The move toward customization is cultural for "Generation Me"; people want personalized hand towels, tailored clothes and cocktails at their wedding reception designed to match the bride and grooms' personalities. When people log onto computers or smart phones, they customize settings to optimize their personal style and workflow.
Now the trend toward personalization is coming to spine devices that fit patient anatomy and could revolutionize how people view spine surgery. They are also designed with the surgeon in mind to maximize his or her time and resources.
"In the last decade or so, we've seen an explosion of technologies that have been catalyzing innovation and improvements within orthopedics and surgical care," says Sjors Hermans, Business Director Spine APMEA & Europe, Medacta International. "As it stands today, I think the most important global trends in healthcare are related to personalization and ease-of-use, and this is definitely true of the advancements we're seeing in spine care."
A few of the key areas poised for growth in the spine device arena are:
• Patient-matched technology
• Customizable implants
• Intra-surgical guidance technologies
• Three-dimensional technology
• Endoscopic technology
"There's been a lot of documented success using customizable solutions in knee procedures, and this methodology is slowly translating over to spinal care," says Mr. Hermans. "Similar to this, I think the intra-surgical guidance technologies will also continue to grow and develop. We have already begun to see initial success with our MySpine patient-matched surgical guides, which newly launched in the United States and are meant to support surgeons during pedicle screw placement."
In minimally invasive and mini-open procedures, the next evolution seems to be endoscopic technology. "I predict we will see a lot of disruption in endoscopic as well as so-called mini-open spine surgeries through new muscle sparing techniques that have the potential to reduce the invasiveness of the procedure and blood loss, and increase clinical outcomes," says Mr. Hermans.
Medical device companies are looking past the low-hanging fruit — simple procedure upgrades and less invasive technique — to design more customizable technologies for complex procedures. Technologies that can increase accuracy, efficiency and outcomes for patients during the recovery period have huge promise.
Three-dimensional printing has also taken off in the medical device space, with initiatives in orthopedics and spine already underway and implanted in patients. These patients are abroad in spine, for the most part, but the technology could come to the United States before too long.
"As of now, I think patient-customized three-dimensional implants have the potential to be game-changers," says Mr. Hermans. "Spinal anatomies vary from patient to patient, with nuanced and very intricate differences. As you can imagine, this presents a challenge for surgeons who have to navigate and repair complicated anatomies with standard implants."
But when surgeons adapt to customizable technology and optimize efficiency, the procedure has the potential to speed recovery because more of the natural anatomy is preserved. It may also reduce reoperations, additional hospitalizations and treatments due to ill-fitting implants and other procedure- and device-related complications. Not to mention reducing the cost on expensive implants.
"The versatile and rapid nature of three-dimensional printers will allow this method to be extremely cost-efficient and assessable," says Mr. Hermans. "Biomechanically, strength testing per implants may remain a challenge in the foreseeable future for innovations of this nature, but on the whole I see huge potential."
But considering cost pressures on healthcare providers, low reimbursement and minimal motivation for big device companies to spend resources in research and development, which of the new innovations will stick? Mr. Hermans says these qualities are the most likely to make sure an implant will be around for the long term:
• Ease-of-use
• Cost-efficiency
• Long-term quantifiable clinical outcomes
"The ability to see a comprehensive collection of clinical data gathered from randomized trials with large patient quantities is extremely helpful when trying to access the technology's broad potential and ultimately fuel its success," says Mr. Hermans. "[Additionally] I think what makes one technology more effective over another comes down to a few factors, the most important being ease-of-use. Surgeons are dealing with complex cases that involve a lot of moving parts and applications, so the ability to quickly navigate and integrate a new solution into their routine is one of the biggest selling points."
There is also opportunity to disrupt the traditional spine space. Individualizing spine surgeries and correcting the sagittal balance for a patient can help improve clinical outcomes, and should be taken into account when performing spine surgeries, says Mr. Hermans, but not at all cost.
"Surgeries of this type are trying to establish natural ideal sagittal balance and in the end tend to become rather more invasive with the corresponding risks of potential complications such as muscle necrosis, infection, dural leaks, hematomas, anaesthesiologic-related issues due to longer surgery time," says Mr. Hermans. "Not every patient will be suitable to undergo this treatment. So a way to match a positive sagittal balance outcome, while minimizing the risk of complication is an example of the potential disruption we could be seeing in the future."