This study aimed to analyze the evolving paradigms in spine surgery training driven by technological innovation and ethical imperatives, and to propose an integrated framework for contemporary spine surgical education. A narrative review of the current literature, educational models, and technological advancements was performed, with a focus on advanced training methods such as simulation, augmented reality (AR), virtual reality (VR), robotics, and artificial intelligence (AI). The review critically assessed the ethical landscape and global disparities in training access. Frameworks from leading spine societies and training centers were examined to identify trends and gaps. Technological tools, including high-fidelity simulators, robotic platforms, and AR/VR modules, have demonstrated effectiveness in enhancing trainee performance, reducing intraoperative errors, and supporting ethical learning environments. Nevertheless, significant challenges persist, including high costs, cultural resistance, a lack of curriculum standardization, and unequal global access. Emerging solutions include competency-based progression models, modular continuing professional development pathways, and AI-driven personalized learning. Spine surgery education must shift from traditional apprenticeship models to a technology-enabled, ethically grounded, and competency-based approach. Simulation, robotics, AI, and mixed-reality platforms can offer safe, standardized, and globally scalable solutions for surgical training. Collaborative action among institutions, policymakers, and professional societies is essential to democratize access and establish universal benchmarks for modern spine education.
Balamurali et al. (Thu,) studied this question.