Accuro Epidural Guidance Device Demonstrated Superior for Spinal Anesthesia Administration Compared to Palpation & Conventional Ultrasound in a Parturient With Extreme Obesity

Accuro's integration of artificial intelligence with ultrasound (AI-US) provides detailed ultrasound image analysis pivotal in complex clinical scenarios.

CHARLOTTESVILLE, Va. - August 16, 2022 - (

RIVANNA®, developers of world-first, imaging-based medical solutions, announced the results of a clinical case study demonstrating that Accuro played a crucial role in aiding the placement of an epidural catheter in a parturient with extreme obesity. The study, published in The Ultrasound Journal, further concluded that the benefits gained by pre-procedural AI-US are multiple: 

• increases patient satisfaction, 

• provides immediate recognition of anatomical structures,

• increases first-attempt success rates,

• reduces needle placement times, 

• and predicts needle direction and distance from the skin to reach target structures. 

As reported in the study, a patient requesting epidural analgesia for labor presented with a calculated BMI of 64.5 kg. Initial landmark palpation for localization of interspinous spaces proved unsuccessful. Secondarily, acquiring standard ultrasound imaging of the lumbar spine was ineffective in identifying target structures due to the amount of subcutaneous tissue. Accuro, which utilizes AI-enabled automatic recognition of spinal anatomy, provided rapid identification of the desired intervertebral space, the correct point for needle insertion and the estimated depth to the epidural space. A senior attending physician placed the epidural catheter on the first attempt. 

Quoted from the study, "…morphological alterations secondary to pregnancy and obesity created difficulties that could not be overcome using traditional landmark palpation nor standard ultrasound techniques." 

"Numerous studies have confirmed the effectiveness and safety of the Accuro-guided technique over the palpation-based approach for spinal placement or epidural catheterization," commented Will Mauldin, Ph.D., co-founder, and CEO of RIVANNA. "This study is notable because it examined the viability of standard ultrasound imaging in labor and delivery, especially in obese patients, as the visibility of the ligamentum flavum, dura mater and epidural space decreases significantly during pregnancy."

Neuraxial ultrasound competency using conventional equipment relies on the operator to provide accurate results. Conversely, Accuro's integrated AI-US technology provides clinicians with more detailed information that can be crucial in complex clinical scenarios. It may offer a new advantage in improving outcomes and training for operators not experienced in neuraxial ultrasound techniques. 

Conducted via the Anesthesiology, Critical Care and Pain Medicine Division at the University of Parma, Parma, Italy, the clinical case study was published in The Ultrasound Journal volume 14, Article number: 34 (2022).


RIVANNA® is a commercial-stage medical device innovator and manufacturer in Charlottesville, Va. RIVANNA's mission is to develop and commercialize world-first imaging-based medical technologies that elevate global standards of care. RIVANNA's technology platform combines the benefits of ultrasound with bone imaging capabilities of x-ray to fill unmet clinical needs. BoneVision™ and BoneEnhance® optimize ultrasound image acquisition and visualization to provide radiation-free alternatives to X-ray-based imaging. When paired with SpineNav3D™ AI-enabled image recognition, the platform offers comprehensive clinician assistance that improves decision-making, clinician workflows, health outcomes and patient satisfaction. The company operates an FDA-registered and ISO 13485:2016 certified manufacturing facility where it produces the Accuro® product line and related medical equipment and components. For more information, visit

Media contact: [email protected].

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Original Source: Accuro Epidural Guidance Device Demonstrated Superior for Spinal Anesthesia Administration Compared to Palpation & Conventional Ultrasound in a Parturient With Extreme Obesity