Spine robotics and enabling technologies had an initial rush of adoption and hype, but in recent years that growth has hit a wall.
According to the American Spine Registry’s 2026 report, the reported use of robotics and computer assistance in spine surgery has plateaued after initial increases from 2017 to 2020 for lumbar and cervical cases.
Although these technologies offer promises of improved precision, efficiency and often enable same-day surgery, factors including costs could be affecting its growth.
“I think the report reflects one of a few things,” Brian Gantwerker, MD, said. “One, it could be a leveling off of widespread adoption. In other words everyone who’s gotten a robot or a system has gotten one, and they’re happy with it. The other thing it might reflect is a tightening of the belts of many ASCs and hospital systems with decreasing remuneration, which is actually hitting physicians harder than large facilities. There might be a lack of appetite for robotics. A third possibility is there’s just a decreasing appetite for these systems, and they may not be seeing the return on investment or the traction of patients that they’d hoped that they would see.”
Whether the cause is related to decreased hype or shifting health system priorities, Dr. Gantwerker said he’s seen more systems being more selective about what to invest in.
“They may not have capital available to pay for these systems, so they’re having to maintain their systems and more, so keeping up with software and hardware upgrades,” he said. “New system purchases are still kind of expensive for private ASCs to buy into. It’s kind of like opening weekend for a movie where you have a massive influx of people flocking to see the movie, and now they’ve seen it. It’s hard to tell, but I would say there’s definitely a financial factor and a limitation of adoption. These are still very expensive systems, sometimes $1 million to $2 million, and that’s a lot of capital they may need for other things.”
