San Diego, CA
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.
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?
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.
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.”
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.
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.
San Diego County will be the center of NASCAR nation this weekend, with fans flocking to Naval Base Coronado for three days of events.
This is the first-ever Cup race held in San Diego County and the NASCAR community is also presenting it as its way of celebrating the 250th anniversary of the U.S. Navy.
Tickets are completely sold out, but locals can still get in on the fun at various event and activities taking place across the region.
Here’s what to know about this one-of-a-kind weekend in San Diego. Full coverage of NASCAR San Diego Weekend can be found at sandiegouniontribune.com/tag/nascar.
What is NASCAR San Diego Weekend?
The three-day event begins with Friday’s Craftsman Truck Series race, continues with an O’Reilly Auto Parts series race on Saturday and wraps Sunday with the Anduril 250.
Grandstands with a capacity for 40,000 fans have been erected, with another 10,000 spectators expected to occupy standing areas around the grounds.
Here’s a turn-by-turn look at Naval Base Coronado’s race circuit
When is it taking place?
Parking lots, which are on base, open each day at 7 a.m. and gates open at 9 a.m.
The Craftsman Truck Series takes place Friday at 4 p.m. The O’Reilly Auto Parts series race blasts off at 2 p.m. Saturday. The main event, NASCAR Cup Series Race, happens Sunday at 1 p.m.
A race-by-race look at NASCAR’s San Diego Weekend
Each day will also feature entertainment, driver Q&As and other activities.
Where is it?
Naval Base Coronado will host the weekend’s activities. All fans in attendance must carry a valid government-issued photo ID at all times.
Going to this weekend’s NASCAR races in Coronado? Here’s what you need to know
All event parking will be located on Naval Base Coronado. There is no event parking available within the city of Coronado.
Who is racing?
Shane Van Gisbergen, Tyler Reddick, Mike McDowell, Chase Elliott and Ty Gibbs are just a few of the names to expect this weekend. A full lineup can be found at nascarsandiego.com/nascar-san-diego-mission-lineup.
These 13 Cup racers could all win Sunday’s Anduril 250 in Coronado
How to watch on TV:
Craftsman Trucks Series race: 4 p.m. Friday on Fox Sports 1
O’Reilly Auto Parts Series race: 2 p.m. Saturday on The CW
NASCAR Cup race: Sunday at 1 p.m. on Prime Video
Local events:
San Diegans have a range of options for getting in on the fun of NASCAR weekend in Coronado, including meet and greets with drivers, watch parties and fan zones.
Your guide to fan events during NASCAR San Diego Weekend
More coverage:
CORONADO, Calif. (FOX 5/KUSI) — Final preparations are underway for NASCAR’s historic race weekend at Naval Base Coronado, where stock cars will compete on an active military installation for the first time in the sport’s history.
Crews, race teams, military personnel, first responders and event staff spent Thursday putting the finishing touches on the temporary road course as thousands of fans prepare to descend on the base for the inaugural event.
“The countdown is on,” as organizers work to transform portions of the installation into a race venue unlike any NASCAR has hosted before.
“It’s a very proud moment for NASCAR and myself and my company for being part of it,” said Jordan Litchko, a NASCAR production partner with ignition production. “It’s the America 250, so what a year to celebrate and be here on the naval base.”
Officials say the event marks the first time a NASCAR national series race has been held on a military base, bringing one of America’s most recognizable motorsports directly onto a working military installation.
Unlike traditional oval tracks, competitors will tackle a temporary road course built specifically for the event.
“It’s a road course race, which adds way more excitement, so it’s going to be ultra challenging,” Litchko said.
Thursday’s preparations included long lines of team members, vendors, staff and emergency personnel picking up credentials and completing security and base access requirements ahead of race weekend.
Meanwhile, drivers and crews got their first close look at the unique layout, which winds through portions of the base and presents a challenge far different from a conventional speedway.
With large crowds expected throughout the weekend, organizers are encouraging fans to plan ahead and allow extra travel time. Traffic delays are anticipated around Naval Base Coronado and nearby access points as spectators arrive for the event.
After months of planning and construction, the wait is nearly over.
On Friday, engines will roar to life aboard Naval Base Coronado, marking a milestone moment for NASCAR and creating a new chapter in the sport’s history. By the weekend’s end, fans will witness a race unlike any ever held before — stock cars competing on a military base in the heart of San Diego.
SAN DIEGO (CNS) – The City of San Diego is beginning to install 286 metered parking spaces this week in downtown San Ysidro in an effort to increase parking turnover, it was announced Thursday.
To develop the plan, city leaders worked with the San Ysidro business community. Revenue collected from the meters is reserved for transportation, parking and safety improvements in San Ysidro.
“Feeding parking meters feeds neighborhood repairs, and we can’t wait to get to work for the San Ysidro community,” said Naomi Chavez, interim director of the city’s Transportation Department. “This new parking zone will bring long overdue change that will help support local business activity and generate revenue that will be reinvested directly into improving neighborhood quality of life in San Ysidro.”
Crews began preparing the bases for the meters last week and installation work is expected to last through June. According to the city, these will be multi-space meter kiosks and drivers should be aware that they will need to go to the nearest kiosk to pay for parking since there won’t be a meter at each space.
Metered parking goes into effect on July 1 and will be enforced 8 a.m. to 6 p.m. Monday through Saturday, excluding holidays. The parking rate is $2.50 an hour, with a maximum time limit of four hours.
City-led parking studies determined vehicles were parking on the streets of the neighborhood for hours or days at a time, making street parking for the area’s businesses scarce.
Drivers who customarily use free street parking when traveling across the border to Mexico are encouraged to use “one of the many paid off-street parking lots in the area,” a city statement read.
“The findings [of the parking study] clearly demonstrate the need for action. High parking occupancy on unregulated segments, along with data showing that 37% of vehicles exceed the existing two-hour limit and an average parking duration of over five hours, indicate that current conditions reduce turnover and limit access for local businesses and visitors,” wrote Alfredo Ripa, president of the San Ysidro Community Economic Development Corporation. “The proposed introduction of approximately 286 metered spaces, along with better signage, clearer designations and continued enforcement, represents a thoughtful and data-driven approach to improving parking availability and supporting economic activity in the community.”
Areas where the meter kiosks will be installed include:
— East San Ysidro Boulevard between Border Village Road to Camino De La Plaza (both sides);
— Border Village Road between East San Ysidro Boulevard (north) to East San Ysidro Boulevard (south), (both sides);
— Front Street between Border Village Road to end of cul-de-sac (south side);
— Bolton Hall Road between East San Ysidro Boulevard to Border Village Road (south side);
— Louisiana Avenue between East San Ysidro Boulevard to end of cul-de- sac (south side);
— Virginia Avenue between East San Ysidro Boulevard to Border Village Road (both sides); and
— East San Ysidro Boulevard between Willow Road and East Park Avenue (south side).
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