Becker’s Healthcare -- Spine and Orthopedic Podcast
James Mooney, Assistant Clinical Professor of Neurosurgery in the Division of Spine Surgery at Virginia Commonwealth University (VCU) | MCV Physicians
02 Dec 2025
On this episode, James Mooney, Assistant Clinical Professor of Neurosurgery in the Division of Spine Surgery at Virginia Commonwealth University (VCU) | MCV Physicians, joins the podcast to discuss the rapidly evolving future of spine surgery. He explores how AI is helping standardize clinical decision-making, the continued growth of minimally invasive and patient-specific technologies, and what increasing AI involvement means for the spine field in the years ahead.
Chapter 1: What is the background of Dr. James Mooney?
This is Carly Beam with the Becker's Spine and Orthopedics Podcast, and today I'm thrilled to be joined by Dr. James Mooney, a spine surgeon at Virginia Commonwealth University. Dr. Mooney, thank you so much for being here today.
Thanks for having me, Carly. I've listened to Becker's in the past, and I think you guys do a great job covering the healthcare system, so I really appreciate the opportunity.
Absolutely. And thank you for your kind words as well. Before we dive into our questions, can you just introduce yourself and share more about your background?
Yeah, so my name is James Mooney. I'm a complex and minimally invasive spine surgeon here at Virginia Commonwealth University in Richmond, Virginia. I'm a new faculty. I did my training down in Birmingham, Alabama at the University of Alabama for seven years in neurosurgery residency, and then I was up in Pittsburgh, Pennsylvania for a complex and minimally invasive spine deformity fellowship.
I'm so excited to be in Richmond and growing the program here.
Yeah, it sounds like you have a lot of expertise and just the full gamut of spine surgery. Can you talk about some of the biggest spine trends that you're following in healthcare?
Yeah, of course. So I think, you know, with any field, artificial intelligence is at the forefront of everyone's minds. And so from my standpoint as a complex spine surgeon, you know, I think about what are the areas that AI is going to assist us with in the OR. And so I think there's a number of categories as far as planning for these bigger spine deformity surgeries.
So, you know, that ranges from radiographic planning to the execution of complex spine surgeries. You know, ultimately, I think we're heading towards a future where every surgery is ultimately planned and executed according to evidence-based And that's multifactorial where AI can, number one, help us choose who to operate on. Number two, help us construct our surgical plans.
And then lastly, help us execute the plan in the OR and monitor our progress towards our preoperative goals intraoperatively. And then I think really the next frontier for artificial intelligence and healthcare as a whole and specific to spine surgery is incorporating these AI paradigms into our clinical decision-making.
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Chapter 2: What are the biggest trends in spine surgery today?
Yeah, thank you for breaking that down. And I want to ask you, I know you have a unique perspective having training in both complex spine surgery and minimally invasive. And, you know, obviously there is, we're seeing more technologies and trends towards minimally invasive surgery.
But, you know, why is it important for minimally invasive spine surgeons to kind of understand the complex and vice versa?
Yeah, that's a terrific question. And so I think one of the reasons I did the fellowship was to really understand which patients to operate on in terms of who's right for a particular procedure. And in my mind, starting out as a surgeon, my goal is to offer the patient the least invasive surgery that we can offer to achieve the goals of surgery. And so a lot of times in these cases,
I'm being sent patients that have big scoliotic deformities or issues that radiographically you would want to, if you didn't hear about the patient's symptoms, you could offer a large surgery.
But when you actually talk to the patient and figure out that this might be a single nerve that's affected, that minimally invasive decompression could give them years of relief before they need a big surgery. And having that minimally invasive training has been very helpful in working these patients up and being able to offer them the least invasive approach.
And then, you know, anytime you operate on a patient, if you fuse a segment of the spine, you're subjecting the rest of the spine to more motion and potential breakdown and need for future surgeries. So really... My deformity training has helped me understand angles and preoperative planning, even for a small, single-level surgery.
It's really important to get that correction, even if you're doing a single-level 5-1 or 4-5 fusion. In the grand scheme of things, if you get that wrong, you're setting the patient up for many future surgeries. So I think that's where my minimally invasive training, UAB, is combined with the deformity training to really help me be able to offer a full gamut of spine procedures to patients.
Definitely. And I was wondering, what do you think will be the one true disruptor to spine surgery next year?
Yeah, within the next year, I think AI is going to continue improving outcomes and You know, it's yet to be seen the full extent of where ultraminimally invasive surgery is going to head. I'm actively following that as well. But I think it's going to be, you know, not one single factor, but a combination of all of these things that are intersecting at such an exciting time where you have
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