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This article discusses a systematic review of the state-of-the-art on augmented reality (AR) and virtual reality (VR) in spinal navigation, where early clinical validations have shown promising outlook on accuracy and scalability parameters. The objective of this research is to evaluate clinical relevance for AR–VR enabled spinal surgical technologies and develop an economic feasibility model for stakeholders, such as patients, hospitals, and research organizations with technology adoption. From the influencing parameters, we identified the research gaps that can be explored going forward and a list of high priority research challenges that could provide an attractive research and development investment case for industry players. [ABSTRACT FROM AUTHOR]