Akron Children's Hospital's Dr. Todd Ritzman on pediatric orthopedic tech improvements, hospital partnerships


Akron (Ohio) Children's Hospital has partnered with the University of Akron to provide orthopedic care to members of the university community. 

Todd Ritzman, MD, chair of the department of orthopedic surgery at Akron Children's, emphasized this partnership, established in July, not only provides more assistance for the university, but shows the growth of Akron Children's, and its ability to provide care for the northeast Ohio athletic community. 

"We've finally matured our medical team to where we have primary care and surgical sports medicine specialists. (The partnership) was a competitive process, with several institutions applying, and we were chosen to collaborate with the university," Dr. Ritzman said during an Aug. 19 interview. 

"It has been great to showcase what we have built here, and the expertise we have at our institution. We are building a sports center of excellence on the University of Akron campus, so we will have a 5,000-square-foot facility in their indoor field house. We will not only manage the care of their athletes there, but will become a center of excellence for all college, high school and middle school athletes in the region." 

The center will not only support Division I athletes, but all athletes at the collegiate level, as well as faculty and staff.

On top of its recent merger, Akron Children's has also become one of the first pediatric orthopedic centers in the country to receive nView AI technology. 

"We already have a more traditional O-arm, which many spine centers have, but the nView should be delivered in the first quarter of next year," Dr. Ritzman said. "It is efficient and low-dose, which is very important with the pediatric population, as it minimizes radiation exposure." 

The hospital is also working on expanding its AI usage with additional mergers and partnerships. 

"We are finalizing a contract with Medtronic Medicrea, which is an AI, pre-operative platform that will track post-operative outcomes to help with surgical planning for scoliosis procedures," Dr. Ritzman said. "The real goal is to optimize patient specific, preoperative templating and planning, and have robotic prefab rods and then track how well we do at restoring their desired alignment with the preoperative templated rod and their postoperative outcome."

While Dr. Ritzman is on board with a lot of surgical AI, and feels comfortable using Medicrea's database for pediatric surgeries, he notes that a lot of pediatric orthopedic surgeons, himself included, are wary about robotics in the orthopedic operating room. 

"I have a couple of good friends in Boston who are using it (robotics in pediatrics). A bit of my concern right now is that there is some hesitancy about accuracy issues with long-segment instrumentations via robotics," he said. "Right now, especially in the adolescent population, spines are quite flexible. With robotic instrumentation, the more segments that are instrumented, the more potential there is for patient movement, and if that is not accurately tracked, then the robotics can be navigating on a plan that is no longer aligned with the patient's actual position on the table." 

"That is probably the primary concern that I have heard. It's very different from adults with arthritis, who have a degenerative, very rigid spine that doesn't have that motion and potential for loss of reliability of the navigation." 

Dr. Ritzman does have hope that improvements are coming soon, and surgical robots will eventually be safe and effective for pediatric use. 

"There is now work being done in real time to create segmental reference, where either using camera technology or on-spine tracking technology, the initial scan can be repositioned despite patient movement. I think it's really close to becoming very accurate and reliable," he said.

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