HCB News: We understand that your development process was unusually rapid, can you tell us about your approach?
SP: The RJB was built with speed, focus, and efficiency rarely seen in medical device development. It went from concept to working prototype in just two months—half the original timeline—and reached its final form in only six design iterations. Rather than relying on traditional development committees or legacy engineering firms, the team deliberately sought partners outside the med-tech space to challenge conventions and avoid over-engineering. Surgeon feedback was integrated strategically—only after the core design had been finalized. This approach ensured the device remained true to its founding vision: function-driven, not feature-burdened.

HCB News: What inspired your minimalist philosophy behind?

SP: Our device was born from a belief that simpler, smarter tools can deliver better outcomes than complex, costly systems. In today’s surgical landscape, there’s an increasing tendency to pursue highly integrated platforms—robots, AI-powered tools, massive imaging towers—that promise precision but often introduce complexity and cost. Ruthless Spine, the company behind the RJB, took the opposite route. Their philosophy was to remove everything that wasn’t essential to the core function of surgical alignment. The result is a device that is intuitive, efficient, and easy to adopt—particularly in hospitals that lack the resources for traditional solutions.

HCB News: Why is the RJB uniquely valuable to smaller operating rooms and hospitals with space constraints in their operating rooms?
SP: It uses no bulky equipment or modules that need to be wheeled around. The RJB’s simple, disposable-use modules are the size of an android tablet. These devices were used in Ukraine and Liberia to perform the first spinal navigation procedures in both those countries.

HCB News: What does the future hold for spinal navigation?
SP: With the RJB receiving FDA De Novo clearance in 2023—the first such approval in over 30 years for a spinal device not tied to robotics—it marks a paradigm shift. As hospitals seek tools that are affordable, effective, and adaptable, the market may move away from large capital systems toward compact, disposable, software-driven devices. Instead of massive carts and towers, the future of navigation could be containers the size of an iPhone stacked on a shelf, ready to transform surgical accuracy with the push of a button.

HCB News: What are the global ramifications of the RJB?
SP: 1.5 million spinal fusions are performed per year in the United States alone. Precise global data of spinal fusions alone is uncertain, but the annual number likely falls between 2.5 and 4 million. Because of its low cost and simplicity, the RJB can be used economically in places like Africa. It is currently being used in Ukraine and Turkey, resource-constrained countries that cannot afford TSN. The expense of TSN is not only the equipment itself, but also its requirement of specialized training. The trained surgical technicians are constantly poached between hospitals, so hospitals must pay them more to retain them. In contrast, any surgical technician can use the RJB and it can be used alongside any current instrumentation system. This makes it primed to expand its usage across developing countries.

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