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It’s ‘trust, but verify’ for new AI spine surgery system

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It’s ‘trust, but verify’ for new AI spine surgery system


On a recent morning, Dr. Joseph Osorio arrived in the operating room ready to sink six surgical screws into his patient’s spine, and he did not seem remotely nervous that their placement and size had been recommended by artificial intelligence software.

Osorio was the first neurosurgeon on the West Coast to begin using Medtronic’s new “Stealth AXiS” surgical robotic system, conducting a spinal fusion procedure to treat degenerative scoliosis at Jacobs Medical Center in La Jolla by anchoring two small custom-shaped metal rods across three vertebrae in his patient’s lower spine.

The process started with a CT scan, identifying the segment of spine that needed reinforcement. A program analyzed the resulting three-dimensional image, using an AI model trained on information from previous successful surgeries, not just where screws should go, but also the best path for their insertion.

An X-ray is taken of a patient’s spine before a spinal fusion surgery at Jacobs Medical Center at UC San Diego Health in La Jolla on Wednesday, April 29, 2026. (Kristian Carreon / The San Diego Union-Tribune)

Board-certified with thousands of such surgeries in his past, having completed a fellowship at Columbia University after a surgical residency at UC San Francisco, Osorio is well-qualified to make these calls with zero help from technology. So, why bother using an algorithm to plan these crucial, but routine details?

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The utility, he said, is similar to what many are now experiencing when they use AI writing tools. The software can quickly get a person to the neighborhood of what they intend to say.

“You might say, ‘write me a paragraph on this,’ and it’s going to cut down your time, but you might still need to change some words, add a comma, tweak a sentence … that’s essentially what the AI is doing here,” Osorio said.

In this particular case, the AI system’s recommendations for screw length and diameter seemed on point, allowing the army of surgical technicians assisting with the procedure to pull the proper supplies ahead of time. The suggested locations, though, did require minor adjustment.

“It was slight, very slight, I’d say probably, like one or two millimeter adjustments,” Osorio said.

And the AI auto planning feature, he added, is even more useful in situations where a patient’s health insurance company will not pay for a pre-surgical CT scan, meaning that the guiding image must be taken after the patient is already sedated in an operating room on the day of their surgery.

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An X-ray is taken of a patient's spine before a spinal fusion surgery at Jacobs Medical Center at UC San Diego Health in La Jolla on Wednesday, April 29, 2026. (Kristian Carreon / The San Diego Union-Tribune)Dr. Joseph Osorio, a neurosurgeon, uses the Medtronic Stealth Axis Autopilot during a spinal fusion surgery at Jacobs Medical Center at UC San Diego Health in La Jolla on Wednesday, April 29, 2026. The machine uses artificial intelligence to help navigate a patient's spine.(Kristian Carreon / The San Diego Union-Tribune)
An X-ray is taken of a patient’s spine before a spinal fusion surgery at Jacobs Medical Center at UC San Diego Health in La Jolla on Wednesday, April 29, 2026. (Kristian Carreon / The San Diego Union-Tribune)

Once a digital surgical plan is created and approved by a qualified surgeon, a surgical robot can use a system of cameras and electromagnetic sensors, registered against each patient’s anatomy with an initial X-ray, to move its arm to each screw location, placing a drilling guide at the exact angle needed to put each anchor in the correct spot. Here, too, AI is at work comparing previously recorded X-rays with real-time sensor data to compensate for any patient movements that may occur.

It is an evolution of Medtronic’s previous “Mazor” robotic spike system, which had already achieved levels of anatomy navigation using sensors and cameras that have reduced the need for X-ray images during surgery. And other medical device companies have launched similar systems, building in AI functions as the entire industry begins to see such augmentation as table stakes to play in a market that has always been as competitive as a high-stakes table in a Las Vegas casino.

Patients may wonder whether this push toward AI guidance is a good thing. After all, this is a technology that has made headlines for its ability to “hallucinate” convincing, but incorrect details.

ECRI, an independent non-profit organization that works to improve patient safety and cost effectiveness in health care, has been watching these systems develop.

In an email, Scott Lucas, ECRI’s vice president of devices, therapeutics and technology, said that the organization does not comment on any individual case or procedure, but has found that AI-enabled systems do have their merits.

“We can say that AI seems to be particularly helpful when it is used to support imaging, planning, navigation and precision in technically demanding procedures such as spine surgery,” Lucas said. “These tools may help surgeons in multiple ways, including tailoring procedures to a patient’s anatomy and improving consistency in implant placement and alignment.”

