spineEOS
Overview
spineEOS is an online 3D surgical planning software developed by EOS imaging, a global medical device company now part of the ATEC Spine Group. It is designed for both pediatric and adult spine cases, including degenerative and deformative spine conditions like scoliosis and kyphosis. The software leverages patient-specific 3D models derived from low-dose, weight-bearing EOS imaging system scans, which provide a comprehensive view of the skeletal structure and its functional alignment. spineEOS offers surgeons real-time automatic feedback throughout the planning process, enabling them to confidently identify surgical targets, optimize pelvic tilt, lordosis, and kyphosis alignment, and plan cage position, size, osteotomies, and rod shape/length. This open-platform tool enhances the understanding of 3D frontal, sagittal alignments, and axial rotations of the spine, pelvis, and lower limb compensatory mechanisms, leading to more accurate diagnoses and personalized treatment plans for improved surgical outcomes. The platform supports the entire care pathway from imaging to surgical planning and post-operative assessment.
Reviewed by Pouyan Golshani, MD — Interventional Radiologist
Key Features
- Age-based normative data for sagittal balance
- Optimized pelvic tilt, lordosis, and kyphosis alignment planning
- Cage planning with real-time feedback on spinal impact
- Osteotomy planning with real-time simulation
- Accurate rod shape, diameter, and length planning
- Open platform, not specific to any implant vendor
- Real-time automatic feedback during planning
- 3D visualization of spine, pelvis, and lower limbs
- Full body sagittal balance analysis
- Patient-specific 3D models from EOS images
Use Cases
- Surgical planning for degenerative spine conditions
- Surgical planning for spinal deformities (e.g., scoliosis, kyphosis)
- Pre-operative assessment for adolescent idiopathic scoliosis
- Optimizing sagittal alignment in spine surgery
- Patient-specific implant selection and positioning
- Post-operative assessment and follow-up against surgical plan
What Physicians Need to Know
Leverage spineEOS's 3D models and surgical planning tools for personalized treatment strategies, especially for complex spinal deformities and sagittal alignment issues. Utilize the low-dose radiation benefit for pediatric patients and those requiring frequent follow-up imaging. Emphasize the weight-bearing imaging capability to assess spinal alignment under functional conditions, which can reveal pathology not apparent in supine scans. Use the pre-operative planning and simulation features to virtually rehearse procedures, optimize implant selection and placement, and anticipate anatomical variations, potentially leading to reduced operative times and improved outcomes. Share the planned surgery and virtual post-correction 3D anatomy with patients to enhance engagement in their treatment. Be aware that 3D reconstruction is a semi-automated process and operator skill can influence accuracy.
spineEOS is part of the EOSapps suite, designed to integrate seamlessly with EOS imaging systems (e.g., EOSedge) for 3D modeling and surgical planning. It supports DICOM 3.0 for robust image management, storage, and query functions, ensuring compatibility with existing PACS infrastructure. The platform offers direct OR integration for efficient transfer of planning targets. As a cloud-based solution (part of EOS Insight), it provides flexible access to data and surgical workflows from various devices. The software generates patient-specific 3D models from biplanar X-ray images and can be used to plan for specific implants like ATEC interbody spacers and patient-specific contoured rods.
Details
| Category | Radiology & Imaging AI, Surgical AI |
| Pricing | Contact for pricing — Not publicly available; likely enterprise/quote-based. |
| Deployment | Cloud-based online platform |
| Compliance | |
| BAA Available | Unknown AI-estimated |
| HIPAA Compliant | Yes AI-estimated |
| FDA Status |
1 AI-estimated spineEOS received FDA approval in April 2016 as an online 3D planning software for spine surgery based on EOS stereo-radiographic 2D/3D imaging. The sterEOS workstation, which is used for 3D modeling and is integral to spineEOS, is also FDA cleared. A recent 510(k) premarket notification (K251747) for "VEA Align; spineEOS" from August 2025 further indicates ongoing regulatory clearances or updates for the software. |
| Integrations | |
| EHR | Not specified |
| Specialties | Neurosurgery, Orthopedics |
What the Web Says
spineEOS is a 3D surgical planning software developed by EOS imaging, designed for pediatric and adult spine cases. It utilizes low-dose, full-body stereoradiographic images from the EOS system to create 3D models and facilitate preoperative planning for spinal deformities and degenerative conditions. Physicians can use spineEOS to simulate procedures, including osteotomies, interbody cage placement, and spinal rod design, aiming to improve surgical outcomes and reduce complications.
Overall: PositiveStrengths
- Significantly reduces radiation exposure compared to traditional X-rays and CT scans, especially beneficial for children and patients requiring frequent imaging.
- Provides high-quality, clear 2D and 3D images of the skeletal system in a weight-bearing (functional) position, offering a more realistic view of spinal alignment.
- Enables accurate 3D reconstruction and measurements of the spine, including vertebral rotation and sagittal parameters.
- Facilitates comprehensive preoperative surgical planning, allowing surgeons to simulate procedures and design patient-specific spinal rods.
- Helps in assessing global spinal alignment, compensatory mechanisms in the pelvis and lower limbs, and can be used for conditions like scoliosis, kyphosis, and leg length discrepancy.
- Improves surgical practice by potentially reducing complications like iatrogenic malalignment and aiding in a better understanding of complex spinal conditions.
Limitations
- Limited data on the direct impact of EOS technology on long-term patient health outcomes and scoliosis patient management.
- Preliminary studies suggest some discrepancies between planned and actual surgical outcomes, such as differences in rod length and inflection points.
- Further work is needed to improve thoracic kyphosis planning within the software.
- The exact quantification of radiation dose reductions in terms of patient health benefits is difficult, and it's unclear if reported doses are consistent with clinical practice.
- EOS is generally not used for soft tissue injuries, acute fractures, or conditions where MRI is the preferred option.
Based on reviews from: PMC, Duke Health, Becker's Spine Review, EOS imaging, HSS, ScanAlign
Last updated: 2026-07-20
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Product demos, reviews, and walkthroughs for spineEOS.
What Is EOS Imaging? Low-Dose X-Ray Technology for Spine Care
Norton Healthcare
