The Role of Enabling Technologies in the Surgical Management of Cervical Spine Deformity

Study Design: – Narrative literature review. Objective: – To review the current evidence and technological advancements related to enabling technologies, including navigation, robotics, and extended reality (XR) for the surgical management of cervical spine deformity, with a focus on their safety, efficacy, and limitations. Summary of Background Data: – Cervical spine deformity is associated with significant morbidity due to neurological compromise and structural imbalance. Surgical correction often involves complex decompression and instrumentation in high-risk anatomical zones. Recent advances in enabling technologies have been increasingly applied to spinal surgery, demonstrating improvements in accuracy, safety, and clinical workflow. However, literature specifically addressing their use in the cervical spine, especially in deformity cases, remains limited. Methods: – A comprehensive review of published studies was performed to assess the application of enabling technologies in cervical spine deformity surgery. Databases were searched for studies involving computer-assisted navigation, robotics, and augmented or virtual reality in cervical procedures, with particular attention to deformity correction, instrumentation accuracy, and perioperative outcomes. A total of 119 studies were reviewed, and the 35 most relevant to cervical spine deformity were included for this review. Results: – Enabling technologies have demonstrated improvements in screw placement accuracy, reductions in radiation exposure, shorter hospital stays, and improved visualization during cervical spine surgery. Navigation systems have been particularly useful in high-stakes regions such as C1-C2 and the subaxial spine, while robotics has enabled precise, reproducible instrumentation in complex or revision cases. Extended reality applications, including AR and VR, offer enhanced 3D visualization and are emerging as tools for both intraoperative support and surgical training. Despite promising early results, limitations include steep learning curves, cost barriers, and limited data on long-term patient-reported outcomes. Conclusions: – Enabling technologies are transforming cervical spine surgery by improving accuracy, safety, and surgical efficiency. Given the anatomical complexity and risks involved, their application in cervical deformity correction holds particular promise. Future studies should aim to standardize protocols and assess long-term outcomes to optimize their integration into surgical practice.