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

Table 5 Future directions and research priorities

Research area	Objectives	Potential clinical impact	Technological applications
AI	Optimize preoperative planning, real-time intraoperative navigation, and postoperative complication prediction	Improve surgical precision and safety; reduce postoperative complications	AI-based imaging analysis; intelligent intraoperative monitoring systems
Personalized medicine	Develop individualized treatment strategies based on patient-specific genetic and anatomical characteristics	Increase surgical success rates; reduce risks associated with inter-individual variability	Genomic profiling; 3D-printed patient-specific implants
Novel biomaterials	Promote spinal tissue regeneration and enhance implant biocompatibility	Accelerate postoperative healing; reduce inflammation and procedure-related complications	Nanofiber scaffolds; bioactive glass; hydrogels and other regenerative materials
Tele-surgery and virtual reality	Enable remote surgical guidance and real-time training; shorten the learning curve	Improve healthcare quality in underserved regions; reduce training time and cost	Remote robotic surgery; virtual surgical simulation; augmented-reality-based navigation systems

AI: Artificial intelligence; 3D: Three-dimensional.