Spinal cord injury care has not yet received the special attention it deserves from the government

In spinal cord injury (SCI) care, recent advances in enabling technologies are revolutionizing treatment, rehabilitation, and long-term care. These innovations are all intended to redefine the quality of life of patients with SCI. The International Spine and Spine Injury Conference (ISSICON) 2024, organized recently in New Delhi by the Sri Balaji Action Medical Institute and the Spinal Cord Society, highlighted this potential by bringing together over 600 participants , including national and international experts, all focused on the advancement of spinal cord injuries. care.

The experts discussed the transformative role of technologies such as the role of Exoscope, robotic surgery, neurorehabilitation tools and artificial intelligence (AI). It is clear that these enabling technologies will be a game changer in SCI care. Unlike previous decades, where survival was the main priority, today’s innovations enable improved function, mobility and independence, shifting our approach from survival to empowerment and functionality. Visibility and precision are essential in spinal microsurgery. The ability to maintain a clear view of the surgical area with magnification is crucial, as it allows surgeons to operate precisely while providing adequate lighting.

Traditionally, microscopes have been the gold standard for such complex procedures, providing the depth of field and illumination needed to navigate complex anatomical structures. However, the limitations of traditional microscopes (primarily the fixed head position required for prolonged periods) often result in neck and back strain for surgeons. Unlike traditional microscopes, exoscopes are equipped with high-definition cameras and 3D viewing screens, allowing surgeons to view a magnified 3D image on a large screen rather than through an eyepiece. This change not only alleviates physical strain, but also improves ergonomic comfort, which can be transformative for procedures requiring prolonged concentration.

The exoscope’s ability to provide enhanced illumination and 3D visualization enables sustained precision, minimizing fatigue and enabling a higher level of surgical performance over extended periods. Additionally, it offers seamless integration with digital systems, facilitating documentation and enabling real-time collaboration with other specialists. Remote access to the exoscope’s 3D feed allows consultations with experts outside of the operating room, which is particularly valuable in teaching hospitals and cases requiring multidisciplinary input. By reducing the physical burden on surgeons and providing digital connectivity, Horoscope paves the way for better, more collaborative care in spine surgery.

The inclusion of AI in spine surgery is also a game-changer, with the potential to reshape the field by enabling data-driven insights and more precise treatment planning. Using AI, large amounts of patient data can be analyzed to identify optimal surgical approaches and predict complications.

Such AI insights, combined with robotic precision, could minimize human errors and outcome variability, thereby improving both surgical efficiency and patient safety. Currently, robotic systems are already used in spinal procedures, facilitating the precise placement of screws, rods and other implants. With AI-driven data analysis, robotic assistance could reach new levels of efficiency. AI systems could improve preoperative planning based on large data sets, enabling more precise equipment placements and effective decision-making. This technology can analyze previous surgical procedures to predict potential complications and suggest the most effective treatment pathways, providing a personalized, data-driven approach to surgical care. Additionally, AI-based analytics have the potential to predict patient outcomes based on past cases, thereby guiding surgeons on likely recovery trajectories and facilitating patient consultations. The ISSICON 2024 workshops reflected this commitment to enabling technologies by providing participants with hands-on experience with emerging techniques, such as robotic and navigation-assisted spine surgery and robot-assisted rehabilitation.

The conference was part of the World Health Organization’s Rehabilitation 2030 initiative, reinforcing a global commitment to improve access to advanced rehabilitation services, particularly in underserved areas. To ensure the longevity of these innovations, ISSICON 2024 is developing eight position statements, created during pre-conference deliberations and expert discussions, to serve as guidelines for SCI care. The Spinal Cord Society advocates for a national spine care program that addresses the growing need for spinal injury care and back pain management.

(Dr HS Chhabra is President of the Spinal Cord Society, Director of Spine and Rehabilitation Services at Sri Balaji Action Medical Institute and Chairman of the ISSICON 2024 Organizing Committee; views are personal)