Whether it is robotic assist, augmented reality (AR) or artificial intelligence (AI), there is no doubt that the march of intelligent tools and the digitization of the operating theater is in full swing.
While most surgeons are familiar with the advanced intelligence offerings from Medtronic plc, Globus Medical, Inc., Stryker Corporation or Zimmer Biomet, it could well be a comparatively small, Deerfield, Illinois-based spinal implant company, Surgalign Holdings, Inc., formerly known as RTI Surgical, which will lead with a next generation intelligent system as a result of its landmark purchase of Holo Surgical, Inc.
Surgalign paid approximately $42 million in cash and stock, with another $83 million in cash and stock after meeting certain milestones for the high tech inventor of a remarkable augmented reality and artificial intelligence surgical platform. By the way, the acronym for a system that combines BOTH augmented reality and artificial intelligence is ARAI.
The ARAI platform provides augmented reality with an “X-ray-like vision” to surgeons in the OR with a three-dimensional image overlaid on the patient. Using artificial intelligence, the system analyzes and identifies intraoperative imaging. The system then segments and labels bony structures and soft tissue and includes the ability to issue alerts and suggestions during surgery. The system also employs an optical navigation tracking system for instrument and implant visualization.
The ARAI system was first used on a patient in Gdansk, Poland, in January 2019 for a lumbar fusion. The system is patented, but, currently, does not have FDA regulatory clearance or approval for use in the U.S.
Surgalign Holdings President and CEO Terry Rich said, “The completion of the Holo surgical acquisition brings an innovative surgical platform and world-class team into our organization, enabling us to advance the standard of care by reimagining what is possible through integrated intelligent technology.
This acquisition is the first step in accelerating our transformation into a leading digital surgical company in spine. In conjunction with the closing of the transaction, we are pleased to announce that virtual and augmented reality expert Prof. Christian Luciano, PhD has joined the Company as leader of our digital R&D initiatives, and spine surgeon Dr. Kris Siemionow, MD, PhD has joined the Company as Chief Medical Officer. In this role, Dr. Siemionow will continue to lead the development of the ARAI platform as well as drive innovation across the portfolio.”
Before the name change from RTI Surgical to Surgalign Holdings, the company sold its OEM orthopedic device business, resulting in a spine device pure-play. Addition of the digital surgery platform will further solidify the company’s role in high-tech spine surgery.

