People around the world seek medical care for back and neck pain that 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 making treatment more personalized, said Mayo Clinic orthopedic surgeon Ahmad Nasr, MD.
Dr. Nassr treats a wide range of spinal conditions that can affect mobility and cause pain, including:
- Herniated disc. The problem involves one of the rubber-like cushions called intervertebral discs that sit between the bones that stack up to form the vertebrae.
- Spinal stenosis. The space around the spinal cord becomes narrower, which can put pressure on the spinal cord and the nerves that run through it.
- Scoliosis. The spine is curved from side to side, which can cause pain and difficulty breathing.
- Spinal tumors, lesions that occur in or around the spine.
- Degenerative spinal diseases most commonly affecting older adults, such as degenerative disc disease and adult degenerative scoliosis. These symptoms can cause severe symptoms such as stiffness, numbness, and tingling due to nerve damage.
Research shows that low back pain is a leading cause of disability worldwide, and older people are one of the most vulnerable populations.
“My practice is to comprehensively evaluate each patient, regardless of age, to determine if they could benefit from spinal surgery based on treatment goals, such as pain relief, restoring work capacity, and improving quality of life,” Dr. Nasr explains.
An alternative to fusion that preserves movement
Many spinal conditions, such as degenerative disc disease, scoliosis, and spinal stenosis, were treated with fusion surgery, which connects two or more vertebrae and heals them as one bone. Although this procedure reduces pain, it also limits spinal flexibility.
Motion preservation devices, such as artificial disc replacements, offer an alternative that preserves more natural spinal movement.
Dr. Nasr served as principal investigator on the Mayo Clinic’s randomized controlled trial that led to Food and Drug Administration (FDA) approval of a TOPS replacement device that stabilizes the spine while preserving motion. This device can be used to treat pinched nerves and spondylolisthesis, which is a slippage between two vertebrae.
Mayo Clinic is the first medical center in the United States to implant an FDA-approved Minimally Invasive Deformity Correction (MID-C) device to treat scoliosis.
Dr. Nasr and other researchers are investigating next-generation implants designed to replace both disc and facet joints to maintain natural flexibility.
Robotics and minimally invasive surgery
Surgeries that once required large incisions can now be performed through smaller openings, reducing postoperative pain, speeding patient recovery, and shortening hospital stays.
Conditions such as herniated discs, spinal misalignments, spinal stenosis, and instability can now be treated with a minimally invasive approach.
Combining robotic-assisted platforms with CT scans and MRI allows surgeons to plan complex spinal surgeries and determine the most accurate path for implants before the procedure begins.
“Advances in robot-assisted surgery, AI, 3D models, and motion-preserving implants allow us to treat complex spinal conditions more precisely and with less damage to the back muscles,” says Dr. Nassr. “These technologies can change the way spine surgeries are performed and support faster recovery for patients.”
Advances in anesthesia, such as specialized nerve blocks, have also greatly improved postoperative comfort and shortened hospital stays.
Personalized surgery using 3D models
For complex cases, surgeons can create a 3D-printed model of a patient’s spine, including nerves and blood vessels, and design a custom implant to match the patient’s anatomy. These models allow surgeons to rehearse procedures and refine surgical plans before surgery.
Complex cases such as advanced adult scoliosis, revision surgeries, and spinal tumors often involve a multidisciplinary team of experts, including orthopedic surgeons, neurosurgeons, anesthesiologists, and rehabilitation specialists.
AI in spine care
AI is integrated into many aspects of spine care at Mayo Clinic. AI-powered tools help analyze clinical data to guide treatment decisions and enhance surgical planning. In research, Dr. Nasr uses AI to better assess bone health and osteoporosis in patients who may need spinal surgery.
“Advances in spine surgery not only enhance patient care but also increase our ability to provide more personalized treatment,” says Dr. Nasr.
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