Seattle Spine Align

Patient parameters

A deterministic real cohort case (first patient in the cohort) is auto-loaded on page open so local and live deployments start from the same patient for side-by-side comparison. Click Find top 5 plans to run the genetic algorithm against this patient. Use Random real patient to pick a different cohort case (with precomputed top-5 plans for Forward mode), or Random simulated patient to generate a synthetic deformity for a live GA run.

Load real case

Spinopelvic (required)

PI * LL * T4PA * L1PA *

Spinopelvic (optional)

PT SS L4-S1 L5-S1 TK C2PA Global tilt

Evaluation mode

Choose the forward model + decision space the planner uses:

Hybrid model uses the full literature maneuver library (ALIF, ACR, XLIF, OLIF, TLIF, PLIF, PSO, SPO, VCR with per-level degrees of correction). Forward model uses the 281-patient cohort's surgical maneuvers only (ALIF, XLIF, TLIF, and PSO) and does not show the per-level degrees of lordosis.

Surgical preferences (optional)

Restrict the GA's surgical maneuver library. Forward mode honors only ALIF / XLIF / TLIF / osteotomy preferences (the cohort vocabulary); ACR / OLIF / PLIF / PSO / SPO / VCR distinctions are silently ignored when Forward is selected.

Maneuver	Allow	Forbid	Require
Interbody cages
ALIF (Anterior lumbar)
ACR (Anterior column realignment)
XLIF (Extreme lateral)
OLIF (Oblique lumbar)
TLIF (Transforaminal)
PLIF (Posterior lumbar)
Osteotomies
PSO (Pedicle subtraction)
SPO (Smith-Petersen / Ponte)
VCR (Vertebral column resection)

Max interbody fusion techniques:

Custom constraints (optional, layered on profile)

Allowed UIV / LIV range (optional). Leave any selector at "any" to skip that bound. When set, the GA cannot pick a UIV or LIV outside the range.

UIV from to

LIV from to

Hardware bounds (optional). Drag both handles of each slider to set min and max. Leave the "Enable" box unchecked to let the GA decide freely.

Number of rods: 2–6

Pelvic screws: 0–4

Parameter	Target	Min	Max	Weight

Disc-space exclusions (optional)

Blocks interbody fusion (ALIF / XLIF / TLIF) and osteotomy from the selected disc spaces, without preventing the construct from spanning the level. Use when a specific disc is off-limits (e.g. prior failed ALIF at L4-5, vascular concern, infected disc).

Alignment goals

Check every goal that should drive the GA. Combinations stack: e.g. GAP + T4-L1PA weights both. Custom adds your surgeon-entered constraints (table below) on top. Surgeons who do not subscribe to a given framework should leave that checkbox unchecked.

Targets are enforced at the timepoint: and max acceptable mech-fail probability (%) .

Genetic-algorithm generations

Use precomputed plans

Compare your own plan

Note: the rules you set in "Surgical preferences" do not affect this section. They bias the GA's plan-search only. When you enter your own plan here, the model returns the unweighted forward-prediction (predicted alignment trajectory plus the raw mechanical-failure probability) so you see what your construct would produce on its own.

ALIF segments (anterior lumbar interbody fusion)

L2-3 L3-4 L4-5 L5-S1

XLIF segments (lateral lumbar interbody fusion)

L1-2 L2-3 L3-4 L4-5

TLIF (transforaminal lumbar interbody fusion)

TLIF (levels)

Osteotomy

Perform osteotomy (PSO) Level

Maneuver	Level	Δ LL (deg)	Supine corr	Reference

The Δ-LL input for each row is clamped to the literature range (min–max) shown in the placeholder for that maneuver / level. PSO, SPO, and VCR effects on T4PA / L1PA are applied automatically per the published priors.

Posterior instrumentation

UIV level LIV level Include construct hardware factors in mech-fail probability UIV implant Cement at UIV+1 # pelvic screws (S2AI / iliac) Iliac fixation type Number of rods Rod material Cross-links between rods Rod diameter Derived: number of fused levels

Clicking Find top 5 plans prepends this plan as the first card in the results so it sits alongside the GA's recommendations.

Penalty tuning (click rows to enable/disable or override weights)

Show / hide · default values shown · changes apply to next GA run only

Alignment-target soft penalties (Term 1)

Each row is one constraint. Toggle to include or skip; weight is the per-constraint multiplier.

Use	Penalty	Weight	Reference

Mechanical-failure proxy factors (Term 2)

Each factor is a literature-derived multiplier. Toggle to include or skip; magnitudes are not exposed because they come from cited papers.

Use	Factor	Reference

Anatomic-risk surcharges (Terms 3 and 4)

Conus-anatomy fitness surcharges. Toggle to include or skip; magnitude is the flat fitness-unit add.

Use	Surcharge	Magnitude	Reference

Note: The runtime scales with the number of generations selected. At 6 generations (the default) the run typically finishes in 40-60 seconds; lower values complete faster, up to 8 takes 60-90 seconds.

Preoperative spine (live)

Updates as you change PI, LL, PT, L4-S1, TK.

Patient parameters

Alignment-target soft penalties (Term 1)

Mechanical-failure proxy factors (Term 2)

Anatomic-risk surcharges (Terms 3 and 4)

Preoperative spine (live)

Your plan, predicted (live)

Top surgical plans

Patient parameters

Alignment-target soft penalties (Term 1)

Mechanical-failure proxy factors (Term 2)

Anatomic-risk surcharges (Terms 3 and 4)

Preoperative spine (live)

Your plan, predicted (live)

Top surgical plans ?

Top surgical plans