Abstract
The pandemic of the new coronavirus infection has swept the world and killed more than 5 million people, which has shocked all human beings who have believed in modern medical progress. Along with the sedation of infections, the balance between restriction and acceleration of socio-economic activities is difficult. With the spread of vaccines and the advent of viral therapeutic agents, we expect how to control this pandemic has finally become visible.
In this situation, we realize that data science and robotics innovations are quite important in many medical fields. Artificial intelligence (AI) diagnosis and remote medical care are becoming a reality, and this direction will accelerate further in 2022, the first year of post-pandemic. The trend of digital transformation (Dx) will also be rushing into Orthopedics next year. In addition, research on virtual reality and augmented reality is being actively conducted, and it has become possible to use it for surgical simulation and technical training. As, in the field of abdominal surgery, remote robotic surgery will soon become available in the field of orthopedics as well.
These Dx trend will prevail to our field instead of experience, and knowledge of medicine, which can change the medical care style dramatically in near future. It is crucial for orthopedic surgeons to always aim for its development and evolution.
The pandemic of the new coronavirus infection has swept the world and killed more than 5 million people, which has shocked all human beings who have believed in modern medical progress. Of course, this number of victims is less than plague, the Spanish cold, and AIDS, but its influence and destructive power that has affected socio-economic activities worldwide in such a short period were quite profound. There were many casualties among the medical staff who have worked in hospitals, and there were occasions when the medical system became dysfunctional. Along with the sedation of infections, the balance between restriction and acceleration of socio-economic activities is difficult. With the spread of vaccines and the advent of viral therapeutic agents, we expect how to control this pandemic has finally become visible.
In Japan, the number of deaths due to infection is lower than in Western countries, but it was found that there are significant problems in hospital bed control and vaccine supply systems. Although the number of hospitals seems to be enough, it was pointed out that the scale of each hospital is too small and the lack of doctors and nurses affects handling critically ill patients. In addition, significant problems existed in information management, which has long been regarded as administrative defects of the Japanese government.
On the other hand, we also realize that data science and robotics innovations are gradually spreading in many medical fields. Artificial intelligence (AI) diagnosis and remote medical care are becoming a reality, which will accelerate further in 2022, the first year of post-pandemic. Orthopedics plays an essential role in ensuring and extending healthy life expectancy in a super-aging society. It is expected that it will attract attention as an area where such innovations can be quickly introduced. The trend of digital transformation (Dx) will also be rushing into Orthopedics next year.
AI diagnostics will soon be available in imaging tests such as plain X-rays, CT, and MRI. The most significant advantage of AI diagnosis is that it can process a large amount of information in a short time. What I find particularly useful is that those can screen metastatic cancer on CT images and MRI. Since the images are usually read by focusing on the target requested by the doctors, no matter how good the radiologist is, not all the images taken may be checked in detail. To find metastatic cancer happens to be in the picture is the same. We also expect AI diagnostics to be used in mass screening. As simple X-rays are usually taken at screening for lung cancer, cervical OPLL, which is a significant risk of spinal cord injury, can be a target of a similar screening system. For example, how about taking a cervical spine X-ray for each license renewal and using AI to determine the presence or absence of OPLL? Once a large OPLL is found, it can be recommended to scrutinize it at a medical institution, and the driver may be more cautious. This can reduce severe spinal cord injury and paralysis. In addition, for joint diseases, osteoarthritis and osteoporosis can be searched for by mass screening, and appropriate therapeutic intervention can be started early for those at high risk. As a result, healthy life expectancy may be extended.
Of course, the wave of digitalization has already been coming into the operating room. Navigation is already routinely used in spinal surgery, allowing for the safe installation of screws. Recently, navigation has come to be used for the correction of severe deformation and bone resection in joint surgery. In addition, robot-assisted surgery is also available for joint diseases. So far, it has only a function to assist the osteotomy, but it appears that it will be possible to do this by itself with electric equipment in the future. In addition, research on virtual reality and augmented reality is being actively conducted, and it has become possible to use it for surgical simulation and technical training. As, in the field of abdominal surgery, remote robotic surgery will soon become a reality in the field of orthopedics as well.
In orthopedic education, craftsmanship and profound experience have traditionally been emphasized in the manual reduction for fractures and cast fixation. In addition, in radiological image tests, the practice has been enthusiastically conducted to interpret and reconstruct from two-dimensional images into three dimensions in mind. However, the development of medical AI can bring new aspects that reduce these kinds of training, experience, and knowledge. Advances of digitization in medical fields have the strong power to change the style of medical care itself. It is crucial for orthopedics to always aim for its development and evolution.
Conflicts of interest
None.