LAUSR

Among the five leading buzzwords of next generation spine care—with so called “Minimally Invasive spine surgery,” “Robotics,” “Virtual Reality”(VR), “machine learning,” (ML) and “Artificial Intelligence” (AI) leading the way—the latter three entities are all based on large-scale data gathering and processing endeavors aimed at enhancing spine care in an artificially created digital realm. The promise of these three abstract entities centers not around concrete goals of things like achieving better spinal decompression, alignment or fixation techniques, improving fusion quality, or even creating novel tissue regeneration options. Instead they aim for abstract achievements, like incrementally improved precision information gathering through pattern recognition and application (ML), enhanced nonhuman decision making (AI), as well as experiential educational and patient interaction options offered by a digitally enhanced version of our reality through virtual reality (VR). All three of these abstract entities are increasingly morphing from possibilities to feasibilities and even realities of medical care and we indeed might not be too far away from them becoming routine applications in our complex field of Spine care. It seems not farfetched to imagine that these three technological entities are not going to remain individual endpoints but may merge into a greater all-encompassing digital entity—a spine “metaverse” with an alternate “existence” of stakeholders in spine care actively participating within this new dimension. The potential of a digital alternate “human” existence has been an enticing fantasy of the science fiction realm probably first introduced in the 1984 “Neuromancer” novel series of the Canadian-American writer William Gibson, who had his characters operate around a virtual reality space he called “Matrix.” In 1992, the writer American Neal Stephenson coined the term “metaverse” in his novel “Snow Crash” as descriptive term of a parallel virtual universe with close intersections to the real world (in addition to his predicted cryptocurrencies and post nation state governance structures meted out by powerful entrepreneurs and corporations). In what could be a case of truth being stranger than fiction, one of the leading social media corporations of our times announced its rebranding using the ancient Greek prefix “Meta Platforms Inc” almost to the date 30 years after the publication of the first edition of “Snow Crash.” The choice of the prefix “meta” is interesting in itself as it connotates a variety of meanings, including “coming behind or beyond an event or focal object”; implying “change or transformation”; and “transcending or substituting” (to name a few options offered in the MerriamWebster dictionary). In our medical world, we are well familiar with the applications of the prefix “Meta” in applications like “Metacarpal,” “Metastasis,” and “Metanalysis.” Some of the early concepts of this platform promise its users to be able to migrate throughout its various media formats in form of one’s own individually created and accessorized avatar. So far, the responses to this attempt at future proofing its business development have met with mixed market place responses; however, the foundation of a marketable digital parallel universe has now been laid down by one of the largest social media corporations of our era. In fact, significant real world market value investments have already been made in the alternate digital life space as seen in the $1.2 million dollar real estate acquisition (using—of course—cryptocurrency) of a 52 parcel plot in a place called “Decentraland” by a Non-fungible Token (NFT) auction house in January 2022. That the parallel virtual world indeed has legs can be seen in the continued success in ventures like “Second Life,” which has been officially in existence since 2009 and reports 70+ million registered accounts and 11,800,000 visits over the 6 months preceding January 2021 including financial transactions for properties and personal modifications and even featuring a Reuters news agency bureau. For younger generations, alternate virtual lifestyles have become firmly established in game environments such as Minecraft and Fortnight. Whoever the eventual proprietors and whatever the eventual format or naming will be, a “metaverse” type digital sphere as a daily companion to human life seems to take shape more concretely and may become the successor to the present day more mundane “internet.” As these developments continue to unfold in real time, the 30th anniversary of the creation of the “metaverse” entity might be a suitable occasion to dream up some possible applications for a future Spine care in such an entity, a literal “Spine Metaverse” (or “Meta Spineverse”).