Letter to the Editor concerning "AI versus the spinal surgeons in the management of controversial spinal surgery scenarios" by Mehmet, S. et al. (Eur spine J [2025]: doi.org/10.1007/s00586-025-08825-w).

We have conducted an in-depth analysis of the comparative study on AI and spinal surgeons presented by Mehmet et al. While we recognize the significant contributions of this work, we also identify certain limitations, including a restricted sample size, extended data collection intervals, and inadequate validation of AI outputs. To address these issues, we propose increasing the sample diversity, reducing the duration between data collection points, implementing double-blind evaluations of AI responses, fostering interdisciplinary collaboration, and establishing a long-term monitoring framework. These measures aim to enhance the scientific rigor, generalizability, and reliability of AI applications in clinical settings.