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An AI-enabled display depicts the position of surgical screws being inserted into a patient's vertebra during a spinal fusion surgery at Jacobs Medical Center at UC San Diego Health in La Jolla on Wednesday, April 29, 2026. (Kristian Carreon / The San Diego Union-Tribune)
An AI-enabled display depicts the position of surgical screws being inserted into a patient’s vertebra during a spinal fusion surgery at Jacobs Medical Center at UC San Diego Health in La Jolla on Wednesday, April 29, 2026. (Kristian Carreon / The San Diego Union-Tribune)

That said, the executive makes it clear that there is no argument for blind loyalty. In these early days, he argues, AI assistance should be less involved with surgeries, and there must be a clear path that allows surgeons to verify the work that their algorithmic assistants perform.

“Used well, AI may strengthen surgical safety; used without appropriate governance, human oversight, training and monitoring, it could introduce new risks, including overreliance, workflow disruption, planning errors or automation bias,” Lucas said.

Such bias, he added, occurs when a surgeon “fails to recognize when the technology is wrong.”

Osorio said that he believes the checks and balances built into the new system he is now using weekly do give him solid checkpoints to make sure that the machine is not hallucinating. While screw placement calculations will automatically calculate for straightforward placements, those with particularly complicated circumstances, such as anatomy that significantly deviates from the norm, will not proceed.

“If things aren’t lining up perfectly in the image, or they’re getting some feedback, it will just refuse to place a screw in that corridor,” Osorio said. “So, it’s only making recommendations in locations that meet the highest standards, and it still requires the surgeon to validate every level.”

AI is now also involved in the calculations used to move the robotic arm to the correct locations for screw insertions and also to make real-time corrections for any patient movement, Medtronic confirmed by email.

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Here too, Osorio said, there are ways to verify that the robot’s calculations are pointing at the correct vertebrae, even though this type of minimally invasive surgery does not expose the target bone before screw insertion.

Surgeons use a bony projection at the back of each vertebra called the spinous process to check the robot’s accuracy, laying a special navigation ring over the landmark to verify that what is showing on the computer’s calculated location screen matches the robot’s arm position.

“A very common statement is ‘trust, but verify’,” Osorio said.

While robotic spine surgery is the latest to begin the process of AI integration, other systems have already made similar moves in knee and hip replacements, urologic procedures, and in some aspects of general surgery.

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Terrifying moment huge sea lions chase tourists off popular California beach

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Terrifying moment huge sea lions chase tourists off popular California beach


Beachgoers in one Southern California town had to run for their lives after two massive sea lions came out of the ocean and onto the beach in San Diego.

In a video posted July 7 on Instagram, Dion Ruzicka captured the terrifying moment the two giant sea creatures hit the shore and began chasing people at the beach on a sunny California day.

One sea lion suddenly charged at stunned beachgoers, barreling across the sand as terrified visitors shrieked and sprinted away while the barking beast gave chase.

Beachgoers in one Southern California town had to run for their lives after two massive sea lions came out of the ocean and onto the beach in San Diego. Instagram/@dionruzicka77

Moments later, a second sea lion joined the chaos, sending panicked crowds scrambling for higher ground — and even into the surf — to escape the pair’s path.

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The more people ran, the more determined the hefty marine mammals seemed, waddling after the fleeing beachgoers in a bizarre game of chase.

“Oh my God,” one person could be heard saying, in the midst of the chaotic scramble.

Video posted on July 7 captured the terrifying moment not one but two giant sea creatures hit the shore and began chasing people. Instagram/@dionruzicka77
San Diego has provided ample warnings to the public alerting them of the dangers they risk going near the wildlife living in the area. Instagram/@dionruzicka77

It didn’t matter whether the visitor was young or old, the sea lion just kept chasing them.  Finally, both animals dived back into the ocean and swam away at a quick pace.

It is not the first time such an encounter has happened in the popular La Jolla spot. A year ago, a video showed a pair of sea lions chasing beachgoers around before finally leaving.


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San Diego has warned the public about the potential dangers of going near wildlife living in the area.

“With the increase in the sea lion population, Point La Jolla has become a popular tourist destination for the public to view these wild animals close up,” a message on the city’s website read.

Officials suggest people watch the animals from the boardwalk and keep their distance from the sea lions. Instagram/@dionruzicka77

As a result, interactions between sea lions and the public have increased.

