Ruthless Spine gains Israeli clearance for RJB interoperative angle measurement instrument

Ruthless Spine announced that Gad Medical Ltd. has received regulatory approval to begin immediate sales in Israel of the company’s RJB interoperative angle measurement instrument, expanding access to the U.S.-engineered platform across one of the world’s more innovation-driven medical markets.

The approval follows the companies’ distribution agreement and positions Israeli hospitals and surgical centers to adopt the RJB system, which is designed to support augmented implant placement through improved stability and precision.

Manufactured in the United States, the RJB system was developed through close collaboration with spine surgeons. The platform supports thoracic, lumbar and sacral fusion procedures and is built for the demands of complex thoracolumbar cases, with a workflow the company describes as intuitive and efficient.

“Receiving authorization to distribute the RJB system in Israel is an important milestone for our team and for spine surgeons across the country,” said David Frances, CEO of Gad Medical Ltd. “The RJB is intuitive, efficient, and engineered for the complexity of real thoracolumbar cases. We’re excited to bring this system into Israeli operating rooms and support hospitals with a solution that elevates patient care.”

The Israel clearance comes amid a period of global momentum for Ruthless Spine following the 2025 North American Spine Society Annual Meeting in Denver. The company announced a strategic partnership with NavJam and its navigation system, combining guidance technology with the world’s first navigated Jamshidi needle.

Gad Medical will serve as the system’s authorized distributor in Israel, providing inventory, supply chain coordination, and technical support, along with on-site OR guidance and structured training for surgeons.

Recent advances in spine surgery technology

The spine surgery sector has experienced a rapid acceleration in technological innovation over the past several years, driven by increasing demand for minimally invasive procedures, more precise intraoperative tools, and improved patient outcomes. Navigation, robotics and smart instrumentation continue to reshape how surgeons plan and execute complex procedures, prompting hospitals worldwide to invest in platforms that enhance accuracy while reducing operative time.

One of the most significant advancements has been the increased integration of navigation-enabled tools similar to the RJB system’s ecosystem. Traditional navigation platforms often require bulky equipment and additional OR personnel, but new systems focus on portability, faster registration, and seamless workflow integration. The emergence of navigated access devices represents a shift toward instrumentation that brings the guidance directly into the surgeon’s hands, reducing reliance on legacy, tower-based systems.

Robotics is also evolving beyond large, multi-arm systems. Developers are experimenting with smaller, single-use or modular robotic components designed to assist with pedicle screw placement or trajectory planning. These tools aim to combine the precision of robotics with the affordability and efficiency demanded by community hospitals.

In parallel, implants themselves are undergoing redesign. Low-profile screws and rods, expandable interbodies, and materials optimized for fusion and imaging compatibility are becoming standard. Systems built around surgeon feedback reflect a growing industry emphasis on ergonomic instrumentation and construct reliability tailored to real clinical challenges.

Data analytics and AI-assisted planning are also gaining traction. Preoperative planning software that integrates imaging, deformity modeling, and risk prediction is helping surgeons tailor constructs to individual patients.

Together, these innovations are pushing the spine surgery field toward more predictable outcomes, reduced complication rates and greater accessibility—particularly in markets seeking high-value technologies that streamline care without sacrificing precision.