Essential innovations in spinal surgery: Contributions from the French school - 13/08/26

Doi : 10.1016/j.otsr.2026.104842

Laura Marie-Hardy ^a,⁎ , Léonard Chatelain ^b, Charlie Bouthors ^c, Solène Prost ^d, Christian Garreau de Loubresse ^b, Charles Court ^c

^a Orthopaedic Surgery Department, Hôpital de la Pitié-Salpétrière, 43-87 bd de l’Hôpital, 75013 Paris, France

^b Orthopaedic Surgery Department, Hôpital Européen Georges Pompidou, 20 rue Leblanc, 75015 Paris, France

^c Orthopaedic Surgery Department, Hôpital du Kremlin-Bicêtre, 78 rue du Général Leclerc, 94270 Le Kremlin-Bicêtre, France

^d Orthopaedic Surgery Department, AP-HM Hôpital de la Timone. 264 Rue Saint-Pierre, 13005 Marseille, France

^⁎ Corresponding author.

Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Thursday 13 August 2026

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.

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Keywords : Sagittal balance concepts (Stagnara/Duval-Beaupère/Legaye/pelvic incidence/sacral slope/pelvic tilt), Scoliosis correction (Cotrel-Dubousset instrumentation/rod rotation/cone of economy/EOS^® imaging), Patient-specific spinal planning (Keops software/custom rods/spinopelvic targets/SVA-PI-LL mismatch), Disc replacement (Prodisc^® lumbar prosthesis/Mobi-C^® cervical prosthesis/adjacent segment degeneration), Pedicle Screw safety (Roy-Camille fixation/PediGuard^®/electrical conductivity/Smart Screw), Vertebral fracture management (percutaneous vertebroplasty/SpineJack^®/cementoplasty/kyphosis correction)