Other Articles

Using DNA to Predict Scoliosis
Six million people (estimate from the National Scoliosis Foundation) have scoliosis in one form or another. The primary age for onset of idiopathic scoliosis is 10-15 years old. Finally, there is a test which can reliably predict scoliosis. Fewer X-rays. Lower cost. Better outcomes.

New Capital, New Science for Cartilage Repair
$36 million invested in the last couple of months. TiGenix has more than that in the bank to fund market penetration. Then a new paper last week finds molecular cause of OA. Cartilage repair momentum is building.

Should I Become a Physician-Employee?
Large healthcare institutions are increasingly purchasing orthopedic practices. What does this mean for patient referrals? How beneficial can it be for orthopedists? The upside is more stability, among other things…and one of the downsides is loss of freedom.

Outrageous Whistleblower Lawsuit Challenged
Spine surgeons sued by whistleblowers in Boston are fighting back. Their lawyer is outraged and says the claimants are just shopping an old and settled case to another judge. Is this the proverbial lipstick on a pig? Find out.

Medical Education Under the Microscope – Is It Up to Today’s Challenges?
Where is the line drawn between what medical schools, residencies, and professors should provide to students and what doctors-in-training should reach for themselves? Here are the results of interviews with three senior surgeons, who opine on things such as attitudes, how people learn, and the possible effects on the field.

The Underlying Meaning of Zimmer’s Purchase of Abbott Spine
From the price paid to the timing, this transaction held an underlying meaning for the entire spinal implant industry. Zimmer, the $4.2 billion (revenue) diversified orthopedic company is now #5 in spine. More to come?

Resurging Lumbar and Cervical Total Disc Replacement Markets! New PearlDiver Estimates
Rumors of the TDA market’s demise were premature. Increasingly positive long term patient data is at the core of a resurging lumbar and cervical TDR market. Senior analyst Matt Menze tackles the TDA market and interviews one of the fathers of TDR, Dr. Scott Blumenthal from the Texas Back Institute. Where is this market actually heading? We think to the $2 billion range by 2015. All details here.

Six Days in June – Biomet and Zimmer Battle for Distributors in Kentucky
Documents filed recently in a Kentucky lawsuit pull the curtain back on an epic battle between Biomet and Zimmer. For six fevered days in June 2007, Biomet CEO Jeff Binder and founder Dane Miller went into the trenches to save one of their own. For all the details, read on.

Multicenter Clinical Trials: Do They Get the Respect They Deserve?
They’re not fast or sexy, but they are critical…large trials, that is. With multiple sites and principal investigators who donate their time, large trials are more complex—and normally yield more actionable data—than smaller, quicker studies. But large trials don’t always get the respect they deserve. And, says at least one physician-researcher, this could affect the future of the field.

Patent Wars: Medtronic Attacks NuVasive
MSD’s lawsuit came amid a period of declining spinal implant market share – from a peak of 60% in late 1998 (just prior to being acquired by Medtronic) to, we estimate, 36% currently – and a growing sense that MSD’s reign as the king of spine was coming to a close. What’s really behind Medtronic’s attack on its former senior exec? Read on.

Spine Gainsharing Through the Looking Glass
The feds have issued their first opinion allowing a spine gainsharing proposal. In Alice in Wonderland style, Through-the-Looking-Glass logic, they said the proposal was improper but would not impose sanctions. Who is the author of such a plan and what’s her secret? Read here.

PearlDiver Data Raises New Questions About Synovial Injections
Synovial injections for painful knees have been approved for use since 1997. If the goal is to improve the quality of life for the patient, is that being accomplished? The latest numbers from the PearlDiver Patient Records Database cast doubt.

Plantar Fascia: The Annual 3 Million Patient Market
“Plantar Fascial Fibromatosis (ICD-9-D-728.71) is right up there in frequency with pain in the shoulder joint, degeneration of lumbar intervertebral discs, pain in the lower leg joint, and carpal tunnel syndrome. As usual, PearlDiver has this market mapped out.

Orthopedic Incubators: Where Little Ideas Grow Up
Business incubation, also known as acceleration, can be a wild ride. Thus it’s best to approach it armed with the solid advice of experienced professionals. Who should take this ride? What can venture financiers bring to the table? These questions and more are answered by two seasoned VC professionals.

Just Say No to CMS Potential Coverage Decision List
Unless you want to be on the receiving end of a non-coverage letter, just say no to CMS’ proposed list of potential National Coverage Decisions. You’ve got until September 28 to make your case. Read what a leading industry consultant and analyst have to say.

Staking a BIG Claim
Alphatec, the company whose IPO collapse served as an object lesson for all medical device companies, has nearly completed its turnaround. The key? New management and new technology. Exhibit A: OsseoFix™—with it Alphatec stakes a claim to the next big spinal implant market.

Northwestern University researchers have published a new paper in the April 2 issue of The Journal of Neuroscience (“Self-Assembling Nanofibers Inhibit Glial Scar Formation and Promote Axon Elongation after Spinal Cord Injury,” 28(14):3814-3823) describing a new nano-engineered gel that inhibits the formation of scar tissue at spinal cord injury sites and enables the severed spinal cord fibers to regenerate and grow.

The gel is actually a self-assembling nanostructure which has been engineered to promote neuron growth. The gel, in the study, was injected as a liquid into the spinal cord injury site and there it self-assembled into a scaffold that supports the new nerve fibers as they grow up and down the spinal cord, penetrating the site of the injury.

The research was conducted using mice with a spinal cord injury. After six weeks the animals had a greatly enhanced ability to use their hind legs and walk.

Lead author John A. Kessler, M.D., Davee Professor of Stem Cell Biology, Chair of the Department of Neurology, Director of the Neuroscience Institute and the Northwestern University Feinberg School of Medicine Stem Cell Institute, said: “There is no magic bullet or one single thing that solves the spinal cord injury, but this gives us a brand new technology to be able to think about treating this disorder. It could be used in combination with other technologies including stem cells, drugs or other kinds of interventions.”

“We designed our self-assembling nanostructures—the building blocks of the gel—to promote neuron growth,” said co-author Samuel I. Stupp, Board of Trustees Professor of Materials Science and Engineering, Chemistry, and Medicine, and Director of Northwestern’s Institute for BioNanotechnology in Medicine. “To actually see the regeneration of axons in the spinal cord after injury is a fascinating outcome.”

The nano-engineered gel works in several ways to support the regeneration of spinal cord nerve fibers. In addition to reducing the formation of scar tissue, it also instructs the stem cells—which would normally form scar tissue—to instead produce a helpful new cell that makes myelin. Myelin is a substance that sheaths the axons of the spinal cord to permit the rapid transmission of nerve impulses.

The gel's scaffolding also supports the growth of the axons in two critical directions: up the spinal cord to the brain (the sensory axons) and down to the legs (the motor axons). “Not everybody realizes you have to grow the fibers up the spinal cord so you can feel where the floor is. If you can't feel where the floor is with your feet, you can't walk," Kessler said.