Many exciting innovations are being developed in the spine device industry, with smaller companies and startups aiming to break into a market dominated by medtech giants such as Medtronic, Stryker and Johnson & Johnson.
Here are the most innovative companies emerging in the spine device industry, according to five surgeons.
Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. Becker's invites all spine surgeon and specialist responses.
Next week's question: In which area of spine care is there the biggest need for innovation? Why?
Please send responses to Alan Condon at acondon@beckershealthcare.com by 5 p.m. CDT Wednesday, April 6.
Editor's note: The following responses were lightly edited for style and clarity.
Question: What spine company do you find particularly innovative in 2022, and why?
Jeremy Smith, MD. Hoag Orthopedic Institute (Irvine, Calif.): There are two companies this year that I feel are the most innovative and their platforms worth experiencing, one established and one up and coming.
Nuvasive's Pulse platform provides integrated navigation, neuromonitoring and alignment planning solutions that will maximize clinical, operational and financial outcomes. Bringing together the most accurate 3D navigation system while minimizing radiation exposure and offering alignment parameter systems with rod-bending technology truly maximizes the technology available in a very small space.
Surgalign has a unique take on spine enabling technology, particularly its use of artificial intelligence and augmented reality. Surgalign's Holo Portal surgical guidance system uses neural networks to process intraoperative imaging, automatically identifying the pedicle and additional anatomy to suggest a surgical plan. This image segmentation and surgical plan is displayed through augmented reality in surgery to quickly align and track surgical instruments, which I believe will help save time and improve outcomes. The additional level of detail provided by AI makes the augmented reality display a very interesting surgical tool, while the promise of AI is automation — minimizing the effort we spend in system setup and planning.
Brian Gantwerker, MD. The Craniospinal Center of Los Angeles: I recently have become familiar with a low-profile, portable MRI scanner by a small upstart company called Hyperfine. The physics are fascinating. They are able to generate an MRI image of the brain with full portability and reasonably good resolution. While it does not scan into the spine as of yet, it promises to keep patients on the ward who need urgent imaging. It is a very exciting time to be in this space, and I think portable imaging has come leaps and bounds since the early 2000s.
Michael Musacchio, MD. NorthShore Neurological Institute and NorthShore Spine Center (Evanston and Skokie, Ill.): With each discectomy surgery, the surgeon must choose between performing a more limited discectomy, which may lead to higher reherniation rates, or a more aggressive discectomy with higher rates of segmental dysfunction and mechanical back pain. This conundrum is amplified in the larger herniation and taller disc segment of this patient population. Historically, we have seen many different techniques and devices aimed at repairing the annulotomy or plugging the hole in an attempt to reduce reherniation rates while preserving more discs, but most have not lived up to potential.
The Barricaid annular closure device from Intrinsic Therapeutics has offered a more durable approach to this annular closure. The device is a Teflon flap that fills larger annular defects to prevent reherniation and is anchored to the bone by a small titanium shim. Anchoring into the bone is unique and more durable than pinning the repair of the annular tear on the damaged ligament or annulus itself. Through a spine surgery clinical trial, NorthShore Neurological Institute is studying the technology to confirm its efficacy. While not the most complex or challenging of surgeries, reducing the reherniation and sequelae of disc degeneration after microdiscectomy is a hugely innovative and important addition to our field.
William Taylor, MD. University of California San Diego: I have recently worked in developing the proton service with Alphatec. I find this to be a practical solution with significant advantages directed toward the lateral and interbody approaches. It offers the opportunity for improved lordosis, decreased complications and superior outcomes with a simple change in approach to lateral surgery.
Hamid Mir, MD. DISC Sports & Spine Center (Newport Beach, Calif.): Most spine companies are doing a great job in supporting innovation in spine surgery, but I see the most innovations in startup companies led by teams of surgeons and talented engineers.