note: This response has been lightly edited for clarity and length. Dr. Kushagra Verma: In 50 years, orthopedic surgery will largely make advances due to patients being managed in a more minimally invasive fashion with a greater emphasis on outpatient surgery. This trend is already emerging over the last 10 years and will continue to grow. Most conditions will be managed outside of the hospital and only very complex cases will require a hospital admission. The difficult recoveries associated with complex surgery will also likely be reduced. In addition, greater advancements in motion-preservation technologies will allow fewer patients to require a fusion for degenerative conditions. The greatest opportunity for this advancement remains in the lumbar spine. Around the country, I would expect to have more and more vascular surgeons trained to properly expose the anterior aspect of the spine even in revision cases. Currently, there are a handful of vascular surgeons interested and experienced in these types of procedures. Lastly, navigation and robotic surgery will evolve, thereby improving the precision of surgery. The surgeon will mainly be tasked with caring for the patient and making the diagnosis, while key portions of the procedure are automated. To what extent automation is involved in spine surgery remains debatable. n levels would support that. 3. Make sure you have adequate staff to run the business – for ASC that means finding administrative and clinical staff to run it as well as a sufficient number of physicians that would be willing to perform surgeries and procedures at your ASC. 4. Control overhead costs – negotiate reasonable rates with medical supply and implant vendors and create policies to avoid unnecessary waste. 5. And of course, make sure your ASC is accredited and complies with all federal, state and local laws and regulations. n

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