Earlier this month, Proprio, a provider of AI-powered surgical technologies, announced that its Paradigm surgical guidance platform had achieved a significant milestone with the completion of 50 successful surgeries.
These procedures were performed along with other surgeons by Dr. Richard Bransford, director of orthopedic spine improvement and world-renowned spine surgeon at Harborview Medical Center at the University of Washington.
PROBLEM
“When placing any instrument in bone, whether it’s pedicle screws, cortical screws, or whatever, the question always arises as to whether the anatomical landmarks, classical navigation, or whatever allows me to place my implants precisely and precisely where In my opinion they should be there. Bransford explained.
“There is also the issue of how much radiation is acceptable to the patient and the operating room staff to strike a balance between risks and benefits,” he said. “We hoped that the artificial intelligence-based surgical guidance system would reduce radiation and still allow for optimal implant placement.”
APPLICATION
The proposal for an artificial intelligence-based surgical guidance system was intended to enable a more “visual” view of the expert anatomy obtained from CT scan and combine it with the intraoperative visual field to enable the placement of implants and possibly measure the change in alignment according to the preoperative plan.
“This would allow for essentially zero intraoperative radiation while still allowing for navigation during implant placement,” Bransford noted. “The real question was whether the infrared cameras and AI ‘eye’ would be able to accurately interpret the ‘visual’ anatomy.
“Similarly, as the orientation of the spine changed, the ‘eye’ could track the changes, which classical navigation could not – being static, as opposed to dynamic artificial intelligence,” he added.
MEETING THE CHALLENGE
The AI-based guidance platform stands out in terms of its capabilities, he said
“It was able to track movement in real time and adapt to manipulation,” Bransford said. “He navigated very carefully while placing the implants in their intended position. I used this method as the attending surgeon, but I also tested it with other people, residents and dental assistants.
“The system is Proprio and has been developed incrementally in Seattle over the last seven to eight years,” he continued. “It worked exceptionally well to meet all requirements and really replaced our classic open case navigation.”
RESULTS
The difficult results achieved by the University of Washington Medical Center include correct placement of implants in the preoperatively planned location, confirmed by CT scan.
“This solution proved to be extremely effective, exceeding our expectations and exceeding the level of use of classic navigation,” Bransford said. “Everything is also recorded, which allows us to measure different aspects of the case in terms of how long each stage takes.
“And the screen allows the entire operating room staff to follow and follow what is happening during the case through the lens of Paradigm,” he added.
INTRODUCING A NEW ERA
“This is a truly revolutionary system that allows us to take surgical navigation to a new level, tracking implants and repositioning in real time, without radiation, using a relatively simple camera floating above the surgical field,” Bransford said. “This really moves the needle to a new level of technology to improve patient care.”