On the horizon of spinal surgery Minimally invasive spine fusion surgery may be improved by new imaging systems that are in development. These systems provide computerized three-dimensional images, which increase the accuracy of identifying anatomic structures. Robotic surgery is another technology that is on the horizon. It should increase the accuracy of minimally invasive spine surgery techniques and make them highly reproducible. The marriage of robotic technology with three-dimensional image guidance should allow for more advances and improvements in spine surgery. Future developments in spine surgery will very likely be distinguished not only by advanced minimally invasive fusion techniques, such as imaging and robotics systems, but by new philosophies of treating spine disorders. For example, artificial discs, which are in the process of FDA testing, have introduced a new field of spine surgery known as non-fusion or motion preservation techniques. Artificial discs may have the potential advantage of maintaining motion in the spine rather than eliminating it, as a fusion does. This may restore the spine more closely to normal function, and lessen the long-term detrimental effects of fusion surgery on discs at adjacent levels of the spine. The discogenic pain associated with pseudoarthrosis (failure of the bone to fuse) would also not be an issue with an artificial disc. At the time of this article, artificial discs in the United States are still in an investigational process and not approved by the FDA for general use. By: Ali Araghi, DO February 11, 2004