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Ambati et al. Art Int Surg. 2025;5:53-64 Artificial
DOI: 10.20517/ais.2024.45
Intelligence Surgery

Review Open Access

Has artificial intelligence in spine surgery lived up to
the hype? A narrative review of recent approaches,

current challenges, and the path forward

Vardhaan S. Ambati, Satvir Saggi, Abraham Dada, Nima Alan
Department of Neurological Surgery, University of California San Francisco, San Francisco, CA 94143, USA.
Correspondence to: Dr. Nima Alan, Department of Neurological Surgery, University of California, 505 Parnassus Ave, M779, San
Francisco, CA 94143, USA. E-mail: nima.alan@ucsf.edu

How to cite this article: Ambati VS, Saggi S, Dada A, Alan N. Has artificial intelligence in spine surgery lived up to the hype? A
narrative review of recent approaches, current challenges, and the path forward. Art Int Surg. 2025;5:53-64. https://dx.doi.org/
10.20517/ais.2024.45

Received: 18 Jun 2024 First Decision: 6 Nov 2024 Revised: 10 Dec 2024 Accepted: 16 Dec 2024 Published: 18 Dec 2025

Academic Editor: Andrew Gumbs Copy Editor: Pei-Yun Wang Production Editor: Pei-Yun Wang

Abstract
Healthcare applications of artificial intelligence (AI) and machine learning (ML) are currently in a stage of
exponential growth; however, their adoption into clinical practice across clinical specialties remains uneven. In
spine surgery, the presence of challenging clinical problems, advanced intraoperative technologies, and large multi-
center datasets positions the field well for the integration of these technologies into the clinic and operating room
(OR). Here, we review recent advances in AI/ML applications in several key domains of spine surgery,
identify methodological challenges shared by many approaches, and suggest solutions that may lead to these
approaches becoming validated, commercialized tools that can reach clinical practice. Ultimately, we aim for
this narrative review to help catalyze further progress in the development and commercialization of AI/ML to
benefit future spine patients.

Keywords: Artificial intelligence, machine learning, spine surgery

INTRODUCTION
The past decades have seen spine surgery at the forefront of healthcare innovation, with countless
[1-3]
advancements in surgical techniques, robotics, and medical devices positively impacting patient care . In

© The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution 4.0
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adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as
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