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BoxSPINE Receives FDA Clearance for Rodless Spinal Fixation System, Redefining a Decades-Old Surgical Approach

April 9, 2026 By SPINEMarketGroup

The DUET™ Spinal Fixation System is a posterior, minimally invasive stabilization system designed to improve patient experience while enhancing fusion strength. It eliminates known failure mechanisms of traditional pedicle screw constructs and streamlines procedures for ASC environments.

WINONA LAKE, Ind. & PLYMOUTH, Ind.–(BUSINESS WIRE)–BoxSPINE, LLC today announced U.S. Food and Drug Administration (FDA) clearance for the DUET™ Spinal Fixation System, a three-piece spinal stabilization system designed to eliminate the need for traditional rods.

For decades, spinal fixation has relied on rod-and-pedicle screw systems first introduced in the 1960s. While widely used, these systems are complex, costly, and dependent on multiple components with known mechanical failure points. They also require extensive instrument sets and inventory, increasing procedural burden for hospitals and ambulatory surgery centers (ASCs).

The DUET™ system was developed to address these limitations with a simplified construct. Instead of relying on rods, the system uses a three-piece design in which a halo device captures a spherical implant head, creating 360° contact and allowing 35° to 60° of articulation depending on patient anatomy. The components are secured with a locking cap that engages directly with the implant.

This design leverages triangular geometry, one of the most stable structural forms in engineering. In mechanical testing, the DUET™ system demonstrated greater strength than predicate devices and more than double the stiffness, improving resistance to deformation under load.

Unlike traditional systems that require hundreds of instruments and implant variations, the DUET™ platform is streamlined, with minimal SKUs and a disposable, single-use sterile instrument kit. This reduction in complexity supports efficiency in the operating room and makes the system well-suited for ASC environments.

“FDA clearance of the DUET™ Spinal Fixation System gives surgeons an exciting and innovative option for their patients,” said Richard G. Fessler, MD, PhD, of Rush University Medical Center. “DUET™ is designed without the main failure mechanisms like rods and tulip heads whose limited contact weakens traditional pedicle screw systems. Instead, it uses a triangle, the strongest geometry in architecture and engineering.”

“Beyond eliminating the rod, we’ve eliminated 90% of the instruments and inventory required for one-level lumbar fusion,” said Richard Cranford, CEO of BoxSPINE. “This creates a cost-conscious solution for ASC settings.”

The global spinal implant market exceeds $10 billion annually, with millions of patients seeking treatment for spinal disorders each year. Yet the foundational technology behind many procedures has remained largely unchanged for decades, contributing to rising costs across the healthcare system. The DUET™ system represents a shift toward simpler, more efficient spinal stabilization designed to meet the demands of modern surgical practice.

BoxSPINE will be at ISASS. Visit them at Booth 314.

About BoxSPINE, LLC

BoxSPINE, LLC, headquartered in Plymouth, IN is a company focused on delivering pre-sterilized, cost-effective medical device solutions with an emphasis on efficiency and inventory control. BoxSPINE has a strategic alliance with Duet Spine Holdings, LLC to deliver a novel and simple approach to spinal surgery, specifically targeting key ambulatory surgical centers (ASCs) in the U.S.

CEO Richard Cranford is a seasoned medical device entrepreneur with over three decades of experience in sales, management, business development, and successful exits in the healthcare industry. His entrepreneurial journey has significantly shaped the medical device and biologics sector, particularly through his ventures associated with Medtronic and the founding of BoxSPINE, LLC. Visit boxspine.com for more information.

About Duet Spine Holdings, LLC

Duet Spine Holdings is a subsidiary of In Queue Innovations, LLC, both are technology-driven intellectual property (IP) incubators and developers headquartered in Winona Lake, IN.

Co-Founder of Duet Spine, Richard G. Fessler, MD, PhD, is a distinguished neurosurgeon and professor in the Department of Neurological Surgery at Rush University Medical Center in Chicago, Illinois. Renowned for his pioneering contributions to minimally invasive spine surgery, Dr. Fessler has established himself as a leading authority in neurosurgery, with a career spanning over four decades marked by clinical excellence, innovative research, and academic leadership. His work on minimally invasive techniques and spinal cord injury treatments continues to shape the field.

Jill Serbousek, also a co-founder, is an experienced business executive with a significant professional background in the medical device industry, notably as a Vice President of Business and Marketing Strategy at Medtronic’s Spine and Biologics business and the founding of In Queue Innovations, LLC.

Both Duet Spine Holdings and In Queue Innovations have built a reputation of delivering innovative and differentiated intellectual property that drives fundamental shifts in solutions for spine surgery. The company markets a complete portfolio of patents and patent applications in the MIS spinal field.

Contacts

Richard Cranford
918.640.5972

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Filed Under: NEWS Tagged With: 2026

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