NekSpine for Rural and Critical Access Hospitals

At a large academic medical center, a surgeon who reduces their operative volume because of an occupational musculoskeletal injury creates a coverage gap the department can often absorb. At a rural or critical access hospital, the same event may mean reduced surgical capacity for the entire community, increased reliance on expensive locum coverage, or cases transferred to regional centers. According to the National Rural Health Association, 2025, even a single surgeon’s reduced performance or departure can jeopardize surgical services for an entire rural region. The American College of Surgeons Bulletin, March 2024, notes that rural areas nationwide had, on average, only sixty-nine percent of the general surgeons needed to meet demand as of 2018, a gap that has persisted and, in some regions, widened. The peer-reviewed literature documents the occupational spine health burden on surgeons regardless of institution size. Contact NekSpine to discuss how the device and pilot structure apply to your institution.

The Staffing Reality at Rural Surgical Departments

Rural and critical access hospitals typically operate with smaller surgical teams, less redundancy across specialties, and greater dependence on individual surgeons to sustain the department’s operative capacity. According to the National Rural Health Association, 2025, the loss of surgical capabilities at rural hospitals can trigger a cascading effect that threatens the viability of other departments, ultimately placing additional strain on the remaining healthcare workforce. Locum surgical coverage carries a cost premium that many rural institutions find difficult to sustain — and according to the American College of Surgeons Bulletin, March 2024, full surgical training from medical school through fellowship can span fourteen years, meaning that replacement recruitment timelines are long regardless of financial investment. Proactive investment in surgical staff occupational health is a risk-management decision with a measurable rationale when weighed against the cost of the alternative.

What the Evidence Shows

Epstein et al., JAMA Surgery, 2018, found neck and back among the most prevalent sites of work-related musculoskeletal disorders in surgical practice across 5,828 physicians in 21 studies, with prevalence increasing over career length. The NekSpine Mayo Clinic study, Annals of Surgery, 2025, reported a 56 percent increase in static endurance time and a 91.7 percent device acceptance rate across twelve surgeons in six specialties during actual operative procedures. The University of Alberta / EWI Works, Sensors, 2026 reported up to a 31% reduction in neck muscle activity and up to a 50% reduction in perceived neck discomfort across multiple flexion angles during simulated surgical tasks. Individual results will vary. The full evidence base is available on our clinical evidence page.

How the Pilot Evaluation Works for Smaller Surgical Departments

The NekSpine hospital pilot execution kit provides the institutional framework for evaluating the device at the department level. For rural and critical access hospitals, the pilot structure adapts to smaller surgical team sizes without requiring the participant volumes that larger academic center pilots might involve. Key elements include:

• A measurement framework for capturing surgeon-reported outcomes before, during, and after the evaluation period
• Participant selection guidance appropriate for small surgical departments where every surgeon may be included rather than a representative sample
• Decision criteria documentation that gives department leadership and administration a clear basis for the procurement decision
• Fitting and onboarding support provided directly by the NekSpine team

Contact NekSpine to request the hospital pilot execution kit and discuss what the evaluation looks like for your specific department.

The Procurement Pathway for Rural and Critical Access Institutions

NekSpine is a personal-use device as described on our device specifications page, which means procurement is structured around individual devices for participating surgeons rather than a departmental equipment purchase with associated facilities or IT requirements. The device has no electronic components, power requirements, or biomedical engineering or IT dependencies. The free trial period allows institutions to evaluate the device and build an internal case for procurement before any purchase commitment is required. Contact NekSpine to discuss pricing, procurement documentation, and what the process looks like for your institution.

Rural and Critical Access Hospitals Have Strong Reasons to Protect Their Surgical Workforce

The peer-reviewed evidence on surgical ergonomic support does not distinguish by institution size. The consequences may be more acute at smaller institutions where surgical capacity is less redundant. NekSpine is available to rural and critical access hospitals through the same free trial and pilot execution framework used by larger institutions. Contact NekSpine to begin a conversation about your institution, or review the full clinical evidence on our clinical evidence page.