Letter to the Future of Spine Care, Education, and Research

From the North American Spine Society, 2025

To our colleagues in 2065— As we write this letter, the North American Spine Society (NASS) marks its 40th anniversary. Four decades ago, a small group of surgeons, researchers, and rehabilitation specialists gathered around a simple conviction: that the best spine care emerges when science, education, and clinical practice move forward together. From that foundation, NASS has grown into a global community of thousands that spans every discipline involved in spine health, every corner of the world, and every stage of professional life. We are writing to you from an era of both extraordinary progress and profound uncertainty. The boundaries between surgery, rehabilitation, and technology are blurring. Artificial intelligence is beginning to inform diagnosis, predictive modeling, and personalized care. Robotics and navigation systems have transformed precision in the operating room. Biologic therapies and regenerative science are pushing the limits of what we once believed possible. At the same time, we are confronting challenges that test the very purpose of our profession: disparities in access to care, clinician burnout, environmental and economic pressures on healthcare systems, and the constant need to measure what truly matters to patients – their function and ability to live fully. We write this letter not simply to record where we stand, but to share what we hope you will continue to carry forward. The Future of Spine Care In 2025, spine care is increasingly recognized as a continuum – not an isolated procedure or encounter, but a lifelong process of prevention, treatment, and management that can hopefully lead to recovery. Our understanding of pain, disability, and well-being has deepened, emphasizing the biopsychosocial model that integrates the physical, emotional, and social dimensions of health. We hope that, in your time, this holistic vision has become the standard of care. That the silos between surgical and nonsurgical disciplines have dissolved. That multidisciplinary teams of surgeons, physiatrists, physical therapists, psychologists, and scientists work seamlessly toward shared outcomes defined not only by radiographs, but by the lives that patients are able to reclaim. We also hope that you have continued to place equity at the center of spine care. In our moment, geography, income, and race too often determine who receives advanced care and who does not. We strive to dismantle those barriers through advocacy, education, and global partnerships. May your generation look back and see that this was the era when inclusion and access became inseparable from excellence. Finally, we hope you have preserved compassion as your most powerful instrument. Technology will evolve beyond our imagination, but empathy remains timeless. May your care be guided by both data and heart. The Future of Spine Education In our time, NASS serves as a hub for lifelong learning. Through our Annual Meetings and online learning modules and through global outreach and multidisciplinary collaboration, we aim to make education both accessible and rigorous. We imagine that, by 2065, education has transcended the limitations of place and privilege. Perhaps your training occurs in virtual operating theaters with real-time global mentors. Perhaps simulation and extended reality have replaced cadaver labs. Perhaps algorithms personalize learning to each trainee’s strengths and gaps. Yet even as your tools advance, we hope you continue to teach the art of listening to patients, to colleagues, and to the evidence itself. We hope that you see teaching as the transmission not only of skill, but of purpose.

We also hope that NASS remains a community where curiosity is celebrated, mentorship is reciprocal, and professional identity is shared across generations. Our early-career members today remind us that education is never one-directional; rather, it is a dialogue between those who came before and those who will lead next. May your educational culture be one that welcomes diverse voices, rewards innovation, and values the teacher as much as the learner. The Future of Spine Research Our commitment to research that improves lives binds NASS across our 40-year history. The questions we ask today are complex: How can we use data to personalize interventions? How do we measure recovery in ways that matter to patients? How can we design trials that reflect the diversity of real-world practice? We are standing at the intersection of clinical experience and computational power. Data networks are linking institutions around the world. Registries and patient-reported outcome measures are creating an unprecedented feedback loop between practice and discovery. The potential is breathtaking, but so is the responsibility. We hope that you, in 2065, have fulfilled the promise of data-driven care without losing sight of individual humanity. That your science is transparent, inclusive, and ethically grounded. That collaboration across disciplines and borders has replaced competition as the engine of innovation.

We imagine that the questions you ask are even bolder: not only how to repair the spine, but how to prevent degeneration; not only how to alleviate pain, but how to understand it; not only how to restore function, but how to enhance resilience. May your research remain guided by the same principle that founded NASS: that the ultimate endpoint of discovery is better care for people. The Future of Professional Community We write this letter as stewards of a Society that has become a global home for spine professionals. From a handful of members to thousands across continents, NASS has grown in influence and responsibility. We have learned that our greatest strength is not our size, but our shared purpose in advancing spine care through education, research, and advocacy. We hope that in 2065, NASS is still a place where ideas are exchanged freely and respectfully. That it remains an organization defined by integrity, curiosity, and service. That it continues to convene conversations that shape the world’s understanding of spine health. Our Message to You When you open this capsule in 2065, you will see names, images, and letters from people you have never met. You may marvel at the tools we used, the questions we asked, or the limitations we faced. We hope you also recognize something familiar – the same commitment to evidence, the same passion for teaching, the same reverence for the human spine – supporting everything that we do. We cannot predict what your world will look like, but we trust that the values guiding you are the same that guide us today: compassion, integrity, curiosity, and service. If our generation has done its part, you will inherit a field that is more inclusive, more data-driven, and more attuned to the patient’s experience than the one we entered. You will have the benefit of technologies we can scarcely imagine and the responsibility to use them wisely. Our charge to you is simple: keep asking better questions; keep teaching generously; and keep listening deeply to patients, data, and each other. The future of spine care is not written in code or cemented in bone; rather, it is built, moment by moment, through acts of understanding and empathy. With respect, hope, and gratitude, The North American Spine Society (NASS) On its 40th Anniversary (2025)