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AI, Machine Learning, and Neurosurgery

Medically reviewed by Ramin AmirNovin, MD, Susan Kerrigan, MD and Marianne Madsen on February 16, 2023

Although robots won’t be performing brain surgery anytime soon, artificial Intelligence (AI) is already transforming our lives. AI is the engine powering personal assistants like Siri and Alexa. It drives recommendation algorithms for streaming channels like Hulu and Netflix. AI and machine learning may also change neurosurgery. So what is it and how can it improve delicate medical procedures?


AI and machine learning


A famous World War II code breaker laid out the theories that drive AI. Often called the father of modern computing, Alan Turing proposed a test in the 1950s. Could someone interacting with a computer be fooled into thinking the machine is human? In other words, can a computer think? For decades, the answer was no. With AI, a task that normally requires human intelligence is performed by a computer. Narrow or “weak” AI is a focused simulation of human intelligence that is concentrated on a single task. This can include everything from personal assistants and streaming channel recommendations to self-driving cars and search engines. 


Along with Isaac Asimov’s Three Laws of Robotics, AI and the Turing Test have influenced the plot and characters in many science fiction movies including Ex Machina along with the Terminator and Star Wars series. A.I. Artificial Intelligence was even the title of a Steven Spielberg-directed 2001 movie starring The Sixth Sense’s Haley Joel Osment. Movies like these depict “Artificial General Intelligence” or “Strong AI.” This is a machine capable of using its own knowledge to solve problems and adapt to changing circumstances –– just like a human being. Unfortunately, in films like Ex Machina the machine quickly decides that human beings are the biggest problem of all –– and the AI works hard to eliminate the issue!


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Knee Replacement - Robotic Surgery

Knee Replacement - Robotic Surgery

AI and modern medicine


Fortunately in modern medicine, robots aren’t trying to kill us. Patients with back issues have been helped by a robot programmed to direct screws during spinal surgery. A patient’s computerized tomography or CT scan is taken prior to the operation. The surgeon then sets a fixed course for the robot based on the CT. During surgery, the robot uses computational algorithms to place screws in the spine. Although it often speeds up the process while increasing accuracy, the downside is that it’s impossible to make adjustments during the procedure. While this is a negative for spinal surgery, it’s even worse for an operation involving the brain. Once the brain is exposed, this vital organ begins to change. It moves to equalize intracranial and atmospheric pressure. The targeted tumor can subtly shift location –– and this is worsened once the surgeon begins cutting. AI improves accuracy. Although a surgeon relies on experience and eyesight along with preoperative imaging, it can be difficult to determine where a tumor ends and healthy tissue begins. Submitting a sample for optical imaging, the computer needs just over a minute to analyze it. Human pathologists need half an hour and are less accurate. 


Machine learning can eventually improve neurosurgery. Part of AI, machine learning is when a computer learns from data without being programmed. The computer can then make predictions. In neurosurgery this can quickly identify unusual cases and help the surgeon craft treatment options. One study showed it can predict the outcome of deep brain stimulation. Neurosurgeons are increasingly adopting machine learning and AI, which can benefit both them and their patients. Although it is unlikely we will see robot brain surgeons anytime soon, the future has already arrived for neurosurgery’s use of AI and machine learning.


Written by John Bankston

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