Disruptive technologies in spine surgery: current trends, outcomes, and ethical implications

Disruptive technologies are reshaping the landscape of spine surgery by enhancing precision, improving patient outcomes, and transforming surgical training and planning. This review explores the integration of augmented reality (AR), virtual reality (VR), patient-specific implants, endoscopic techniques, advanced navigation, and robotics in spine surgery. Preoperative applications include immersive VR-based resident training and AR-assisted surgical planning, which have demonstrated improved accuracy and confidence in trainees. Patient-specific surgeries leverage advanced segmentation and 3D printing to tailor implants and procedures to individual anatomy. Intraoperative technologies such as endoscopic and robot-assisted spine surgery offer minimally invasive alternatives with favorable recovery profiles, while neuronavigation improves workflow and reduces radiation exposure. Despite their potential, these innovations face challenges related to high costs, limited accessibility, and the need for rigorous validation. This narrative review highlights current trends, clinical outcomes, and ethical considerations in the adoption of these technologies, emphasizing the importance of equitable implementation and standardization of outcomes and training across diverse healthcare settings.