The current state of spinal care is an epidemic that afflicts over 266 million people globally. The average patient with chronic low back pain endures a lengthy diagnostic journey, often involving cycles of generalized physical therapy, injections, invasive surgeries, and sometimes procedures that carry significant risk with an unsatisfactory probability of lasting success. This cycle of uncertainty and generalized treatment carries a massive economic burden and represents a core deficiency in how the medical technology sector approaches spinal pathology.

To find a blueprint for transforming spinal care, medical technologists and orthopedics can take a page out of cardiology’s playbook, a field that has already undergone its own profound revolution. The treatment of heart disease was once reactive, largely dependent on late diagnoses and generalized, invasive diagnostic or surgical procedures. It was difficult to imagine understanding the heart’s complex mechanisms without invasive techniques. Now, through decades of sustained innovation and a strategic commitment to diagnostic precision, modern cardiology has become a paradigm of early detection, minimally invasive intervention, and patient-specific treatment often limited to prescription medical therapy.

Medical technologists must recognize the importance of innovating both surgical and diagnostic decision support tools for spine care in tandem.

Cardiology Device History

The Electrocardiogram, first developed in the early 20th century by Willem Einthoven, completely revolutionized the way doctors were able to diagnose heart disease. By placing electrodes in certain areas of your body, they were able to detect the heart’s electrical signals, providing an in-depth look into a patient’s heart rate, muscle health, and blood flow.

Roughly half a century later, the echocardiogram was popularized by Inge Edler and Hellmut Hertz. The two took a sonar device from a nearby shipyard and configured it to record cardiac echoes from Hertz’s own heart. This device was able to utilize ultrasound to create dynamic, real-time images of the heart’s structure, chamber volumes, valve movement, and pumping strength.

Both of these key inventions were consequential because they were noninvasive and provided a wealth of information previously only attainable by invasive procedures.

The diagnostic toolkit extends further to functional assessments, such as the Cardiac Stress Test, which monitors the heart’s performance under controlled exertion. Then later, advanced imaging modalities, such as Coronary CT Angiography (CCTA), became available, offering a highly detailed, non-invasive visualization of the coronary arteries themselves.

The common denominator across all these cardiac innovations is the commitment to non-invasive diagnostics, objective data, and subsequent precision and intervention. This philosophy allowed cardiologists to shift away from generalized treatments toward those meticulously tailored to the individual patient’s condition, leading to substantial improvements in outcomes and a reduction in morbidity and mortality associated with heart disease.

Spinal Innovation History

The contemporary state of spinal care bears a striking resemblance to the antiquated model of heart disease treatments pre-20th century. Chronic low back pain is too often treated as a homogeneous condition.

The 1970s, in particular, could be considered a “golden era” for spinal diagnostic tools. The first computed tomography (CT) scan was performed on a human in 1971 in London. The CT scan was able to take several X-ray images from various angles and use a computer to “reconstruct” them into a 2D image. Then, less than six years later, the first ever Magnetic Resonance Imaging scan (MRI) was performed on a human body in 1977.

In the 80s and 90s, MRIs and CT scans saw several key upgrades. MRIs started using stronger superconducting magnets, allowing for higher-resolution images and faster scan times. CT scanners, meanwhile, the invention of the spiral CT drastically reduced scanning times and opened the possibility of multi-planar reformatting and 3D reconstructions.

These enhancements, driven by engineers and physicists, are not just technical milestones; they enable direct improvements in patient care, allowing doctors to capture higher-resolution images faster, reduce patient anxiety through wider and more open systems, and ultimately, provide clinicians with the unprecedented clarity needed for earlier, more accurate diagnoses. The sustained efforts in advancing MRI are what allow companies like Aclarion to leverage this superior imaging modality for enhanced patient outcomes today.

Since then, scientists have enhanced the MRI in several ways, and it’s important to keep that momentum going and expand into other forms of imaging. The current diagnostic reliance on standard anatomical imaging, such as CT and MRIs, frequently reveals structural abnormalities (like disc degeneration) that may or may not be the actual source of the patient’s pain.

One of the most famous examples of this is the Landmark Study (Jensen et al., 1994). Researchers performed lumbar MRI scans on dozens of people who never experienced back pain. 52% of those scanned had a disc bulge in at least one level, and 27% had a disc protrusion. This study confirmed that just because someone has an abnormal disc structure or protrusion, it doesn’t mean that it will cause them pain. Yet, more than 30 years later, many practitioners still treat lumbar abnormalities and pain as a one-to-one correlation.

This is where the parallel with cardiology becomes imperative. Just as heart problems were not optimally treated through invasive techniques, patients with spinal pain need to see meaningful innovations in both decision support and diagnostic technology. The spinal care industry must move beyond simply identifying anatomical abnormalities and begin to understand the specific pathophysiology of the patient’s condition at a biochemical level.

