Earlier this month, Proprio, an artificial intelligence-powered surgical technology vendor, announced that its surgical guidance platform, Paradigm, had reached a significant milestone with 50 successful surgeries completed. 

Those procedures were performed, along with other surgeons, by Dr. Richard Bransford, director of orthopedics spine quality improvement and a world-renowned spine surgeon at the University of Washington Harborview Medical Center.

THE PROBLEM

"In the placement of any instrumentation into bone, whether pedicle screws, cortical screws or whatever, there is always the question as to whether anatomical landmarks, classic navigation or whatever is allowing me to place my implants exactly and precisely where I think they should be," Bransford explained.

"There also is the issue of how much radiation is acceptable to the patient and the OR staff to have a fine balance of risk and benefit," he said. "The hope was that an AI-powered surgical guidance system would allow for less radiation and still allow for optimal placement of implants."

PROPOSAL

The proposal behind an AI-powered surgical guidance system was to allow for a more "visual" expert eye to take the anatomy obtained from a CT scan and marry this to a visual intra-operative field to allow for placement of implants and eventually also measure change in alignment as planned pre-operatively.

"This would allow for essentially zero radiation intra-operatively while still being able to navigate implant placement," Bransford noted. "The real question was could the infra-red cameras and 'eye' of AI be able to interpret the 'visual' anatomy accurately.

"Equally, as the spine was being re-oriented, could the 'eye' track the changes, which classic navigation could not – being static as opposed to AI being dynamic," he added.

MEETING THE CHALLENGE

The AI-powered guidance platform excelled in what it was able to accomplish, he said

"It was able to track motion in real time and adapt to manipulations," Bransford said. "It very accurately navigated placement of implants in the intended position. This was used by myself as the attending surgeon but also equally well with fellows, residents and PAs.

"The system is Proprio, being developed in Seattle over the past seven to eight years with stepwise development," he continued. "This worked exceptionally well to accomplish all that was asked and really has taken over from our classic navigation in open cases."

RESULTS

The hard results the University of Washington Medical Center has achieved include accurately placed implants in the location that was planned pre-operatively with CT-verified confirmation.

"This has been hugely successful, has superseded our expectations and has surpassed our utilization of classic navigation," Bransford reported. "Equally, everything is recorded allowing us to measure various aspects of the case in terms of timing of each step.

"Also, the screen allows all OR personnel to track and follow what is going on during the case through the Paradigm lens," he added.

USHERING IN A NEW ERA

"This is truly a revolutionary system, allowing us to take operative navigation to a new level, tracking implants and change in alignment in real time with no radiation with a relatively straightforward camera hovering above the operative field," said Bransford. "Truly, this is moving the needle to a new level of technology for the betterment of patient care."

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