Backed by strong supportive evidence, the minimally invasive spine approach continues to gain steam in 2018. Device companies are making splashes in the industry with novel MIS technologies and spine surgeons are increasingly leveraging the technique.
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Here are 15 insights into the MIS spine landscape.
1. An April 2016 Spine study found patients undergoing minimally invasive fusions experienced 88.7 percent lower blood loss than the open procedure group. Additionally, the study found, hospital stays among the minimally invasive group were 64 percent shorter than hospital stays in the open procedure group.
2. The global minimally invasive spine surgery market will likely grow at a 7.57 percent compound annual growth rate through 2020, according to a Healthcare Market Reports analysis. While the growing number of spinal disorder cases will boost the market, a dearth of experienced MIS surgeons will slow market expansion.
3. The global minimally invasive surgical device market is anticipated to exceed $18 billion by 2021, medGadget reports. Advancements in minimally invasive surgery, reduction in healthcare costs and an increase in the geriatric population will drive the market during the forecast period.
4. In the coming years, market competitors will need to overcome the decrease in reimbursements for minimally invasive spine procedures, according to a Future Market Insights report.
5. According to an Apex Market Reports analysis, the top device companies in the global minimally invasive spine surgery market are DePuy Synthes, Medtronic, NuVasive, Stryker, Zimmer Biomet, Aesculap Implant Systems and Alliance Spine.
6. The global XLIF surgery market is poised to reach nearly $2.56 billion by 2024, according to a Reports Monitor analysis. The market was valued at $1.64 billion in 2016, and is expected to grow at a compound annual growth rate of 5.7 percent. Key market drivers include the increase of minimally invasive procedures and number of spinal disorder cases. In 2017, the XLIF interbody cages segment led the space, capturing 75.8 percent of the global market.
7. In January 2018, Blue Cross Blue Shield Association updated its quality evidence recommendation for minimally invasive sacroiliac joint fusion using triangular implants. BCBSA upgraded its BCBSA rating to "moderate" quality evidence, indicating the prevalence of sufficient evidence to determine the effects technology has on health outcomes. BCBSA believes individuals with SI joint disorders treated with sacroiliac fusion or fixation with a triangular implant results in a meaningful improvement to the net health outcome.
8. Paradigm Spine published its European study of coflex and decompression alone two-year trial results in the Journal of Neurosurgery: Spine. The study included 225 patients at seven sites throughout Europe with two-year follow-ups. Researchers found the coflex patients experienced higher composite clinical scores, 0.017, compared to the decompression alone group. Additionally, decompression alone patients reported greater loss of foraminal and posterior disc height maintenance compared to the coflex group. At the two-year follow up, the decompression alone group was 1.4 times more likely to be using opioids.
9. Minneapolis-based Inspired Spine reported surgeons have performed more than 500 Oblique Lateral Lumbar Interbody Fusions. The minimally invasive procedure uses an incision of 15 mm and incurs 80 percent less blood loss compared to a traditional fusion. Following the learning curve, a surgeon will likely perform OLLIF in less than one-third of the time a traditional fusion takes. A study published in Cureus found OLLIF saved hospitals an average of $9,500 per case compared to transforaminal lumbar interbody fusion.
10. In February 2017, Kern Singh, MD, founded the Minimally Invasive Spine Study Group. Dr. Singh serves as co-director of the Minimally Invasive Spine Institute at Midwest Orthopedics at Rush in Chicago. A 501(c)(3) nonprofit organization, MISSG intends to promote research and advancement of MIS spine. The group features an online patient registry, REDCAP, containing data from 3,000 unique patients treated with MIS approaches. Frank Phillips, MD, co-director of the Minimally Invasive Spine Institute at Midwest Orthopaedics at Rush, and Sheeraz Qureshi, MD, associate professor at New York City-based Hospital for Special Surgery, join Dr. Singh on the board of directors.
11. Tampa, Fla.-based The BioSpine Institute opened the doors of its new clinic in Orlando, Fla., Feb. 5. This clinic represents the institute's third location, with one in Spring Hill and the other in Tampa. Orthopedic spine surgeons Frank Bono, DO, James Ronzo, DO, and Roderick Claybrooks, MD, perform minimally invasive spine surgeries at The BioSpine Institute.
12. Renew Spine Care and SpineMark Corp. entered into a strategic alliance agreement in October 2017 to establish a mutually aligned mission of improving patient diagnosing, integrating minimally invasive spine surgery protocol and merging medical technology. Renew is composed of spine surgeons specializing in MIS, treating multiple spine levels, bilaterally, in the lumbar, cervical and thoracic regions. SpineMark Destination Centers promote a multispecialty holistic care approach for diagnosis, operative, non-operative and conservative treatment, striving to create a universal standard for early intervention of spinal pain.
13. In January, Robert Masson, MD, founder of Ocoee, Fla.-based Masson Spine Institute, shared key spine technology trends likely to take hold in 2018 with Becker's Spine Review. He noted, "The trends toward increased prevalence of minimally invasive surgery are leading to increased ability to execute outpatient spine reconstruction surgery."
14. In December 2017, Jocelyn Idema, DO, discussed the future of MIS spine surgery technology with Becker's Spine Review. Dr. Idema practices at Washington, Pa.-based Advanced Orthopaedics and Rehabilitation.
"Innovative technologies, such as improved navigation systems, robotics and the various implant techniques, will continue to positively impact the spine industry in the future. It is important to note that although these technologies continue to change and improve, the spine industry must also balance the cost-effectiveness and value of these technologies, always striving for the best patient outcome and experience for the patient."
15. Tucson, Ariz.-based Northwest NeuroSpecialists spine surgeon Richard Chua, MD, emphasized robotic image guidance is the next "big thing" in spine surgery during a December 2017 interview with Becker's Spine Review.
"I believe there will be continued growth in the application of minimally invasive spine surgical techniques, including improvements in implant technology, biologics, instrumentation and biomechanical considerations…I believe that the integration of image guidance and robotics will be the next big thing in spine surgery over the next five to 10 years. The ability to improve accuracy of instrumentation placement, reduce X-ray exposure to the patient, surgeon and staff as well as the ability to more efficiently correct deformities will result as the robotics, engineering and surgeon adoption become more feasible."