Abstract: Methods and systems for intraoperatively determining alignment parameters of a spine during a spinal surgical procedure are disclosed herein. In some embodiments, a method of intraoperatively determining an alignment parameter of a spine during a surgical procedure includes receiving initial image data of the spine including multiple vertebrae and identifying a geometric feature associated with each vertebra in the initial image data. The geometric features each have a pose in the initial image data and characterize a three-dimensional (3D) shape of the associated vertebra. The method further comprises receiving intraoperative image data of the spine and registering the initial image data to the intraoperative image data. The method can then update the pose of each geometric feature based on the registration and the intraoperative image data, and determine the alignment parameter based on the updated poses of the geometric features associated with two or more of the vertebrae.