## 4 Discussion  
A critical review of the literature on the discussed topic in four major bibliographic databases (PubMed. Web of Science, Scopus, dblp) yielded 65 publications, including only 20 in the last 10 years (2016-2025, Figures 8-11). No lead authors, their affiliations (research teams) or funding sources were observed. The main Sustainable Development Goal (SDG) is good health and well-being. Figure 11: Documents by country. Figure 10: Documents by area. Figure 9: Documents by type. More than half of the studies fall within the discipline of medicine, and studies using AI/ML are few (Figure 10). A particularly important area of research is the undertaking of minimizing or eliminating risk factors in the patient's condition before and after spinal surgery with implants. Negative consequences should be prevented or limited [14]. Biomaterials in implants currently used are not fully tested for their safety and comfort. The development of these biomaterials will contribute to safer and more effective wound healing and improved therapy efficiency [15]. Subcortically implanted microchips (without disturbing the surrounding tissues) offer hope for a new, non-pharmacological approach to treating some neurological deficits. In the study, animals survived the procedure and lived with the microchip in situ for 1-3 months without visible neurological effects, but implantation of even a small chip was associated with some tissue damage, creation of new pathways for neural signals, and consequently with reactive changes surrounding the implant. However, no collagen deposition suggesting fibrosis was observed. This may facilitate the development of brain computer interfaces (BCI) technology in the treatment of neurological disorders [16]. There is also a need for strong interdisciplinary cooperation, for example, to inform surgeons about rare complications and their non-specific symptoms that occur even 5 years after the implant procedure [17]. This will provide guidance for surgical strategies using the implants discussed in this article, similar to those used in peripheral nerve regeneration, which may provide improved therapeutic outcomes [18]. Implantation procedures, post-implantation planning, and goal setting must be precisely established based on clinical studies, and special attention should be paid to safety aspects and measurement conditions [19]. Despite the development of therapeutic techniques, the percentage of postoperative cerebrospinal fluid leakage remains high and reaches up to 32%. Hence, there is a large and urgent need for appropriate substitute materials for repairing defects, including due to possible complications and desired properties depending on the type and location of lesions. What is worse, the research results to date show that no ideal graft material can meet all of the above requirements, and biological, synthetic and host tissues only complement each other in them. Composite materials present an opportunity here [20]. Implantation of a hydrogel containing a biological drug modulating the immune system can provide an effective anti-inflammatory and neuroprotective effect. This may require large doses of, for example, chitosan-collagen hydrogel, but it provides a reduction in swelling and an improvement in motor function associated with the resolution of inflammation [21]. There are several other novel solutions already proven in other therapeutic areas, such as nerve wraps for peripheral nerve injuries [22]. The polyglycolic acid-collagen tube provided pain relief in patients, but the return of sensory function was insufficient (at 30 months of follow-up), so not all solutions work in the long term [23]. It is also difficult to find studies or reviews directly comparing the results of nerve autograft, transplant, and allograft; therefore, research using AI/ML, and ultimately digital twins of the patient, may be a starting point for research, didactic, and ultimately simulation solutions in order to select the optimal solution for a given patient.