Modern Cardiology Diagnostics

More recently, cardiology has seen a shift away from traditional nuclear stress tests driven by private sector innovation in noninvasive diagnostics. For example, before HeartFlow started trading on the Nasdaq in August of 2025, it had successfully disrupted the status quo and introduced FFRct by leveraging proprietary algorithms to replicate the precision of invasive fractional flow reserve catheter procedures without the need for a cath lab. By leveraging CCTA and sophisticated AI-enabled SaaS solutions in the cloud, private companies transformed complex imaging into actionable clinical data. This technological leap is evidenced by the widespread adoption of these decision support tools in over 4,000 hospitals globally and the attainment of Category 1 reimbursement codes, signaling a new standard in cardiovascular care.

The broader implication of this shift is that cloud-based SaaS solutions are no longer peripheral technologies; they are now the primary diagnostic engines for determining Coronary Artery Disease (CAD).

Major cardiology societies have granted these platforms Level 1 diagnostic endorsements, effectively positioning them as the first line of defense rather than secondary testing options. While advanced imaging provides the essential “raw material,” significantly advanced clinical value lies in the AI’s ability to analyze and translate complex physiological data into intuitive, easy-to-interpret reports. This transition underscores a pivotal moment where independent, private-sector advancements are defining the future of patient-specific accuracy and improved outcomes.

Parallels Between Cardio and Spine Technologies

The current diagnostic options in spine often involve invasive, expensive, and subjective procedures like provocative discography. With the cardiology societal recognition and endorsement of FFRct to help understand the blood flow implications of an occlusion in the heart, many cardiologists will not place a stent without that noninvasive confirmation of physiologic impairment; yet, the previous levels of treatment planning uncertainty persist in many spinal interventions.

Closing the gap between how Cardiology and Spine approach treatment planning is the very opportunity that exists today for advanced MR Spectroscopy.

Imagine NOCISCAN as the molecular equivalent of the cardiac diagnostic toolkit for the spine. It moves beyond anatomical structure to provide a biochemical fingerprint of the disc tissue. Utilizing non-invasive MR Spectroscopy, NOCISCAN identifies and quantifies unique biomarkers within the disc tissue, the precise chemical agents that comprise the structural integrity of the disc, and those chemicals, like certain acids, that cause pain. This process transitions the treating physician’s insight of the source of back pain from a physical assessment to a functional and chemical one.

The shift we are advocating in spinal care precisely mirrors the journey of cardiology. Cardiology evolved from invasive evaluation of flow-limiting stenosis to noninvasive interrogation of both blood flow implications and plaque burden insights utilizing CCTA plus an additional SaaS AI application. Spinal care must evolve from anatomical evaluation of back pain to include the specific biochemically active, pain-generating disc.

The powerful, non-invasive diagnostic tools in cardiology ensure that highly invasive procedures are reserved as the final, necessary option, guided by clear, objective data. Technologies like NOCISCAN offer that same foundational, non-invasive, objective data for spinal care, enabling clinicians to select the most appropriate treatment path with the highest probability of success.

Clinical Considerations

The clinical implications of this precision are undeniable. When treatments correlate with the specific biochemical data provided by such targeted decision support tools, patient outcomes are significantly improved. For the patient, this means the end of a long, often painful journey. For healthcare systems, it promises a substantial reduction in the high economic burden of generalized, frequently failed treatments and costly revision surgeries.

Private companies delivering cloud-based SaaS solutions have become integral in the Cardiology world. Many of the most meaningful advances in applying AI to clinical decision making did not come from large conglomerates, but from focused, innovative startups that were able to move quickly to solve real clinical problems.

Conclusion

The revolution in cardiology was achieved through a sustained commitment to innovation and the recognition that precision underpins effective treatment. The lessons learned from the non-invasive scrutiny of the heart provide a clear and compelling roadmap for transforming spinal care. By embracing sophisticated, non-invasive tools that identify the specific chemical source of chronic low back pain, the industry can finally move away from a generalized approach and usher in an era of targeted, high-efficacy, and less invasive spinal treatment. This is not simply a desirable evolution; it is a clinical and economic imperative.

Brent Ness became the chief executive officer of Aclarion in September 2021. He is a highly accomplished executive with over 25 years of medical device and healthcare technology experience, specializing in leading innovative companies through pre-FDA clearance, high-growth commercialization, and international market expansion. Before joining Aclarion, Ness served as president and chief commercial officer of Cleerly Inc., where he was instrumental in building key industry partnerships, including with Canon Inc., to successfully drive the adoption of their AI-enabled cardiology solution. Previously, as chief operating officer of Mighty Oak Medical, he oversaw the progression of principal products, such as the FIREFLY platform, from pre-FDA clearance through to a full international market launch. He also served as chief commercial officer of HeartFlow Inc., where he and the executive team led the company through pre-FDA clearance and executed a global expansion of early adopter sites. Additionally, as president of ProNerve LLC, Ness successfully led a strategic roll-up and consolidation of the highly fragmented Interoperative nerve monitoring industry. His extensive experience also includes senior leadership roles at industry giants Medtronic, GE Healthcare, and Philips North America. Mr. Ness holds a BS in Business Administration from the University of North Dakota and an MBA from the University of Colorado.