Exoscope Visualization, Navigation Guidance, and Robotic Precision in Spine Surgery

Advancements in technology have ushered in a new era in spine surgery, offering innovative tools and techniques that improve surgical precision, efficiency, and safety. By exploring emerging technologies and techniques for minimally invasive spine surgery (MISS), providers may better address the challenges posed by spine pathology in an aging population and the imperative for refined surgical strategies to optimize outcomes of patient well-being. This narrative review analyzes studies exploring emerging technologies in MISS that contribute to better visualization and surgical accuracy, highlighting their respective surgical indications, objective reports of patient outcomes and user experiences, limitations in their use, and barriers to widespread implementation. This paper examines a spectrum of MISS technologies, including exoscope-assisted procedures, navigation-guided surgery, and robotic-assisted techniques for a range of spinal pathologies. The findings demonstrate enhanced preoperative knowledge and planning, as well as improved intraoperative precision and visualization, which may minimize tissue injury, surgical time, and postoperative complications. These technologies also enable more ergonomic surgical positioning for physicians and improved displays of the surgical site to the entire surgical team. Despite the potential benefits of these emerging technologies, the high costs of equipment and maintenance, as well as limited opportunities for sufficient training associated with their implementation, continue to pose limitations for supplementing or replacing existing surgical techniques.