Nowadays, minimally invasive spinal surgery techniques (MISST) are the most publicized procedures. While patients expect that their surgeons provide this most up-to-date care, routine clinical practice in many healthcare systems still relies on the widespread utilization of traditional open spinal approach techniques. Reasons vary from implementation hurdles, such as higher cost or lack of robust clinical evidence to justify the transition from open surgery to MISST protocols, and inadequate surgeon training.

Postgraduate training programs often lag behind in teaching newer surgical treatment concepts and procedures. Many innovations are started by entrepreneurial spine surgeons in the private sector, where high-grade clinical evidence supporting these innovations is often missing. The combination of new technology, unfamiliar surgical approaches, and novel medical necessity criteria for intervention to alleviate spine pain creates a set of circumstances that may prove challenging even to motivated innovative spine surgeons. To some traditionally trained spine surgeons who have to decide whether to embrace new clinical protocols, they may even seem insurmountable. Consequently, many of them are either self-taught in MISST or carry on with their traditional practice.

This Special Issue aims to close the training and knowledge gap that spine surgeons may encounter between their postgraduate training and the day-to-day demands of their busy clinical practice. Judging the pitfalls and work involved in mastering the learning curve of the newer MISST correctly is one of the critical factors to succeed with the retooling of a well-established traditional spine surgery practice. Therefore, we intend to bring together experienced authors knowledgeable in the MISST practice transition dynamic. We welcome both original research and review articles.

Potential topics include but are not limited to the following:

• Current spine surgery training standards in postgraduate residency and fellowship training programs
• Future innovations in spine surgery
• The impact of artificial intelligence
• Economic drivers of modern spine care
• Pearls of full endoscopic anterior and posterior cervical foraminotomy
• Impact of the learning curve of contemporary minimally invasive spinal surgery techniques on clinical outcomes
• Surgeon skill level analysis as an independent predictor of clinical outcomes with modern minimally invasive spinal surgery techniques
• Cost-benefit analysis of modern navigation, robotics, and artificial intelligence (AI) technology applications to improve consistency in clinical outcomes
• Comparative complications analysis of minimally invasive lumbar microsurgical versus endoscopic decompression surgery
• Patient selection algorithms for mastering the learning curve for tubular retractor and endoscopic spinal surgery
• Clinical outcome analysis between university- and private practice-based postgraduate training programs in minimally invasive decompression of lumbar lateral canal stenosis