AI, robotics and motion-preserving implants expand spine surgery options for patients

Mayo Clinic orthopedic surgeon describes advances in care for common back, neck problems

ROCHESTER, Minn. — People worldwide seek medical care for back and neck pain, which can interfere with sleep, mobility and daily life. For individuals who need surgery for spinal conditions, advances in robotics, artificial intelligence (AI) and motion-preserving implants are expanding treatment options and allowing for more personalized treatment, according to Ahmad Nassr, M.D., orthopedic surgeon at Mayo Clinic.

Dr. Nassr treats a wide range of spinal conditions that can affect mobility and cause pain, including:

• Herniated disk, a problem with one of the rubbery cushions, called disks, which sit between the bones that stack to make the spine.
• Spinal stenosis, a narrowing of the space around the spinal cord that can put pressure on the spinal cord and nerves that travel through the spine.
• Scoliosis, a side-to-side curve of the spine that can cause pain and breathing problems. 
• Spinal tumors, lesions that start in or around the spine.
• Degenerative spine conditions that most commonly affect older adults, such as degenerative disk disease and adult degenerative scoliosis. These conditions can cause severe symptoms, including stiffness, numbness or tingling from nerve damage.

Research has shown that low back pain is the leading cause of disability around the world, and the elderly are one of the most vulnerable populations.

'My practice is to assess each of my patients holistically, regardless of their age, to determine whether they can benefit from spinal surgery based on the treatment goal, whether it's to reduce pain, restore their ability to work or improve their quality of life,' Dr. Nassr explains.

Motion-preserving alternatives to fusion

Many spinal conditions — such as degenerative disk disease, scoliosis and spinal stenosis — used to be treated with fusion surgery, in which two or more spinal bones are connected and heal as one bone. The procedure reduces pain but also limits spinal flexibility.

Motion-preserving devices, such as artificial disk replacement, offer alternatives that maintain more natural spinal movement.

Dr. Nassr served as principal investigator at Mayo Clinic in randomized controlled trials that led to Food and Drug Administration (FDA) approval of the TOPS replacement device, which stabilizes the spine while preserving movement. The device can be used to treat pinched nerves and spondylolisthesis, which is a slippage between two vertebrae.

Mayo Clinic was the first medical center in the U.S. to implant the FDA-approved Minimally Invasive Deformity Correction (MID-C) device to treat scoliosis. 

Dr. Nassr and other researchers are studying next-generation implants designed to replace both the disk and facet joints to maintain natural flexibility.

Robotics and minimally invasive surgery

Surgeries that once required large incisions can now be performed through small openings, reducing postoperative pain, helping patients recover faster and shortening hospital stays.

Conditions such as herniated disks, misalignment of the spine, spinal stenosis or instability can now be treated with a minimally invasive approach.

Robotic-assisted platforms, combined with CT scans and MRI, allow surgeons to plan complex spinal procedures and determine the most precise pathways for implants before surgery begins.

'Advances in robotic-assisted surgery, AI, 3D models and motion-preserving implants are allowing us to treat complex spinal conditions with greater precision and less disruption to back muscles,' Dr. Nassr says. 'These technologies are changing how spine procedures are performed and can support faster recovery for patients.'

Advances in anesthesia, including specialized nerve blocks, also have significantly improved postoperative comfort and shortened hospital stays.

Personalized surgery with 3D models

In complex cases, surgeons can create 3D-printed models of a patient's spine — including nerves and blood vessels — and design custom implants tailored to the person's anatomy. These models allow surgeons to rehearse procedures before the operation and refine surgical planning.

Complex cases — such as advanced adult scoliosis, revision surgery or spinal tumors — often involve a multidisciplinary team of specialists, including orthopedic surgeons, neurosurgeons, anesthesiologists and rehabilitation specialists.

AI in spine care

AI is integrated into multiple aspects of spine care at Mayo Clinic. AI-supported tools assist in analyzing clinical data to guide treatment decisions and enhance surgical planning. In research, Dr. Nassr uses AI to better assess bone health and osteoporosis for patients who may need spine surgery.