Orthopedic Surgeons Gain 'X-Ray Vision': Linyan Medical Launches AR Navigation Platform for Spinal Surgery, Targeting a Billion-Dollar Blue Ocean Market

In 1935, American science fiction author Stanley G. Weinbaum envisioned a virtual reality headset capable of delivering fully immersive experiences in his novel *Pygmalion’s Spectacles*, marking the earliest traceable conception of VR.

Thirty-three years later, Ivan Sutherland, known as the father of computer graphics and the father of augmented reality, developed the first augmented reality system, “The Sword of Damocles.” In 1997, Ronald Azuma, a professor at the University of North Carolina in the United States, published the first report on augmented reality, thereby establishing the definition of AR.

To date, VR/AR has evolved into a widely recognized digital visualization technology, gradually permeating various industries. It has been extensively applied in precision-intensive sectors such as scientific research, aviation, healthcare, and the military. In the medical field, this technology has gained industry acceptance and is experiencing robust growth. According to a market research report published by Zion Market Research, the global augmented and virtual reality healthcare market was valued at approximately $850 million in 2018 and is projected to reach around $5.115 billion by 2025.

Against this backdrop, LINYAN (LINYAN Medical), dedicated to the research and development of AR-based orthopedic surgical navigation platform technology, was established.

“My background is quite different from that of others; my life trajectory may be difficult to understand through conventional thinking,” said Dr. Liu Yang, CEO of LINYAN. “I began teaching myself computer skills at around the age of 10, entered university to study computer science at 16, and started my own business at 18. Riding the first wave of the internet boom, I achieved early success and attained some modest accomplishments.”

After gaining substantial resources and capital across multiple industries, Liu Yang, now in his thirties, decided to simplify his life’s trajectory by committing to the healthcare sector as his lifelong career. Holding a Ph.D. in Healthcare Management from the University of Montpellier in France, Liu was exposed to numerous cutting-edge medical technologies during his studies abroad. Leveraging this experience alongside his prior professional expertise in computer science, he chose to dedicate himself to the field of clinical visualization in orthopedics.

“China has more than 10 million patients with spinal disorders who urgently need surgery to eradicate their pain, but only slightly over 100,000 patients actually receive surgical treatment for spinal conditions each year,” said Liu Yang. “From a commercial perspective, orthopedics is the crown jewel of hospital services, and spine care is the most brilliant gem on that crown. Spinal surgeries are highly complex and entail substantial costs, yet no domestic company has achieved localized R&D and industrialization in this field.”

Thus, in 2015, Liu Yang assembled a team of industry researchers and medical experts to jointly develop and build an internationally leading augmented reality (AR) navigation platform for spinal surgery. The platform overlays registered virtual images onto actual lesions, thereby enabling real-time clinical feedback to assist surgeons in performing various types of spinal procedures.

As population aging accelerates and sedentary lifestyles among young people become increasingly prevalent, the incidence of spinal disorders such as lumbar disc herniation is rising year by year. Many patients require surgical intervention to alleviate their pain, and pedicle screw placement forms the foundation of spinal surgery.

On the other hand, high-quality medical resources in China are currently concentrated in a subset of Grade A tertiary hospitals in first- and second-tier cities, with relatively few hospitals and physicians in prefecture-level and county-level institutions capable of performing spinal surgeries. The high cost of surgical equipment hinders its widespread adoption in primary care settings, making freehand techniques based on individual physician experience the most common approach. However, given the complex anatomy surrounding the spine, traditional manual methods often fail to ensure the accuracy and safety of pedicle screw placement.

Guided by the philosophy of supporting the clinical medical market, LINYAN launched its first-generation augmented reality (AR) navigation platform for spinal surgery, “WHATifMED,” in 2019. The platform’s core technologies include heterogeneous spatial localization and AR display algorithms, active fitting registration algorithms, real-time tracking of all surgical instruments, remote data mapping, and curved surface calibration and reconstruction. It comprehensively identifies true lesions for each patient and provides real-time feedback, further advancing the precision and safety of minimally invasive orthopedic surgeries, thereby maximizing physicians’ productivity.

“In the past, surgeons had to rely on their experience, imagination, and various skills to perform operations,” said Liu Yang. “Now, with our platform, they can see precise guidance right before their eyes, allowing them to carry out surgeries by simply following the instructions, much like ‘playing a video game.’”

It is reported that LINYAN has currently established clinical collaborations with the Chinese PLA General Hospital, Shanghai General Hospital, Shanghai East Hospital, and Shanghai Pudong Hospital, earning practical affirmation from numerous physicians. Liu Yang stated, “Based on statistical data from multiple investigator-initiated clinical studies, the average accuracy of our navigation platform has reached 0.5 mm. This will better meet the public’s healthcare needs for accessible, high-quality surgical care, reduce the incidence of surgical complications and health insurance expenditures, conserve healthcare resources, and alleviate the societal burden of medical costs.”

According to the "2019-2022 Big Data and Benchmark Enterprise Operation Monitoring Report on China's Medical Device Market" released by iiMedia Research, China's medical device market has maintained a steady growth trend over the past five years, increasing from RMB 255.6 billion in 2014 to RMB 530.4 billion in 2018, with an average annual growth rate of approximately 20%. Both operating revenue and net profit have sustained rapid growth, and the market size is projected to exceed RMB 900 billion by 2022.

“Currently, the penetration rate of high-end medical devices exceeds 40% in North America and stands at 35% in Europe, but is only 4.3% in China. In the niche segment of spinal surgery, it is nearly zero. Therefore, the market potential is enormous,” said Liu Yang. “As China’s first orthopedic AR surgical platform to enter clinical trials, we enjoy a significant first-mover advantage.”

Liu Yang revealed that the company is currently raising RMB 40 million in its A+ round of financing to advance clinical trials and dual-certification applications for the “Wodifu” augmented reality (AR) navigation platform for spinal surgery, with plans to launch it on the market by 2021. “Our current sales targets are actually quite conservative, aiming for RMB 600 million in the first three years. We are more concerned that once the product is launched, we will be completely unable to meet market demand, and our production capacity may even fall short.”

In addition to launching the AR navigation platform for spinal surgery, Liu Yang stated that the company’s strategic layout over the next five years will encompass the entire industry chain, covering indications from the lumbar, thoracic, and coccygeal regions to the cervical spine and ultimately the entire spine; ranging from relatively simple pedicle screw placement procedures to highly complex surgeries for scoliosis and ankylosis; and extending from broad coverage in second- and third-tier markets to deep penetration in first-tier markets.

On the other hand, the National “13th Five-Year” Special Plan for Technological Innovation in Medical Devices explicitly calls for accelerating the development of frontier technologies such as virtual reality, augmented reality, and positioning and navigation, so as to further enhance healthcare coverage and tiered diagnosis and treatment. The advancement of national policies has also provided support for the development of LINYAN’s therapeutic solutions.

Liu Yang remarked, “The application of AI and AR technologies in healthcare is a long and arduous journey. We are establishing our own industry standards, and we hope that more partners will join this market to contribute collectively to the development of healthcare in China, ultimately creating well-being for the nation and its people.”