AO Spine International

Dear colleagues of 2065,

On behalf of AO Spine International, it is an honor to leave this message as part of the North American Spine Society’s 40th Anniversary Time Capsule.

In 2025, spine care is defined by both unprecedented challenges and remarkable advances. We live in a world where the burden of spinal disorders is increasing due to aging populations, rising expectations for quality of life, and the growing demand for safe, accessible, and affordable care. At the same time, we face disparities in access to surgical expertise and technology, particularly in less privileged regions. These inequalities remain one of the greatest challenges for our global community.

Yet, the past decades have brought extraordinary progress. We have seen minimally invasive and endoscopic techniques evolve from experimental approaches to standard practice in many centers, reducing patient morbidity and recovery time. We have witnessed the integration of artificial intelligence and big data into diagnostics, surgical planning, and even intraoperative decision-making. Advances in biologics and regenerative medicine are beginning to transform the way we think about healing and recovery. And, perhaps most importantly, education has become increasingly global, digital, and interactive, enabling knowledge to flow across borders more freely than ever before.

AO Spine, as the largest international community of spine surgeons, researchers, and educators, has embraced this transformation. Our strength lies in the diversity of our members: surgeons from every continent, representing different systems, resources, and experiences, united by a shared commitment to improve patient care. We do not believe that innovation belongs to one country or one region alone. Instead, we are convinced that progress comes from collaboration—listening to and learning from each other, across cultures and geographies.

To those of you reading this in 2065, I must confess a certain healthy envy—not because I do not value and enjoy the time in which I live, but because I am deeply curious to know how the advances we now only glimpse have matured in your era. How have robotics, artificial intelligence, and biologics transformed surgery and recovery? How has education evolved to train surgeons in ways we cannot yet imagine? And, most importantly, how has global cooperation continued to expand and strengthen?

Despite these questions, I also carry a hope: that the patient and their family remain, in your time as in ours, at the center of everything we do. Technology, science, and progress must never overshadow the human connection, the compassion, and the responsibility that define us as physicians.

Accompanying this message, I share with you a short video highlighting our latest global congress, held in Rio de Janeiro in May 2025. I hope you find it both enjoyable and interesting to see how our activities looked in our days, and that you may compare them with the ones you are experiencing in yours. https://youtu.be/xssZ6Eskjj

As Chair of AO Spine International in 2025, I am privileged to lead an organization that believes no single surgeon, no single institution, and no single country can face these challenges alone. It is only together—through shared knowledge, mutual respect, and the pursuit of excellence—that we can truly advance spine care for the benefit of all.

With respect, gratitude, and hope for your journey ahead,

Juan Emmerich

Chairperson, AO Spine International