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This study introduces the fast adaptive focus tracking robotic optical coherence tomography (FACT\u2010ROCT) system, which provides real\u2010time, artifact\u2010free imaging during surgery, addressing motion artifacts and resolution degradation. Imaging occurs in 22 patients, including 13 with gliomas (WHO grade I\u2010IV). This represents the first in situ OCT imaging of human spinal cord tumors, enabling the differentiation of tumor types in real\u2010time. The standard deviation of the attenuation coefficient serves as a physical marker, achieving 90.2%\u2005 \u00b1 \u20052.7% accuracy in distinguishing high\u2010 from low\u2010grade gliomas intraoperatively at a threshold of 0.75\u2005 \u00b1 \u20050.01\u2005mm\n                    <jats:sup>\u22121<\/jats:sup>\n                    . 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