AI Paving the Way for Personalized Spine Implants

Andrew Chan, MD, of Och Spine at NewYork-Presbyterian and Columbia in New York City, is leveraging artificial intelligence to improve surgeries with personalized spine implants.

In June, Dr. Chan completed his first case using a 3D-printed implant that was personalized with the help of artificial intelligence.

"We have patient imaging, and we securely transmit that to one of our industry partners that work on this. Then they use that data and patient-specific inputs to inform the design of these personalized devices," Dr. Chan, co-director of minimally invasive scoliosis surgery, told Becker's.

Imaging and data from the surgeon helps implant design, and then AI can automatically 3D segment the spine, Dr. Chan said.

"Then they're able to move the spine into an ideal configuration based on the patient and surgeon input, and that helps to inform the design based on that plan and the individual topography of the patient's bone" he said. "Everybody's bones are like a fingerprint. It's a little bit different, even though there's averages like a spinal model would show. But because everybody's bones are slightly different, a different personalized device or cage would be ideal for any given patient. Other vendors have stock cages, which have many options, but they are often flat on the surfaces. But a lot of patients' bones are not flat on their surfaces."

A key advantage personalized implants have over stock cages is the predictability of some surgical outcomes, he said.

"One of the difficulties [with] stock cages is you can't predict as well how the coronal plane correction is going to be," he said. "Sometimes a wedge-shaped graft, as opposed to a straight graft, will give you the best scoliosis correction you want, and that hasn't been available for us to use. With these personalized devices, I'm able to put in a wedged shape implant to then correct the scoliosis. Sometimes I can even limit the surgery to a smaller surgery to get the patient the overall global correction they need."

Dr. Chan has completed several surgeries with the personalized implant technology, and interest in growing.

"Patients are very interested in the technology now that they know about it," Dr. Chan said. "In fact, I've had patients come to me specifically because they know I do this kind of procedure now."

The AI-assisted personalized implant designs have helped Dr. Chan improve precision in patient care, specifically with spinal lordosis, sagittal plane and coronal plane.

"I want to design an implant that gets my patient's spine to this exact degree of lumbar lordosis, which is perfect for their specific spine based on [their] measurements," he said. "We have been able to hit that within a degree reliably, which is incredibly impressive. What we're always trying to do is improve spine surgery, and for a long time, we were trying to just recognize what the goals we should be hitting are … Now it's about being able to reliably hit that goal once you've defined it."

From a value perspective, Dr. Chan said insurers have been keen on covering the technology.

"There's an acknowledgement from payers that devices such as this are revolutionary," he said. "That's why they get a special designation that helps reimburse hospitals that are willing to use these groundbreaking technologies, even if they cost more, because they recognize there should be some offset for the research and development of these devices."