Earlier this month, Proprio, an artificial intelligence-powered surgical technology provider, announced that its surgical guidance platform, Paradigm, had reached a major milestone with 50 successfully completed surgeries.
These procedures, together with other surgeons, were performed by Dr. Richard Bransford, director of orthopedic spine quality improvement and a world-renowned spine surgeon at the University of Washington Harborview Medical Center.
THE PROBLEM
“When placing any instrumentation in the bone, whether pedicle screws, cortical screws or whatever, there is always the question of whether anatomical landmarks, classical navigation or whatever will allow me to precisely position my implants. places where I think they should be,” Bransford explained.
“There is also the question of how much radiation is acceptable to the patient and the OR staff to strike an appropriate balance between risk and benefit,” he said. “The hope was that an AI-powered surgical guidance system would allow for less radiation while still allowing optimal implant placement.”
PROPOSAL
The proposal behind an AI-powered surgical guidance system was to enable a more “visual” expert eye the anatomy obtained from a CT scan and links this to a visual intraoperative field to allow implant placement and ultimately measure the change in alignment as planned preoperatively.
“This would allow virtually no radiation intraoperatively while still allowing implant placement,” Bransford noted. “The real question was whether the infrared cameras and AI ‘eye’ can accurately interpret ‘visual’ anatomy.
“As the spine was reoriented, the ‘eye’ could also track the changes, which classical navigation could not – because it was static instead of AI being dynamic,” he added.
MEETING THE CHALLENGE
The AI-powered guidance platform excelled in what it could achieve, he said
“It was able to track movement in real time and adapt to manipulations,” Bransford said. “It navigated very accurately to the placement of implants in the intended position. This was used by me as the attending surgeon, as well as by colleagues, residents and PAs.
“The system is Proprio, which has been developed in Seattle over the last seven to eight years and has been developed incrementally,” he continued. “This worked exceptionally well to achieve everything requested and has really taken the place of our classic navigation in open cases.”
RESULTS
The hard results achieved by the University of Washington Medical Center include accurately placed implants in the location planned preoperatively, with CT-verified confirmation.
“This has been hugely successful, exceeding our expectations and exceeding our use of classic navigation,” Bransford reported. “Everything is also recorded, which allows us to measure different aspects of the case in terms of the timing of each step.
“Also the screen allows all OR staff to monitor and monitor what is happening during the case through the Paradigm lens,” he added.
ENTERING INTO A NEW ERA
“This is a truly revolutionary system that allows us to take surgical navigation to a new level, tracking implants and changing alignment in real time, without radiation, with a relatively simple camera hovering over the surgical field,” said Bransford. “Really, this moves the needle to a new level of technology to improve patient care.”
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