For years, AI’s role in spine care has been pitched as a future tool, something that might eventually help with imaging, planning or documentation. But a group of surgeons and health systems is using AI for a more immediate problem: deciding which patients should reach a spine surgeon in the first place.
Michael Verdon, MD, a spine surgeon with Dayton (Ohio) Neurologic Associates, told Becker’s his practice has been using an algorithmic triage tool for roughly three years. When patients call for a referral, the software walks them through a structured set of questions and routes them based on symptom severity. His reported results: Clinic throughput has doubled, and surgical volume is up about 10%.
“The patients get early treatment with the right person at the right time,” Dr. Verdon said.
A use case hiding in plain sight
The appeal of front-end triage is straightforward. Spine clinics across the country are absorbing patients with short-term musculoskeletal pain who would likely improve with time, medication or physical therapy, while patients with true neurological pathology can wait longer than they should to reach the right level of care.
Khalid Odeh, MD, a spine surgeon with Michigan Orthopaedic Specialists and attending spine surgeon at Corewell Health in Royal Oak, Mich., sees the same imbalance in his own practice and views AI as the most realistic path to fixing it.
In his framework, patients with neurological deficits would be fast-tracked to surgical evaluation, those with mechanical pain routed to therapy-first care, and chronic pain patients guided toward multidisciplinary management.
“A lot of them would get better without even seeing a spine surgeon,” Dr. Odeh told Becker’s.
For that vision to work, AI needs to reliably distinguish between routine pain and signs of neurological compromise using the clinical documentation already being generated in emergency departments, urgent care centers and primary care offices.
Larger systems are moving in
Hospital for Special Surgery in New York City recently partnered with Ema to deploy AI agents for scheduling and triage, with the stated goal of matching patients to the right specialist faster. Other spine voices have made a similar case, arguing that AI-driven clinical decision support, analyzing imaging, functional status, psychosocial risk factors and prior treatment history, can identify which patients are most likely to benefit from surgery and which should be routed to structured conservative pathways.
The momentum also tracks with where orthopedic leaders see the field heading. Kevin Bozic, MD, chair of surgery and perioperative care at Dell Medical School at the University of Texas at Austin, has argued that triage and longitudinal management, not procedure volume, should anchor the field’s shift toward value.
For surgeons, the payoff is counterintuitive but consistent: a smaller, better-matched patient panel.
“I think most spine surgeons would rather have a smaller number of patients that could benefit from surgery,” Dr. Odeh said.
The structural barrier
The technology is increasingly available. The greater challenger is coordination.
Patients enter the system through fragmented channels, primary care, urgent care and emergency departments, each with different incentives and limited integration with one another. Any triage layer that hopes to scale has to bridge those gaps and share data across them.
Dr. Odeh sees that fragmentation firsthand. “There’s not a lot of integration,” he said.
It is a barrier other orthopedic leaders have encountered. Tan Chen, MD, of Inova Orthopaedics and Sports Medicine in Fairfax, Va., recently told Becker’s that orthopedic care in most health systems remains “notoriously fragmented,” with patients ricocheting between primary care, radiology, pain management, physical medicine and rehabilitation, neurology and surgical specialists.
In integrated systems, that alignment is within reach. In fragmented markets, it remains the central barrier between today’s referral patterns and the more efficient front end early adopters are starting to build.
As more tools come online and early results accumulate, the question for spine programs may shift from whether to rebuild the front door to who builds it first.
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