Anterior decompressive procedures for the treatment of vertebral tumors have become increasingly popular in an attempt to improve the quality of life, relieve pain, and preserve or restore neurologic function. However, these procedures carry a significant rate of complications including hardware failure, due in part to technical factors. A computer-assisted system allowing for precise preoperative planning and real-time intraoperative interactive image localization has been implemented for spine instrumentation to optimize anterior instrumental fixation. We discuss our initial clinical experience and application to anterior vertebrectomy, and vertebral reconstruction with anterior instrumental fixation. We believe that computer-assisted spine surgery using infrared-based technology offers the necessary elements to make its use fast, reliable, and intuitive, providing an accurate and safe approach for optimization of spine surgery.