Abstract
BACKGROUND: Procedural and technical advances in spinal surgery, such as the utilization of minimally-invasive techniques, have evolved alongside the development and distribution of tools such as navigation, robotics, augmented reality (AR), dynamic visualization, and preoperative planning modules. Each innovative advancement in a surgeon's ability to see, measure, and manipulate human tissue entails an improvement or novel application of existing tools. Similarly, given the enormous economic and opportunity costs associated with the research and development of novel technologies, these efforts must be refined to address existing needs and infrastructure gaps. The successful application of enabling technologies such as robotics, navigation, and minimally-invasive techniques, is therefore dependent upon the expansion of new surgical tools and techniques. METHODS: We review numerous technological advances (Navigation, Intraoperative Imaging, Robotics, Augmented Reality, Computational Planning and Visualization) within the field of spine surgery and demonstrate their mutually beneficial, yet dependent, relationship with one another in advancing spine surgery technology through both expert opinion and published literature. RESULTS: We provide an overview of several different domains of enabling technology as they pertain to novel applications in spinal surgery and review current uses, limitations, and areas of potential improvement. CONCLUSIONS: The integration of augmented reality, robotics, visualization and navigational technologies, minimally invasive techniques, and other advanced tools have enabled the surgeon to perform both standard and novel procedures in unique ways.