VB Spine completes acquisition of Augmedics' CT-fluoroscopy technology for xvision platform

VB Spine LLC has completed its acquisition of exclusive rights to Augmedics' CT-to-fluoroscopy (CT-Fluoro) technology for spine applications and will begin integrating it into the xvision Spine System® platform, the company announced.

CT-Fluoro technology combines a patient's preoperative CT scan with fluoroscopic images captured from a standard 2D C-arm to support augmented reality (AR) guidance during spine procedures. Paired with xvision, it adds a new registration method — the process by which a navigation system aligns a patient's imaging data with their actual anatomy in the operating room — expanding the imaging options available to surgeons using the platform.

“We are pleased to complete this transaction and continue building on the momentum of our technology portfolio,” said Marc Viscogliosi, co-CEO of VB Spine, speaking on behalf of his brothers and fellow co-CEOs, Anthony and John Viscogliosi. “The addition of CT-Fluoro technology to xvision reflects our commitment to equipping surgeons with advanced navigation solutions that support a wide range of spine procedures.”

VB Spine describes itself as the largest privately held spine company. The CT-Fluoro acquisition follows the company's recent purchase of the SpineHawk intraoperative visualization platform from Robotron Surgical Technologies, part of a broader strategy of building out an enhanced visualization portfolio across its spine offerings.

Frank Phillips of Midwest Orthopedics at Rush University Medical Center, who performed the world's first AR-navigated minimally invasive spine surgery — a lumbar fusion with spinal implants in a patient with spinal instability — said the technology could broaden which practice settings can offer AR-guided procedures.

“Incorporating CT-Fluoro technology into spine surgery workflows gives more surgeons in more settings the opportunity to adopt AR navigation as a standard for their practice, particularly in regional hospitals and ambulatory surgery centers where traditional intraoperative 3D imaging and navigation systems are cost-prohibitive,” Phillips said. “In my own ASC practice, the ability to use AR off a preoperative CT has been game-changing. After two standard intraoperative fluoroscopic images and a minute or two of registration, I'm able to proceed directly with AR-guided surgery.”

VB Spine and Augmedics said they are working together to ensure a seamless transition of the technology, though the companies did not specify a timeline for when CT-Fluoro-enabled xvision systems will be available to surgeons more broadly.

Access to navigation technology remains uneven across practice settings

The CT-Fluoro deal touches on a persistent divide in spine surgery: access to advanced navigation technology often depends heavily on a facility's size and capital budget. Traditional intraoperative 3D imaging and navigation systems typically require dedicated imaging equipment, such as a mobile CT scanner or O-arm, along with the space and capital investment to house and maintain it — infrastructure that is often out of reach for smaller hospitals and ambulatory surgery centers (ASCs) even as more spine procedures shift into outpatient settings.

That shift has been accelerating for several years, driven by payer pressure to reduce costs, patient preference for shorter recovery times and advances in minimally invasive technique that make same-day spine surgery feasible for a growing share of cases. As procedure volume moves into ASCs, the navigation and visualization tools historically confined to large hospital systems have had to adapt or find lower-cost pathways to the same operating rooms.

Augmedics has positioned itself at the center of that shift since introducing xvision, the first FDA-cleared AR navigation system for spine surgery, which projects navigation data directly onto a surgeon's field of view rather than requiring surgeons to look away to a separate monitor. Registration methods that rely on more widely available equipment, such as standard C-arm fluoroscopy rather than specialized intraoperative CT, are one path toward lowering the equipment threshold for adopting AR guidance.

For physicians and practice administrators evaluating navigation technology purchases, the broader trend suggests vendors will continue developing registration and imaging options tailored to lower-cost settings, rather than treating advanced navigation as a hospital-only capability. Whether that translates into meaningfully lower total cost of ownership for ASCs and regional hospitals will likely depend on how vendors price hardware, software licensing and service contracts as these systems reach a wider range of practice sizes.