Motion Preserving, Fusion-Free Spine Care

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    Motion-Preserving Spine Treatments

    Lumbar Total Joint Replacement (MOTUS)

    Restore function and motion without fusion

    Currently in ongoing US IDE study. Patient enrollment is complete and is pending final data collection

    Living With

    Severe back pain doesn’t have to mean a lifetime of limitations

    Chronic low back pain can slowly take away your independence. Simple activities like walking, exercising, traveling, or even sitting comfortably can feel exhausting or impossible. Many patients are told their only option is spinal fusion, a procedure that permanently limits motion.

    At Spine Motion Specialists, we believe your spine was designed to move. That belief is what led Dr. Scott Hodges to invent the MOTUS Lumbar Total Joint Replacement. After more than 35 years as a spine surgeon and decades studying biomechanics, Dr. Hodges saw firsthand the limitations of fusion and set out to create a better solution, one focused on restoring motion, function, and quality of life.

    MOTUS was designed as a true alternative to fusion, offering patients a way to regain movement instead of losing it. This procedure reflects Dr. Hodges’ lifelong commitment to advancing spine care and putting patients first.

    What is it?

    MOTUS is an innovative, first-of-its-kind total joint replacement for the lumbar (lower) spine that replaces both the intervertebral disc and the facet joints in a single motion-preserving procedure. 

    Unlike traditional spinal fusion, which permanently locks two vertebrae together, MOTUS is designed to restore natural motion and balance by reconstructing the entire joint unit of the spine. This emerging technology aims to provide comprehensive stability and motion in patients with degenerative lumbar conditions that have historically required fusion surgery.

    Who is a

    Good Candidate

    Lumbar total joint replacement may be an option for patients who:

    • Have degenerative spine conditions including:
      • facet arthropathy and/or arthritis
      • spinal instability
      • spinal stenosis
      • Spondylosis (grade 1)
      • disc degeneration
    • Have chronic low back pain
    • Have failed conservative treatments
    • Would traditionally be candidates for spinal fusion
    • Want to preserve motion and avoid fusion

    Important note:

    The MOTUS device has been designated a Breakthrough Device by the FDA and is being studied under an Investigational Device Exemption (IDE) trial in the U.S. with expected study completion in 2026. Enrollment for the U.S. trial has included several hundred participants across multiple states, with comparative groups matched to standard fusion procedures. Early outcome publications indicate encouraging results, showing greater improvements in measures of pain and disability compared to traditional fusion at one year in pilot and preliminary studies published in peer-reviewed spine journals. The full IDE trial outcomes and long-term effectiveness data are still pending as MOTUS continues through its regulatory process.

    What Happens

    During The Procedure

    The MOTUS procedure is performed through a posterior approach (through the back), allowing direct access to the affected spinal segment.

    During the procedure:

    • The surgeon accesses the spine from the back
    • Both damaged facet joints are removed
    • The diseased spinal disc is removed
    • The MOTUS implants are positioned bi-laterally to replace the entire joint

    Once the implants are placed, its dual bearing components are designed to mimic the natural mechanics of the spine. This allows the implant to resist rotation and shear forces while supporting axial loads, similar to how a healthy disc and facet joints function together.
    Advanced imaging and surgical planning are used throughout the procedure to ensure precise alignment, proper posture restoration, and nerve decompression when needed.

    Similar to a knee or hip replacement, MOTUS replaces the entire functional joint complex, restoring both the stabilizing role of the facet joints and the mobility normally provided by the disc. This comprehensive approach helps recreate natural movement while maintaining stability.

    What are the benefits

    Lumbar Total Joint Replacement using the MOTUS system is designed to reconstruct the entire functional spinal joint rather than eliminating motion through fusion. The goal of this technology is to restore both mobility and stability by addressing all components of the motion segment.

    Restores motion at the treated level

    Unlike fusion, which permanently locks two vertebrae together, MOTUS is designed to preserve movement at the treated segment. The dual bearing components of the implant are engineered to mimic the natural mechanics of the spine, allowing controlled motion in multiple directions.

    Addresses the entire joint complex

    MOTUS replaces both the spinal disc and the facet joints, treating the full motion segment. This is similar to a hip or knee replacement, where the entire joint is reconstructed rather than just one component. By addressing all joint structures, the procedure is designed to restore more natural biomechanics.

    Designed to resist abnormal forces

    The implant is engineered to resist rotation and shear forces while supporting axial loads, similar to how healthy disc and joint structures function together. This design helps maintain stability while still allowing movement.

    Targets multiple pain generators

    By replacing the disc and facet joints and allowing for decompression when needed, MOTUS is designed to address all three major sources of pain

    • Disc related pain
    • Facet joint degeneration
    • Nerve compression

    This comprehensive approach is intended to treat the underlying structural causes of pain rather than just one component.