“Members of the public have been observed trying to touch, take selfies, and get as close to sea lions as possible which is a dangerous situation for both the public and the animals,” it added.

Officials suggest people watch the animals from the boardwalk and keep their distance from the sea lions.

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The summer months are pupping season for these ocean animals. Instagram/@dionruzicka77

While it is unclear what lead to Tuesday’s chase, the summer months are pupping season for these ocean animals. Mothers and fathers become protective of their young ones, and will display aggressive behavior, if they sense a threat, per officials.

“These interactions are not only dangerous for both humans and wildlife, it may be a violation of the federal Marine Mammal Protection Act which helps to safeguard these animals,” the city said.

The California Post has reached out to the La Jolla Parks and Beaches group for further comment. 





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Opinion: More apartments eased rents. Townhomes could aid buyers.

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Opinion: More apartments eased rents. Townhomes could aid buyers.


San Diego’s most beloved neighborhoods, like North Park, Golden Hill and Sherman Heights, were built by people who needed a place to live and found one. But the bungalows, fourplexes and cottages that gave working San Diegans a foothold in those neighborhoods can hardly be built anywhere else in the city.

Rules written decades ago banned them. For 70 years, San Diego has been paying for that mistake in the form of a city its own workforce can no longer afford to live in.

Neighborhood Homes for All of Us is the city’s plan to fix that: family-sized townhomes, rowhouses and small duplexes built in the neighborhoods where San Diegans most want to live.

While San Diego rents are softening as new apartments are built, the cost of buying a home is not moving, and it won’t, because the rental and ownership markets run on entirely separate tracks. Renters benefit when more rentals are built, forcing landlords to compete for them.

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However, a family trying to buy a home benefits only if more homes are available for sale. San Diego home prices now exceed nine times the median household income, among the worst ratios in the nation, according to Harvard’s Joint Center for Housing Studies. Building rental housing is important, but it does not change the math for a buyer.

The homes that would change it — family-sized, on the ownership track, in the neighborhoods where people most want to raise children — have been illegal to build for decades. San Diego produced roughly 7,000 condos and townhomes a year in 2005. By 2022, that number had collapsed below 500. Part of that drop is because of litigation rules that drove up insurance costs for builders, caps on pre-sales that finance these projects and high fees. Another major reason is that we simply do not allow starter homes on smaller lots. So, instead, builders default to rentals because that’s what current rules allow them to build profitably.

London Moeder Advisors, a San Diego real estate economics firm, finds that eliminating the city’s large-lot-size mandates could produce new townhomes at 42% less cost than surrounding single-family homes without taxpayer subsidies. While this price point is still high for many, it’s more attainable for young families starting out. And importantly, the price could drop further if the state advances reforms to address litigation rules and pre-sale caps that drive up costs.

The city’s program is also focused on adding homes in San Diego’s neighborhoods with the best-performing schools and most accessible jobs. These are also the neighborhoods with the most restrictive regulations on smaller starter homes. A teacher whose classroom is in La Jolla cannot afford to live there. A firefighter stationed in Mission Hills commutes from Santee. The homes that would let them stay are currently illegal to build in much of these areas. Neighborhood Homes changes that.

While critics may say San Diego already has the tools for adding homes to neighborhoods, why add another program? Because each of those tools was for a different purpose. None were designed to add more for-sale housing.

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ADUs, the backyard homes now common across the city, typically top out at 750 square feet (because of fee cliffs) and entail intricacies when selling to own. Other tools, like Senate Bill 9, have been layered with requirements that make it far too complicated and expensive for many homeowners to split their lots to add homes. Laws like Senate Bill 79 are important for adding more housing near transit. But none of these tools focuses on family-sized, ownership-track townhomes in an established neighborhood.

The Neighborhood Homes initiative asks a simple question: Where do the families who can’t afford a million-dollar home but don’t want an apartment go? We can continue to say certain neighborhoods are off-limits to the teachers, trades workers and young families who want to live there, or San Diego can set its own terms for how they grow, with local standards in a form the city controls.

San Diego’s most beloved streets were not preserved into existence. They were built — a duplex here, a rowhouse there — by people who needed a place to live in the city they loved and found one. That is what Neighborhood Homes makes possible again.

Asad is a former board member of the YIMBY Democrats of San Diego County. He resides in Mid-City.

