The broader impact/commercial potential of this Small Business Innovation Research (SBIR) Phase II project is a novel means for providing in hospital image-guided navigation to improve the accuracy and affordability of surgical procedures. Surgical procedures, notably those involving the spine, require high levels of precision. Existing navigation tools implent more complex, higher cost disposable components, or invasive technologies that prevent greater widespread adoption especially in smaller hospitals and outpatient centers. This project aims to commercialize a novel technology that enables surgeons to project images of patient’s internal anatomy and various tool positioning directly onto to the patient’s body surface for direct visualization in real time with sufficient precision for specific operational procedures. By improving surgical accuracy and reducing complications such as misplaced implants or reoperations the objective is to improve patient outcomes with a modern navigation tool while reducing operational and hospital costs. This Small Business Innovation Research (SBIR) Phase II project focuses on developing the technical components needed for a new surgical navigation method that combines 3D sensing and light projection in an interactive and responsive manner. The technology development includes furthering software development that enables the system to analyze the position of the patient and anatomy in real-time and accurately align medical images with th