Artificial intelligence in spinal imaging - a narrative review

Clinical integration of artificial intelligence (AI) in spinal surgery is still in its early stages, with spinal imaging being the most prominent. We present a review of recent literature on the topic. The reporting of traditional spinal imaging has been slow due to overburdened staff and unreliable in some patients. AI applications have shown promising results in improving the speed and quality of imaging while reducing costs and radiation exposure. Specific examples of clinical implementation include osteoporosis screening, diagnosing degenerative spine diseases and differentiating tuberculous and pyogenic spondylitis, helping in preoperative measurements and surgical planning. Other tools have demonstrated the ability to help clinicians in real time to reduce rates of missed fractures and to rule out cord impingement in emergency settings. Novel variants of magnetic resonance imaging (MRI) and synthetic computed tomography (sCT) scans, without ionizing radiation, have been successful in reducing the resource burden and scan time, while maintaining clinical utility. At its current stage, AI has the potential to improve significantly and is expected to tremendously enhance the efficiency and accuracy of radiologists and spine care providers. However, clinical validation studies are still required before the widespread integration of AI in direct patient care.