Dr. McMains, of Indianapolis-based OrthoIndy, was the first in the world to perform an anterior lumbar interbody fusion with Theradaptive’s OsteoAdapt SP implant as part of a clinical trial.
Dr. McMains joined the “Becker’s Spine and Orthopedic Podcast” to discuss his outlook on spine biologics.
Note: This is an edited excerpt. Listen to the full conversation here.
Question: Spine biologics is an area where it could stand to be more deeply researched. Are there any applications that you want to see spine surgeons explore more with biologics? Any other interesting research that you’re doing as well in this area?
Dr. Craig McMains: As spine surgeons, our gold standard is what we call an autograft. In other words, it’s bone taken from the patient’s own body and used in their spinal fusion. That works really well, but the concern is that if you had to get enough bone to lay in the spine, you usually were harvesting it from somewhere else, what we call a donor site. It causes pain and issues from the place you harvested it. These other options, whether it’s what we call an allograft coming from a cadaveric source or from a synthetic source like OsteoAdapt, are really promising, because then we can potentially get a fusion result as good as an autograft without causing further harm to the patient. I think that the opportunity to expand upon synthetic use, where we don’t have to complicate the procedure by having the risk of a cadaver sourced product that maybe could be as good, if maybe not even better than an autograft is a dream that we all achieve or striving for. Anything that can make the surgical experience easier and faster is always the goal. We’re constantly looking at all kinds of other biologics. We’ve looked at some other synthetic products, and the thing I’m excited about is not just getting a solid fusion, but getting to that fusion faster. If you can keep the patient, if you get the patient back to their normal life quicker, it’s a win for everybody.
Q: When you think about the role of biologics in spine care in five years, what does that look like?
CM: There’s just a crazy amount of interest in the space. I think more people, as we get better products, will utilize things like synthetics. The innovation is going to come from personalized medicine. You’re going to have personalized biologics. You’re going to have a biologic that knows how to go into your body and stimulate it to lay down bone in the most effective and the most efficient manner possible. As we expand forward, we’re going to get to those solid fusions faster and we’re going to apply that learning of biologics into the implants themselves. Right now we put pieces of metal or pieces of biologic plastic into the body, and the body doesn’t like to have foreign substances in it. We could somehow tell the body that, “Hey this is coated in a bioactive substance,” the body recognizes whatever implant you put in as part of itself, and it’ll speed up that healing process and get a better outcome. That’s on the chemistry side of things. On the digital side the question is how do we know that we’re getting faster fusions and better fusions? We’re starting to leverage our learnings in the digital space to get real-time feedback and getting information about the real-time healing process.