OTSR - 2026-08-06 - Journal Article; Review
Essential Innovations in Spinal Surgery: Contributions from the French School.
Marie-Hardy L, Chatelain L, Bouthors C, Prost S, de Loubresse CG, Court C
Topics
Key Takeaway
French surgical pioneers contributed at least 10 distinct innovations to spinal surgery over 50 years, including Cotrel-Dubousset instrumentation, EOS imaging, vertebroplasty, disc arthroplasty, and PediGuard pedicle guidance, collectively reshaping global deformity, trauma, and stabilization practice.
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Summary
This narrative review traces French contributions to spinal surgery across biomechanics, deformity correction, trauma, and technology over the past 50 years. Key figures include Duval-Beaupère and Roussouly for sagittal balance parameters, Cotrel and Dubousset for 3D deformity correction and segmental instrumentation, and Roy-Camille for pedicle screw fixation. Technological outputs include EOS low-dose biplanar imaging, vertebroplasty, lumbar disc prostheses, and emerging platforms in robotics and AI-assisted surgical planning.
Key Limitation
As a non-systematic narrative review authored without explicit conflict-of-interest disclosure regarding national attribution, it cannot objectively quantify the relative global impact of French versus contemporaneous international contributions to any specific innovation.
Original Abstract
French innovation has profoundly shaped the evolution of spinal surgery over the past fifty years. While many French contributions are now internationally recognized, few studies have explored their impact on the biomechanical understanding of the spine, the development of surgical techniques, or their broader implications. This review aims to trace France's contributions to advancing spinal physiology, deformity surgery, and spinal stabilization, while outlining future perspectives for the specialty. From a surgical standpoint, the work of Stagnara, Duval-Beaupère, Legaye, and Roussouly laid the foundation for modern concepts of sagittal balance and spinal alignment. Cotrel and Dubousset revolutionized scoliosis management by introducing the three-dimensional deformity model and segmental instrumentation. Meanwhile, Roy-Camille, Louis, Argenson, Onimus, and Marnay advanced spinal trauma surgery, surgical approaches, and instrumentation techniques. Technological innovations include EOS imaging, vertebroplasty, disc prostheses, PediGuard® pedicle guidance systems, preoperative planning tools, custom rods, and data analysis platforms. More recently, France has emerged as a key player in robotic surgery, artificial intelligence, personalized surgery, and surgical simulation. Level of evidence V; Narrative review.