Intelligent neurosurgery: technological convergence, clinical transformation, and future challenges

The development of neurosurgery has now entered a new stage of Intelligent Neurosurgery, driven by artificial intelligence (AI) as its core force. Intelligent Neurosurgery, grounded in modern neurosurgery, integrates cutting-edge technologies such as AI, machine learning, surgical robotics, brain-computer interfaces (BCIs), big data, digital twins, and neuromodulation. Through a human-machine collaborative model, it constructs an intelligent diagnosis and treatment system covering the entire process of “precise preoperative evaluation—intraoperative real-time navigation and assistance—meticulous postoperative management.” Its core technological pillars include deep learning-driven automated image segmentation and molecular subtype prediction, surgical robots achieving submillimeter precision, BCIs establishing direct communication pathways between the brain and external devices, multimodal data fusion integrating clinical, genomic, and imaging information to build predictive models for optimized decision-making, and digital twin and neuromodulation technologies enabling personalized treatment simulation and reversible neural regulation. Clinical applications now extensively cover maximal safe resection of brain tumors, personalized parameter optimization for functional disorders such as Parkinson’s disease and epilepsy, and minimally invasive interventional treatments for cerebrovascular diseases. Furthermore, Intelligent Neurosurgery demonstrates significant value in military medicine for the rapid, intelligent management of traumatic brain injury. However, challenges including data privacy, algorithmic accountability, ethical norms, and uneven technology dissemination remain critical obstacles to its development. The essence of Intelligent Neurosurgery lies in empowering traditional disciplines with cutting-edge technologies to form an intelligent control system, ultimately achieving “patient-centered” precision medicine. Future directions will focus on the evolution of core technologies from assistance towards semi-autonomy, the construction of smart operating rooms and remote collaboration, and the expansion from disease treatment to neural function enhancement. The establishment and promotion of this system will reshape the paradigm of neurosurgical diagnosis and treatment by balancing technological innovation with ethical norms, ultimately delivering preciser, safer, and more efficient medical services to patients worldwide.