The article "Image-Guided Navigation in Spine Surgery: From Historical Developments to Future Perspectives" by John Preston Wilson, Jr., Lane Fontenot, Caleb Stewart, Deepak Kumbhare, Bharat Guthikonda, and Stanley Hoang provides a comprehensive overview of the evolution and current state of image-guided navigation in spine surgery. The authors highlight the critical role of intraoperative navigation in ensuring accurate instrumentation placement and discuss the advancements from early fluoroscopy to modern robotic-assisted systems. They emphasize the importance of maintaining navigation accuracy through the use of internal fiducial markers and the benefits of reduced revision surgeries and postoperative complications. The article also explores the historical development of imaging modalities, including X-ray, CT, and MRI, and their impact on surgical techniques. It further discusses the current state of image-guided navigation, including active and passive navigation systems, 2D versus 3D navigation, and advanced technologies such as machine vision and augmented reality. The technical aspects of image-guided navigation, such as preoperative planning, image registration, dynamic instrument tracking, and real-time visualization, are detailed. Finally, the authors conclude by discussing the clinical workflow using navigation-guided technology and the future directions for making navigation technology a standard of care, focusing on cost reduction, education, and system advancement.The article "Image-Guided Navigation in Spine Surgery: From Historical Developments to Future Perspectives" by John Preston Wilson, Jr., Lane Fontenot, Caleb Stewart, Deepak Kumbhare, Bharat Guthikonda, and Stanley Hoang provides a comprehensive overview of the evolution and current state of image-guided navigation in spine surgery. The authors highlight the critical role of intraoperative navigation in ensuring accurate instrumentation placement and discuss the advancements from early fluoroscopy to modern robotic-assisted systems. They emphasize the importance of maintaining navigation accuracy through the use of internal fiducial markers and the benefits of reduced revision surgeries and postoperative complications. The article also explores the historical development of imaging modalities, including X-ray, CT, and MRI, and their impact on surgical techniques. It further discusses the current state of image-guided navigation, including active and passive navigation systems, 2D versus 3D navigation, and advanced technologies such as machine vision and augmented reality. The technical aspects of image-guided navigation, such as preoperative planning, image registration, dynamic instrument tracking, and real-time visualization, are detailed. Finally, the authors conclude by discussing the clinical workflow using navigation-guided technology and the future directions for making navigation technology a standard of care, focusing on cost reduction, education, and system advancement.