Concord, Mass. – September 15, 2026 -- OnPoint Surgical's augmented reality navigation system placed pedicle screws with a positional error of 1.1 mm and an angular error of 1.3°, figures 2 to 5 times smaller than those reported for competing navigation and robotic platforms, according to a peer-reviewed study published in the Journal of Spine Surgery.
Cadaveric study finds 100% screw placement accuracy with zero medial or inferior breaches
The study, titled "Accuracy of a high-resolution augmented reality (AR) guidance system with novel 3D stereoscopic targeting for spinal surgery," evaluated 80 pedicle screws placed by three experienced spine surgeons across five cadaveric specimens, including osteoporotic anatomy. Surgeons used both open and minimally invasive techniques across the thoracic and lumbosacral spine. Positional and angular error were measured in three dimensions against planned trajectories using post-operative CT scans, with radiographic accuracy independently graded by a blinded fellowship-trained musculoskeletal radiologist using the Heary and Gertzbein-Robbins classifications.
Statistical comparisons against major navigation and robotic systems were highly significant
OnPoint Surgical said the differences in positional and angular error versus other major navigation and robotics systems were statistically highly significant across all comparisons. "A positional error of 1.1 mm and an angular error of 1.3° are 2–5× smaller than what the major navigation and robotic platforms have reported, and the comparisons were statistically highly significant across the board," said Philipp Lang, M.D., CEO of OnPoint Surgical.
3D stereoscopic targeting magnifies deviation roughly tenfold in the surgeon's field of view
The company attributes the accuracy to its proprietary 3D stereoscopic targeting technology, which magnifies positional and angular deviation approximately ten times and overlays it directly onto the surgical site rather than on a remote monitor. Additional contributing factors include a 320-gram headset with tracking array, high display resolution, a patent-protected AR display alignment method, and a proprietary image registration technique that replaces traditional scanner tracking.
Study authors span five major U.S. medical institutions
The paper's authors represent Henry Ford Hospital, Stanford University Medical Center, Boston University Medical Center, Kaiser Hospital Roseville, and Tulane University. Serena S. Hu, M.D., Vice Chair and Chief of the Spine Service at Stanford University Medical Center's Department of Orthopedic Surgery, said the accuracy level was achieved without the surgeon taking their eyes off the operative field, calling it meaningful for cases involving small pedicles and challenging anatomy.
The OnPoint AR platform is FDA cleared and protected by more than 60 granted U.S. and international patents. The full study appears in the Journal of Spine Surgery, 2026;12(6):88, DOI: 10.21037/jss-2026-1-0034.