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Techniques and technology for spinal surgery have evolved together throughout the past few decades.  There has been a growing popularity of image-guided surgery that has now progressed to robotic-assisted surgery with many FDA approved image-guided surgical robot systems now widely available such as Medtronic’s Mazor X Stealth™ Edition robotic guidance system or Globus Medical’s ExcelsiusGPS® Robotic Navigation Platform.  As this trend continues, it is important to understand the basis for these technologies and examine the benefits and trajectories to improve safety and effectiveness going forward.  In this review we examine the history, currently available technology, and the multiple benefits that have been studied regarding image-guided navigation and robotics in spine surgery.