The latest advancements in spinal surgery—from adaptive spine intelligence to using AI for preoperative planning to 3D-printed implants—can sound like something out of science fiction. But Theresa Pazionis, MD, MA, FRCSC, ABOS puts a very human face on all these innovations—and is using them to enhance the already-exceptional care she provides.
“When I began practicing in 2014, spine surgery relied heavily on freehand screw placement with minimal navigation,” Dr. Pazionis, an Assistant Professor of Orthopedic Surgery and Sports Medicine at the Lewis Katz School of Medicine, explains. “We were templating spine surgeries on paper or early versions of Surgimap, which gave us great outcomes, but didn’t have the level of integration and consistency we see with robotic planning platforms today.”
“Over time, we’ve integrated AI and robotics into preoperative planning, using systems that have integrated GPS, adaptive spine intelligence and patient-specific, personalized rods and interbody implants,” Dr. Pazionis continues.
“These technologies enable us to map surgical goals with high precision, optimize screw placement, and design patient-specific implants, resulting in more consistent outcomes, fewer complications, and improved correction accuracy compared to traditional methods. We’re also able to track patient- and surgeon-specific outcomes using radiomics, or data extraction from serial radiographs, to use predictive analytics to better plan and personalize surgical plans for our patients.”
More Personalized Spinal Surgery
In other words, these innovations help to make spinal surgery more consistent, more precise, and more personalized. The latter ties in with a broader trend in medicine, as Dr. Pazionis explains.
“The future is moving towards personalized surgical care,” she says. “Whether or not we’re using personalized or off-the-shelf 3D-printed spinal implants, planning using predictive analytics and robotics platforms allows us to give the patient the best surgery for their anatomy and physiology. Today, you can access patient-specific cages and 3D-printed implants tailored to individual anatomies. These allow for better load distribution across the endplate as opposed to point-loading, more precise correction, and reduced revision rates.
“With tools like patient-specific rods, we now leverage predictive analytics and digital twins to simulate outcomes, ensuring the best surgical strategy,” Dr. Pazionis continues. “This not only benefits the patient by improving their quality of life, but also reduces costs for healthcare systems by minimizing reoperations.”
Tech Meets Highest-Level Skill
Of course, as impressive as these technologies are, they’re best understood as enhancements to spinal surgeons’ highest-level skills.
“Robotics and customized implants are not a substitute for excellent surgical technique,” Dr. Pazionis explains. “Medical optimization, including bone health and sarcopenia management, and excellent and efficient intraoperative carpentry are and always will be the gold standard of care. These implants are just the icing on the cake.”
Still, the results speak for themselves—and with Dr. Pazionis leading the way, the future of spinal surgery at Temple Health looks very bright indeed.
