Response to the letter to the editor regarding: “A call for dynamic guidelines: Incorporating AI ethics into social media best practices for spine professionals”
Zachary A. Cupler, Andrew Trontis, Brandon Lucke-Wold, Samuel M. Schut, Khoi D. Than, James E. Eubanks, Robert J. Butler, Reem Elwy, David Gendelberg

Abstract
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Taxonomy
TopicsArtificial Intelligence in Healthcare and Education · Social Media in Health Education · Medical Imaging and Analysis
To the Editor,
We thank Sham et al. for their persuasive letter to the editor [1] pertaining to our recent article, ``Social Media Best Practices for the Spine Care Professional,” [2] with regards to responsible and ethical use of artificial intelligence (AI). The authors propose strong rationale to incorporate AI when considering future iteration of social media best practice guidelines for spine care professionals. Their proposed AI recommendations for future guidelines focused on three themes: (1) accuracy and validity of AI-generated output as guided by a human, (2) transparency and trust to the public by ensuring appropriate disclosure of AI-reliance to generate or modify content, and (3) attribution and originality to identify source material, avoid misattributions, and prevent unsupervised thought being conveyed as clinical opinion.
Identified as out of scope of our paper in our limitations, we do recognize the importance of AI in future guidelines and highlighted that we anticipated future iterations to these best practices as new technology emerges which rightfully should consider AI in this context. We are pleased to read such positive feedback regarding our synthesis of best practices for social media use for spine care professional. Individual members of this authorship team maintain interest in AI initiatives. The North American Spine Society does have workgroups with particular interest in AI that are prioritizing guideline development for application among spine care professionals.
Disclaimers
This is not an official position of the North American Spine Society.
The views expressed in this article are those of the authors and do not reflect the official policy or position of the Department of Veterans Affairs, or the United States Government.
Declaration of Competing Interest
The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. All authors acknowledge their personal use of social media platforms.
The reference list from the paper itself. Each links out to its DOI / PubMed record.
- 1Shams Z.Montemurro N.Chaurasia B.A call for dynamic guidelines: incorporating AI ethics into social media best practices for spine professionals North Am Spine Soc J NASSJ 202610.1016/j.xnsj.2026.100853 · doi ↗
- 2Cupler Z.A.Trontis A.Lucke-Wold B.Schut S.M.Than K.D.Eubanks J.E.Social media best practices for the spine care professional North Am Spine Soc J NASSJ 23202510074810.1016/j.xnsj.2025.100748 PMC 1227247640688350 · doi ↗ · pubmed ↗
