Optimizing the clinical adoption of total joint replacement of the lumbar spine through imaging, robotics and artificial intelligence.

Introduction: The objective of this article is to assess the potential of imaging, robotics, and artificial intelligence (AI) to significantly improve spine care, preoperative planning and surgery.

Areas covered: This article describes the development of lumbar total joint replacement (TJR) of the spine (MOTUS, 3Spine, Chattanooga, TN, U.S.A.). We discuss the evolution of intra-operative imaging, robotics, and AI and how these trends can intersect with lumbar TJR to optimize the safety, efficiency, and accessibility of the procedure.

Expert opinion: By preserving natural spinal motion, TJR represents a significant leap forward in the treatment of degenerative spinal conditions by providing an alternative to fusion. This transformation has already occurred and is continuing to evolve in the primary synovial joints such as hip, knee, shoulder and ankle where arthroplasty outcomes are now so superior that fusion is considered a salvage procedure. The convergence of imaging, robotics and AI is poised to reshape spine care by enhancing precision and safety, personalizing treatment pathways, lowering production costs, and accelerating adoption. However, the key challenges include ensuring continued collaboration between surgeons, researchers, manufacturers, and regulatory bodies to optimize the potential of TJR.