Applications of Computer-Assisted and Robotic Navigation in Anterior Cervical Spine Surgery: A Scoping Review.

Computer-assisted navigation and robotic guidance have become increasingly adopted in spine surgery to improve anatomical localization, trajectory planning, and implant placement accuracy. However, their application in anterior cervical spine surgery remains limited and heterogeneous. This scoping review aimed to map the available clinical evidence regarding the applications, technological evolution, safety, and reported accuracy of computer-assisted and robotic navigation in anterior cervical procedures. The review was conducted in accordance with the PRISMA extension for Scoping Reviews and the methodological framework proposed by Arksey and O'Malley. PubMed/MEDLINE was searched for English-language clinical studies published between January 2010 and December 2025. Reference lists of included articles were also manually screened. Eligible studies reported the use of computer-assisted navigation or robotic guidance in anterior cervical spine surgery. Study characteristics, surgical indications, navigation platforms, technical strategies, and clinical outcomes were extracted and qualitatively synthesized. Fourteen studies met the eligibility criteria. The evidence consisted predominantly of case reports and small case series, with only a limited number of retrospective observational studies. Navigation was used for anterior cervical discectomy and fusion, corpectomy, transcorporeal microforaminotomy, odontoid screw fixation, and complex anterior instrumentation. O-arm-based navigation and StealthStation were the most frequently reported platforms. Alternative reference-frame strategies included Mayfield-, Caspar retractor-, and clavicle-mounted systems. The included studies generally reported technically successful procedures, acceptable implant positioning, neurological or symptomatic improvement, and few complications; however, outcome definitions and follow-up were inconsistent. Computer-assisted and robotic navigation appear feasible for selected anterior cervical procedures, particularly in anatomically complex cases. Nevertheless, the available evidence remains limited, heterogeneous, and predominantly low-level. Prospective comparative studies using standardized outcome measures are required before definitive conclusions regarding clinical superiority, long-term effectiveness, or cost-effectiveness can be established.