Minimally invasive spine surgery with endoscopy, navigation, robotics, and artificial intelligence: Clinical evidence and future directions

Table 2 Comparison of surgical techniques and indications

Technique	Indications	Advantages	Disadvantages
Endoscope-assisted decompression	DDD; spinal canal stenosis	Minimal tissue trauma, rapid recovery, and reduced intraoperative blood loss; high-resolution imaging improves surgical visualization	Limited indications; steep learning curve; high operative complexity
Percutaneous endoscopic discectomy	Mild to moderate disc herniation	Small incision, less postoperative pain, shorter hospital stay; reduced soft-tissue disruption	Restricted endoscopic field of view and relatively narrow indications; requires high technical precision
Robot-assisted surgery	Spinal deformity correction; multilevel spinal fixation	High surgical accuracy and reduced human error; improves pedicle screw placement accuracy and lowers complication rates	High equipment cost and demanding training requirements; complex system maintenance
3D fluoroscopy and real-time navigation	Spinal fixation procedures; pedicle screw placement	High accuracy; lowers the risk of screw misplacement; real-time imaging shortens operative time and reduces radiation exposure	Requires substantial radiation exposure; depends on expensive imaging equipment

DDD: Degenerative disc disease; 3D: Three-dimensional.