PathKeeper's EIC Accelerator Bet on Spine Navigation, Revisited

The European Commission's list of companies selected in the October 2019 cut-off of the EIC Accelerator pilot names a grant-only winner from Rechovot called Deep Health Ltd., with a project called Optics-MISS, for "Optical Real-Time Anatomical Tracking- Minimally Invasive Spine Surgery", according to the EC winner list. The company now trades as PathKeeper Surgical. Its own Horizon 2020 page calls it "formerly known as Deep Health", and CORDIS lists PathKeeper Surgical Ltd at 16 Carmel Street, Rechovot, as coordinator of the same project, grant agreement 945729. The Israeli company register gives the same address for PathKeeper Surgical Ltd, company number 515781342, according to the Israeli Corporations Authority's company data. Two clinical studies of the system are still registered under the sponsor name Deep Health Ltd. on ClinicalTrials.gov. When the company changed its name is not public.

The EU contributed €2,478,087.50 to a €3,540,125 project that ran from March 2020 to August 2022. PathKeeper's system uses a 3D camera to match the exposed vertebrae to the patient's CT scan and then keeps tracking them during surgery, without the repeated X-rays or intraoperative CT scans that other navigation systems use. The open-surgery version cleared the US Food and Drug Administration in March 2023. The minimally invasive version, the "MISS" in the project's name, has not been cleared or launched, and the company's website states that the system "is not available for sale in the European Union".

Where PathKeeper Stands Now

PathKeeper is active. The Israeli register shows the company as active, with an annual report filed in June 2026, a new director added the same month, and a share allotment, a share split and a change of share classes registered on 16 August 2026, according to the register's record of company changes. The register does not publish the accounts of private companies, so its revenue, losses and equity could not be checked.

In November 2025 the company completed an investment round of "several million dollars" from Club-D Innovation, an investment club of Israeli doctors, Arbelon Holdings and other investors, according to Globes, which OrthoWorld also reported. The exact amount was not disclosed. Two months earlier, Highridge Medical of Westminster, Colorado, signed an exclusive US distribution agreement for the system, according to MassDevice; the company announced the same partnership on its news feed. In May 2026 MedTech Innovator selected "Pathkeeper Surgical (Kfar Saba, Israel)" for its 2026 accelerator cohort, according to Pulse 2.0 and MedTech World.

Sources disagree on some basics. The company's website says Erez Lampert founded PathKeeper in 2018, while Globes names Opher Kinrot and Lampert as founders, and the Israel Innovation Authority lists both as co-founders. The Authority names Tzachi Ezra as chief financial officer; the company's team page names Jonathan Gold. The registered office is in Rehovot, but the FDA filing and the company's press releases give an address in Kfar Saba.

The Technology: Tracking Bone Instead of X-Raying It

In spine fusion surgery, surgeons drive screws into the pedicles of the vertebrae, a few millimetres from the spinal cord and major blood vessels. Most operations are still done freehand under repeated X-ray images. CORDIS quotes the company's estimate that over 90% of the 5 million spine surgeries a year are done manually and that about 30% of pedicle screws are misplaced with the freehand technique. Established navigation systems build an anatomical map at the start of the operation, usually from an intraoperative scan, and then follow only the surgical tool.

PathKeeper's camera works in the near-infrared spectrum and captures the 3D surface of the exposed bone. Software matches that surface to the patient's preoperative CT scan, a step called registration, and then tracks each vertebra and the surgical tools continuously. The FDA 510(k) summary describes a portable cart with the camera on an articulated arm, planning and navigation software, and reusable reference frames that attach to common surgical tools. The FDA accepted 7D Surgical's Envision 3D system, which also registers the spine optically, as the predicate device, so the core principle was not new to the US market. What PathKeeper claims as its difference is continuous tracking of each vertebra rather than a one-time map. The project's final report states that registration takes "less than 15 seconds" against 30 minutes for competitor systems and that surgeons are "5X more accurate" in screw placement than with the best robotic system. These are the company's own claims; no peer-reviewed comparison was found.

