Optical Navigation, Fluorescence-Guided Surgery, and Artificial Light Technologies in Modern Neurosurgery: Advancing Precision Surgical Visualization

Technological advances in optical imaging and artificial light technologies have substantially transformed modern neurosurgical practice by improving intraoperative visualization and surgical precision. This narrative review evaluates current applications of fluorescence-guided surgery, optical navigation systems, near-infrared imaging, augmented visualization platforms, and artificial intelligence-assisted intraoperative imaging in neurosurgery. Particular attention is given to clinically established fluorophores, including 5-aminolevulinic acid, fluorescein sodium, and indocyanine green, which are increasingly used for tumor delineation, vascular assessment, and real-time tissue perfusion analysis. Emerging technologies such as Raman spectroscopy, multispectral imaging, holographic navigation, and nerve-specific fluorescent probes are also discussed in the context of precision and minimally invasive neurosurgery. Current evidence demonstrates that advanced optical systems improve surgical orientation, maximize extent of resection, and support preservation of critical neurovascular structures, particularly in neuro-oncology, vascular neurosurgery, and skull base surgery. However, limitations related to fluorescence specificity, standardization, cost, and technological accessibility remain significant challenges. The continued integration of multimodal optical imaging, computational navigation, and AI-assisted visualization is expected to further enhance intraoperative decision-making, surgical safety, and postoperative outcomes, contributing to the future development of precision image-guided neurosurgery.