This pilot study introduces and evaluates a mixed reality (MR) training system for spine surgery that integrates immersive visualization, 3D-printed anatomical models, and real-time performance feedback. Fifteen medical students at Xi’an Jiaotong University participated in structured tasks covering theoretical learning, procedural learning, and practical training modules. Results show high user acceptance and efficient completion times: basic modules took approximately four minutes each, whereas the more demanding practical training module averaged 12.57 min. Likert-scale and System Usability Scale (SUS) scores indicated strong satisfaction, particularly with the realism of 3D-printed models (5.0). However, some issues arose, including difficulties with gesture-based interactions, inconsistent voice command responses, and a limited field of view from the HoloLens 2. Despite these challenges, interview feedback highlighted the system’s intuitive design and potential to enhance surgical education. Overall, this study underscores the promise of MR-based training for spine surgery and identifies areas—such as interaction design and hardware performance—requiring further refinement.