While some seasoned spine surgeons may express skepticism towards the increasing integration of technology in the operating room, the vast majority acknowledge the undeniable impact that enabling technology has had in propelling the field of spine surgery forward. Advancements in technology have revolutionized the landscape of spine surgery, offering unprecedented levels of safety and efficacy for patients undergoing such procedures. These technological innovations encompass a wide array of tools and techniques, ranging from spinal navigation, the development of minimally invasive surgical instruments, and robot-assisted surgical systems.
The advent of spinal navigation has transformed the techniques of both non-instrumented and instrumented surgery. Currently, the most widely used navigation system utilizes a CT-guided system that allows the surgeon to identify critical structures in real-time with high precision [1]. By far, the most prevalent application of spinal navigation is in the instrumentation of the spine. Many surgeons have found that the use of intra-operative navigation can improve the reliability, accuracy, and safety of pedicle screw placement. Nevertheless, there are certain barriers to achieving error-free navigation in the span of a surgeon’s career. The medical community eagerly anticipates breakthroughs in navigation that could ensure flawless usage.
Technological advancements in intra-operative medical devices have granted the creation of many surgical tools and techniques to perform minimally invasive spine surgery successfully. Although introduced decades ago and already adopted in many European and Asian countries, endoscopic spine surgery has been a popular topic amongst spine surgeons of late. Over the past few years, improvements in the endoscope to allow enhanced visualization, has stimulated endoscopic spine surgery technique that includes cervical, thoracic, and lumbar approaches. Once thought of as implausible, endoscopic spine surgery has shown promising outcomes as an ultra-minimally invasive technique [2]. Endoscopic spine surgery is just one example of many of how enabling technology can have an influence on trends in surgical technique.
In regards to neurosurgical education, cutting-edge technology like virtual reality (VR), augmented reality (AR), and mixed reality (MR) are increasingly recognized as a driving force and pivotal elements for enhancing spine operative skills and surgical learning without compromising patient care [3]. These technologies have demonstrated remarkable potential in enhancing operative skills and facilitating surgical learning, all while upholding the highest standards of patient care [4]. Various applications across the extended reality spectrum have undergone thorough evaluation, consistently yielding reliable outcomes. Nevertheless, despite promising results, the integration of these technologies is still in its infancy and requires a unified educational consensus for neurosurgical education and training. The transformative possibilities presented by these innovations are revolutionary, particularly in the context of spine surgery, where they can enhance preoperative planning, resident education, and possibly educative global impacts.
Robotic-assisted spine surgery represents a significant leap forward in surgical technology, offering promising advancements for surgeons. Currently, several robotic systems are available from various manufacturers, providing spine surgeons with a range of options. Among its diverse applications, robotic assistance shines most notably in pedicle screw placement. While studies assessing the accuracy of robotic-assisted pedicle screw placement have yielded mixed findings [5,6], there is widespread recognition of the need for continued refinement and enhancement of these robotic systems. The enthusiasm for advancing this technology among spine surgeons underscores its importance. Considering the successful integration of technology in the operating room, it is imperative that spine surgeons actively support and foster the development of robotic-assisted spine surgery.
In conclusion, the integration of technology into spine surgery has propelled the field forward, offering enhanced safety and efficacy for patients. From the implementation of spinal navigation systems to the development of minimally invasive surgical techniques and the advent of robotic-assisted surgery/extended reality technologies, technological innovations have reshaped the way spine surgeries are performed. While challenges and barriers remain, such as achieving error-free navigation and further refining robotic systems, the commitment of spine surgeons to advancing these technologies is evident. Embracing and encouraging the ongoing development of technology in the operating room will undoubtedly continue to drive improvements in patient outcomes and further solidify the role of technology as a cornerstone of modern spine surgery practices. As we look towards the future, continued collaboration between surgeons and technology developers will be essential in harnessing the full potential of these advancements and ensuring that patients receive the highest standard of care.
