Low back pain is one of the most common and costly challenges in military healthcare. It’s a leading cause of medical discharge, and it directly affects force readiness by delaying or preventing return to duty. For CRNAs, anesthesiologists, and pain management specialists working within the Department of Defense (DoD), addressing spinal pain efficiently and effectively is a clinical priority with operational consequences.
At RIVANNA, we’ve spent years developing imaging technologies that bring precision and efficiency to neuraxial procedures. But adapting those technologies for military healthcare required not just refinement but also collaboration. The turning point came when we focused our grant strategy on a problem that was both high need and high impact: the treatment and procedural management of low back pain in service members. That focus became the foundation for a successful DoD-aligned research initiative, supported by a world-class team of military consultants and clinical collaborators.
Collaborative Development: From Civilian Technology to Military Utility
Traditional ultrasound guidance has limitations when used in spinal procedures. General-purpose systems require advanced interpretation and are not designed with neuraxial anesthesia or spinal interventions in mind. These barriers are magnified in operational medicine environments, where provider experience, time, and equipment availability may vary.
In order to address this need, RIVANNA will collaborate with leading military healthcare experts to develop the Accuro 3S-MIL. The Accuro 3S is a portable ultrasound guidance system that features automated spinal landmark detection, real-time needle tracking, and in-plane needle access, streamlining complex neuraxial procedures into efficient, single-operator workflows, regardless of ultrasound experience. The 3S-MIL variant, a portable ultrasound guidance system, will be optimized for use in military settings by making the system more compact and durable.
What ultimately distinguished our grant proposal was the ecosystem we built around our technology. Through partnerships with DoD-affiliated subject matter experts, we validated use cases that matter most in active-duty settings and identified gaps that could be addressed through real-time image guidance. This interdisciplinary approach rooted in real-world military clinical feedback continues to shape how we design, test, and deploy our technology to ensure its performance in military medical centers and hospitals.
Precision Innovation With Operational Relevance
The long-term value of this work extends beyond spinal imaging. It reflects a method for translating civilian innovation into field-relevant capability. The clinical burden of low back pain in service members is quantifiable in days lost, repeated interventions, and compromised readiness. Addressing that burden requires tools that work in the settings military providers operate in — not just in controlled clinical trials but in day-to-day practice.
Military healthcare is evolving. Imaging tools must evolve alongside it. By combining accurate, portable neuraxial imaging with sustained collaboration between engineering teams and military providers, we’re building toward a more effective standard of care for pain management and procedural efficiency in uniformed medicine.
Acknowledgement
The U.S. Army Medical Research Acquisition Activity, 808 Schreider Street, Fort Detrick MD 21702-5014 is the awarding and administering acquisition office. This work was supported by The Assistant Secretary of Defense for Health Affairs endorsed by the Department of Defense, in the amount of $3 million through the Peer Reviewed Medical Research Program under Award Number HT94252510463. Opinions, interpretations, conclusions, and recommendations are those of the author(s) and are not necessarily endorsed by The Assistant Secretary of Defense for Health Affairs endorsed by the Department of Defense.