HCB News: Why are screw placement inaccuracies still a problem?
SP: One of the major flaws in TSN is its dependence on preoperative CT imaging for surgical planning. These images are taken when the patient is in a different position from how they will be during surgery. Any variation between these two positions—such as spinal alignment, table tilt, or patient posture—can affect accuracy. Even small deviations may lead to critical errors in screw trajectory or depth. The systems also rely on precise registration of anatomical landmarks, a process that can be time-consuming and prone to error, especially in busy or high-pressure operating room environments.
HCB News: What is the RJB, and how does it address these issues?
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SP: The RJB is a simple, compact, trajectory guidance tool designed specifically for lumbosacral pedicle screw placement. Unlike bulky towers and imaging platforms, the RJB fits into a briefcase and requires no capital infrastructure. It is a single-use, Bluetooth-enabled module that connects directly to surgical instruments. When paired with a tablet running the RJB app (on iOS or Android), it provides real-time feedback on instrument trajectory in both the axial and sagittal planes, relative to gravity. This gives surgeons an intuitive and precise sense of orientation during screw placement—enhancing their natural skill without dictating it.
HCB News: How does the device differ from traditional navigation tools?
SP: The RJB breaks away from the assumption that effective navigation requires large-scale machinery, radiation exposure, or prolonged setup times. With a 30-second setup and no need for anatomical registration, it streamlines surgical workflow dramatically. TSN can take 20–30 minutes just to register a patient and acquire necessary images—time during which the patient is anesthetized and the team is idle. The RJB eliminates this bottleneck. Furthermore, it is not dependent on a clear line of sight or complex environmental calibration, making it versatile and reliable in diverse surgical conditions.
HCB News: How does the RJB support surgical accuracy?
SP: By providing constant, real-time data about the trajectory of a surgical instrument, the RJB enables precise alignment without the surgeon needing to visually verify or reorient instruments manually. Think of it as “cruise control” for spinal surgery—it doesn’t replace the driver, but helps maintain consistent, optimal performance. Surgeons retain full control and judgment, while the RJB enhances their accuracy and confidence, especially in challenging anatomical regions where minor deviations can have major consequences.