    Preserves spinal alignment and posture

    Advanced imaging and surgical planning are used to achieve precise implant positioning and alignment, with the goal of restoring posture and balanced spinal mechanics.

    Alternative to fusion

    MOTUS was developed specifically as a motion preserving alternative to spinal fusion for patients who would traditionally require fusion due to advanced degeneration. The goal is to maintain function rather than restrict it.

    For many patients, this means

    Lasting pain relief without sacrificing mobility.

    Why Spine Motion Specialists?

    Your care plan is built around your goals, your movement, and your lifestyle, never a protocol.

    Dr. Scott Hodges brings 35+ years of experience and a deep understanding of spine biomechanics to every patient visit.

    • Fusion-free philosophy

    • Motion-preserving expertise

    • Concierge, one-on-one care

    • Extended 60–90 minute consults

    • Virtual visits available for travel patients

    Lumbar Total Joint Replacement (MOTUS)

    Frequently Asked Questions

    MOTUS has received FDA Breakthrough Device designation and is completing its FDA IDE study. Patient enrollment is complete and is pending final data collection.

    Traditional disc replacement only addresses one part of the joint, the spinal disc. While this can be very helpful for patients whose pain is coming primarily from the disc, many people with more advanced degeneration also have damage to the facet joints, which play a major role in stability and motion.

    For patients with isolated disc related issues, Dr. Hodges also offers cervical and lumbar disc replacement as a motion preserving solution designed to relieve pain while maintaining natural movement.

    MOTUS is a true total joint replacement, similar to a hip or knee replacement. It replaces both the disc and the facet joints, recreating the full function of the spinal segment.

    By addressing all three major pain generators, the disc, the facet joints, and nerve compression, MOTUS helps restore motion while maintaining stability. This comprehensive approach allows the spine to move naturally while preventing abnormal motion that causes pain.

    Facet replacement focuses on only one part of the joint, the facet joints. While this can be very effective for patients whose pain is primarily coming from those joints, it does not address problems within the spinal disc itself.

    MOTUS is a true total joint replacement, meaning it treats the entire motion segment of the spine. This includes both the disc and the facet joints. Just like a hip or knee replacement, MOTUS recreates the full function of the joint, not just one component.

    By addressing all major sources of pain, the disc, the facet joints, and nerve compression, MOTUS restores motion while maintaining stability. This comprehensive approach allows the spine to move naturally while preventing the abnormal movement that causes pain.

    For patients whose pain is isolated to the facet joints, Dr. Hodges also offers TOPS facet replacement, a motion preserving option designed specifically for degenerated or arthritic facets.

    MOTUS is currently being evaluated in an FDA Investigational Device Exemption (IDE) clinical study and is not yet available for general clinical use. Enrollment in this study is now complete, and the anticipated completion timeline is sometime in 2026.

    At this time, MOTUS is only available to patients who qualified and were enrolled in the clinical trial. Dr. Hodges, as the inventor of this technology and a leading expert in lumbar total joint replacement, continues to follow outcomes closely as the study progresses.

    For updates on when MOTUS may become commercially available in the United States, you can return to this site or visit www.3Spine.com for the latest information.

    In the meantime, Dr. Hodges offers other motion preserving treatment options including disc replacement and facet joint replacement for patients who may be appropriate candidates.

    This is one of the most common things we hear from patients. Many people are told that spinal fusion is their only path forward, especially when both the disc and facet joints are damaged. For years, fusion was the only surgical option available for these complex cases.

    This is exactly why Dr. Hodges invented Lumbar Total Joint Replacement and founded Spine Motion Specialists. After more than 35 years as a spine surgeon, he saw firsthand how fusion often limited mobility, changed biomechanics, and placed added stress on nearby spinal levels. He believed patients deserved a better option.

    MOTUS was designed to be a true alternative to fusion, focused on restoring motion and function instead of eliminating it. By replacing the entire joint, both the disc and facet joints, this procedure helps maintain natural movement while still providing stability.

    For many patients, this means:

    • Greater freedom of movement
    • Less stiffness long term
    • Reduced stress on surrounding spinal levels
    • A more natural feeling spine

    Fusion may still be appropriate in certain situations, but at Spine Motion Specialists, our goal is to explore every motion preserving option first. A consultation with Dr. Hodges can help determine whether a fusion free alternative may be right for you.

    The MOTUS implant is designed for long term durability and to handle the normal stresses of daily movement. It is engineered using advanced materials similar to those used in hip and knee replacements.

    Ongoing clinical research continues to evaluate long term outcomes, but the goal is for MOTUS to provide lasting pain relief and sustained function. Dr. Hodges will discuss what current data shows and how it applies to your specific situation.

    Take the next step

    Not sure if Lumbar Total Joint Replacement is right for you?
A consultation can help you understand your options and make a confident decision.