What the EIC Project Promised, and What the Record Shows

Optics-MISS was an SME Instrument phase 2 project under the EIC Accelerator pilot of Horizon 2020. The grant agreement was signed on 18 February 2020, and the project ran for 30 months from 1 March 2020 to 31 August 2022, according to CORDIS. Its stated aim went beyond open surgery: a miniature 3D camera inserted into the retractor tubes of minimally invasive spine surgery, a single-use electronic tool tracking unit, and real-time tracking that would open "new clinical application" such as cervical spine procedures and tumour removal. The EC list names no other beneficiary for the project; CORDIS lists one linked third party, a PathKeeper company in Skopje, North Macedonia, which received €847,087.50 of the EU contribution.

The final periodic report, covering March 2021 to August 2022, says the team designed the miniature camera, built a prototype smart tool and a surgery planning module, held a cadaver lab with the prototype system, and could "show the operation of a full navigation system in MISS procedures" on phantoms and in cadaver testing. CORDIS lists three public deliverables, an ethics report, a product presentation and product brochures, on its results page, and no publications.

The product that reached the market is narrower. The FDA received PathKeeper's 510(k) on 4 August 2022, four weeks before the project ended, and cleared it on 8 March 2023, according to the FDA database; trade media reported the clearance in June 2023, including ODT and Orthopedics This Week. The clearance covers "posterior approach open spine fusion surgery during pedicle screw placement in the thoraco-lumbo-sacral region". The cleared system lists no miniature camera and no electronic tool tracking unit, and cervical surgery is outside its indication. The FDA database lists no other clearance for the company. No CE marking was found, and the company's website carries the disclaimer that the system is not available for sale in the EU.

1. Real-time optical navigation for open spine surgeryDeliveredFDA clearance K222355, March 2023; first US cases August 2023.
2. Miniature 3D camera for minimally invasive surgeryPrototype onlyCadaver tests per CORDIS; not in the cleared system.
3. Electronic tool tracking unitPrototype onlyPrototype per CORDIS; not in the FDA summary.
4. Cervical spine and tumour proceduresPartlyOne tumour case reported in 2024; cervical use not cleared.
5. Sales in the European UnionNot achievedWebsite: not available for sale in the EU.
6. Published clinical resultsNone postedTwo registered studies, status unknown, no results.

What Came After the Grant

The first US operations with the system took place at St. Vincent's Medical Center in Bridgeport, Connecticut, where four surgeons performed two multi-level lumbar fusions, the company announced on 3 August 2023. In November 2023 it reported its first case at Southcoast Health's St. Luke's Hospital in New Bedford, Massachusetts, in a press release. In March 2024 it signed a know-how agreement with Mayo Clinic to research lower radiation exposure in pediatric scoliosis surgery, according to the company's announcement. In November 2024 the company reposted an Israel Hayom report that surgeons at Hadassah Ein Kerem used the system to remove a spinal tumour from a 16-year-old, on its blog. Hadassah's spine chief Josh Schroeder has been the company's clinical adviser since its founding, so this case is not independent evidence.

By November 2025 the system had been used in 130 operations in Israel and the US, the company told Globes. In the same month it reported the first outpatient case in a US ambulatory surgery center, by Houston surgeon Richard Westmark, according to OrthoWorld; Westmark is listed as the company's chairman on its team page. The number of systems sold and the company's revenue are not public. Kiplin Capital is named as a returning investor in a January 2025 company post; earlier round sizes could not be verified.

Two clinical studies sponsored by Deep Health Ltd. are registered: an observational study at Hadassah in Jerusalem with an estimated 200 patients, started in October 2021 (NCT04914585), and a 32-patient study at a Leeds hospital comparing PathKeeper with traditional pedicle screw placement, with an estimated start of 30 October 2025 (NCT06554093). Both records show the status "unknown", were last updated in February 2025 and post no results.

Why It Matters for Europe

Reducing radiation in medicine is written into EU law and policy. The Basic Safety Standards Directive 2013/59/Euratom requires in Article 56 that doses from medical exposures, including those used for "guiding" procedures, be kept "as low as reasonably achievable", and the Commission's 2021 SAMIRA agenda sets out actions on the quality and safety of medical radiation use. A navigation system that replaces intraoperative CT with an optical camera fits that aim, for patients and for operating room staff exposed in every case.

The EU's return on its €2.48 million is harder to see. Part of the development work was done by the group's Skopje affiliate, outside the EU, and the product went first to the US market, where its distributor, its chairman and its first outpatient case are based. Seven years after the EIC selected the project, a European patient cannot be operated on with the system the EU helped to finance.

The Verdict

PathKeeper and the EIC have not been asked for comment for this article. It is based entirely on public records and published statements, linked throughout.