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Tom Krasovic: Justin Verlander’s announcement recalls Padres’ 2004 draft blunder

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Tom Krasovic: Justin Verlander’s announcement recalls Padres’ 2004 draft blunder


So Justin Verlander is calling it quits, effective at the season’s end.

There’s Padres-related history to explore with Verlander, 43.

With it comes many groans.

San Diego passed on Verlander as part of the infamous, franchise-rocking decision to draft Mission Bay High School’s Matt Bush with the first overall pick in 2004.

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Had the Padres chosen Verlander and tweaked the Old Dominion alum’s delivery, as the Tigers did soon after selecting him No. 2 overall, the best innings-eater of his generation could’ve headed San Diego’s rotation for many years.

As a National Leaguer, Verlander would’ve pitched against pitchers, rather than designated hitters. His annual ERA would’ve fallen by about a half run, per DH and no-DH data of that time.

The Padres would’ve boasted a generational monster atop their rotation as soon as 2006, when Verlander won the American League rookie of the year award with Detroit, while the San Diego rotation featured next year’s NL Cy Young winner, Jake Peavy.

Recall also that Petco Park, from its opening in 2004 until its remodel in 2012, played as big as Yellowstone National Park.

Not that the DH rule greatly impeded Verlander, a nine-time All-Star.

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Many times over, the ace rewarded Tigers general manager Dave Dombrowski and scouting director Greg Smith for drafting him one spot after Kevin Towers and Bill Gayton — their options reduced by Padres owner John Moores’ stated opposition to drafting Scott Boras-assisted prospects Jered Weaver and Stephen Drew — selected Bush, the easy-to-sign but troubled shortstop turned pitcher.

Verlander helped Detroit reach its first two World Series in decades. He led the league in innings three times as part of chewing up 200-plus innings in eight consecutive seasons.

Dombrowski had displayed an unwavering faith in betting big on hard throwers.

Unfazed by power-righty Kyle Sleeth breaking down soon after he took him third overall in 2003, Dombrowski and Smith, a former Padres scout, became dead set on taking Verlander if the Padres didn’t.

Why didn’t Towers and Gayton choose Verlander?

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Foremost, the Padres generally didn’t like him as much as the Tigers did.

In fact, they preferred Weaver and Drew.

But Moores all but blocked his scouts there. He was openly critical of their adviser, Boras, saying he didn’t trust him. The two had clashed in the Kevin Brown talks that ended with Brown joining the Dodgers, months after Brown had led the Padres to the 1998 World Series.

Moores was subjected to other kinds of pressure, too. Legal complaints had delayed Petco’s construction. Those complaints all failed in court. But in the interim, the price of steel rose. Padres ownership bore that cost.

Even though Moores’ baseball staffers whiffed on Verlander and failed miserably in choosing Bush, Moores put them in a tough spot. He in effect removed two players who would both pan out as big leaguers.

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Someone with the Tigers correctly foresaw that shortening Verlander’s stride would sharpen his control. Untroubled by his 21-18 college record and bursts of subpar accuracy, the Tigers’ duo touted the 6-foot-5, 240-pounder’s “electric” combination of size, velocity and a powerful curveball.

Signing Verlander wasn’t easy.

David Verlander, the pitcher’s father and a union organizer with experience in sticky negotiations, said a contractual impasse led him to negotiate directly with Smith, leading to a deal, per CWA-Union.org.

The sides agreed on a $3.12 million signing bonus, which was less than the $3.15 million bonus the Padres paid to Bush, who was advised by Jeff Moorad.

The Boras-advised Weaver and Drew, who went 12th and 15th to the Angels and Diamondbacks, respectively, got $4 million apiece — but they and Verlander each got major league contracts, increasing the value of all three deals.

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It wasn’t until close to the 2005 draft that Weaver was signed. He nonetheless returned great value to the Angels.

Verlander went on to pitch for the Astros after GM Jeff Luhnow obtained him at age 34 from Detroit.

Verlander became a better pitcher with Houston, benefiting from the tech-and-data-driven edges the Astros provided him. Verlander embraced high-speed camera data, eventually dropping his two-seam fastball and limiting his rising fastball to high in the zone. Prodded by high-speed imagery, he adjusted his slider grip.

He won his second and third Cy Youngs with the Astros, and now stands 266-159 with a 3.33 career ERA in nearly 3,600 innings.

For baseball’s hungriest fanbase, he represents a case of what might have been.

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