Redefining precision: the current and future roles of artificial intelligence in spine surgery

The integration of artificial intelligence (AI) into spine surgery presents a transformative approach to preoperative and postoperative care paradigms. This paper explores the application of AI within spine surgery, focusing on diagnostic and predictive applications. AI-driven analysis of radiographic images, facilitated by machine learning (ML) algorithms such as convolutional neural networks (CNNs), potentially promises enhanced accuracy in identifying spinal pathologies and deformities; by combining these techniques with patient-specific data, predictive modeling can guide and inform diagnosis, prognosis, surgery selection, and treatment. Postoperatively, AI can leverage data from digital wearable technology to enhance the quantity and quality of outcome measures surgeons use to define and understand treatment success or failure. Still, challenges such as internal and external validation of AI models remain pertinent. Future directions include incorporating continuous variables from digital biomarkers and standardizing reporting metrics for AI studies in spine surgery. As AI continues to evolve, transparent validation frameworks and adherence to reporting guidelines will be crucial for its successful integration into clinical practice.