1. Global Overview
Over seven million spinal procedures are performed worldwide each year. The associated market, valued at USD 17.6 billion in 2024, is projected to reach USD 26.1 billion by 2031, with a compound annual growth rate (CAGR) of 5.8%.
2. Why AI Is a Game Changer
- Preoperative planning Deep neural networks segment vertebrae and discs with Dice coefficients > 0.95, calculate the Cobb angle with a mean error < 3°, and predict disc degeneration with up to 92 % accuracy, reducing planning times and variability among surgeons.
- Navigation and robotics • Mazor X Stealth Edition (Medtronic) combines 3D planning, integrated navigation, and predictive analytics. • Mako 4 SmartRobotics (Stryker) incorporates Q-guidance; its first spinal cases were presented at AAOS 2025. • ExcelsiusGPS / ExcelsiusHub (Globus Medical) offers free-hand navigation with real-time patient array monitoring. These systems achieve submillimetric accuracy in screw placement and can reduce complications by up to 30 %.
- Complication prediction Models with AUC > 0.85 anticipate infections, implant misplacements, or reoperations, enabling preventive strategies and earlier discharges.
3. Available scientific evidence
Between 2020 and 2024, 105 clinical studies on AI in spinal surgery were published: 69 % focused on prognosis and diagnosis, 27 % on image analysis, and 2.8 % on intraoperative assistance. A meta-analysis of 17,911 patients showed a 96.2 % accuracy for navigated screws versus 94.2 % with conventional techniques, along with less bleeding and shorter hospital stays.4. Main challenges
- Data interoperability: no standardized protocols exist for surgical video and robotic telemetry.
- Cybersecurity: healthcare incurs the highest costs; a breach averages USD 10.93 million.
- Adoption cost: full implementation of robotic and AI platforms requires high economic investments from hospitals.
- Multicenter evidence: retrospective studies predominate; randomized cost-effectiveness trials are needed.
5. Trends and near future
- AI4Spine Surgery consortium: established to develop a global, annotated database that accelerates model training.
- Market boost: analysts estimate AI will contribute between 20 % and 25 % of total spine sector growth by 2030.
- Upcoming technology milestones: haptic interfaces with real-time feedback and partial automation of tasks (osteotomies, suturing, closure) that could be integrated before 2030.
Conclusion
Artificial intelligence does not replace surgical expertise but enhances it: increasing precision, reducing complications, and paving the way for hyper-personalized treatments. The immediate challenge is to translate abundant proof-of-concept into high-level clinical evidence and ensure data security in this new surgical era.References
- Banga B. How AI is reshaping spine surgery. Medical Technology Issue 86, May 2025. medical-technology.nridigital.com
- Medtronic. Mazor™ Robotic Guidance System. Technical datasheet, consulted June 2025. medtronic.com
- Stryker. Press release “Stryker showcases next generation of Mako SmartRobotics™ at AAOS 2025”, March 11 2025. stryker.com
- Globus Medical. ExcelsiusHub™ Freehand Navigation. Product page, 2025. globusmedical.com
- Papalia GF et al. “Higher Accuracy and Better Clinical Outcomes in Navigated Thoraco-Lumbar Pedicle Screw Fixation Versus Conventional Techniques: A Systematic Review and Meta-Analysis”. Spine 49(19):1370-1380, 2024. pubmed.ncbi.nlm.nih.gov
- IBM Security. “Cost of a Data Breach: The Healthcare Industry”, August 6 2024. ibm.com
