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

In the field of spinal cord injury (SCI) care, recent advances in enabling technologies are revolutionizing treatment, rehabilitation, and long-term care. All of these innovations are poised to redefine the quality of life for SCI patients. The International Spine and Spinal Injuries Conference (ISSICON) 2024, recently organized in New Delhi by the Sri Balaji Action Medical Institute and the Spinal Cord Society, highlighted this potential by bringing together more than 600 participants, including national and international experts, all focus on SCI progress. care.

Experts discussed the transformative role of technologies such as the role of the Exoscope, robotic surgery, neurorehabilitation tools and artificial intelligence (AI). It is clear that these enabling technologies will be game-changers in SCI care. Unlike previous decades where survival was the primary focus, today’s innovations enable improved function, mobility and independence, shifting our approach from survival to empowerment and functionality. Visibility and precision are paramount in spine microsurgeries. 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 illumination.

Traditionally, microscopes have been the gold standard in such complex procedures, providing the depth of field and illumination needed to navigate intricate anatomical structures. However, the limitations of traditional microscopes—primarily the fixed head position required for extended 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 see 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 that require extended concentration.

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

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

Such AI information combined with robotic precision could minimize human error and variability in results, increasing both surgical efficiency and patient safety. Today, robotic systems are already being used in spine procedures, helping to precisely place screws, rods and other implants. With AI-based data analysis, robotic assistance could reach new levels of effectiveness. AI systems could improve preoperative planning based on large data sets, enabling more accurate hardware placements and efficient decision making. This technology can analyze previous surgeries to predict potential complications and suggest the most effective treatment pathways, providing a personalized, data-driven approach to surgical care. In addition, AI-based analytics have the potential to predict patient outcomes based on past cases, guiding surgeons on likely recovery trajectories and aiding in patient consultation. The ISSICON 2024 workshops reflected this commitment to enabling technologies, giving participants hands-on experience in emerging techniques such as robotic and navigation-assisted spine surgery and robot-assisted rehabilitation.

The conference was aligned with the World Health Organization’s Rehabilitation 2030 initiative, strengthening the global commitment to improve access to advanced rehabilitation services, especially in disadvantaged areas. To ensure the longevity of these innovations, ISSICON 2024 is developing eight position statements, created through 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 needs in spine injury care and back pain management.

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