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Procedure of the Month

This is the case of a 68 year-old male suffering from severe back pain for 3 months. Patient failed conservative treatment with high doses of analgesics. MRI was performed, as shown in Figure 1 below. This T2-weighted image clearly revealed evidence of acute fracture with bone marrow edema at the L1 level. Which choice do you think best describes the patient's treatment options (click on the x-ray below to take the multiple choice/guess test)?

Figure 1: Preoperative T2-weighted sagittal MRI showed evidence of bone marrow edema indicative of acute fracture at the L1 level (arrow).

Case review and x-rays courtesy of
Dr. Bassem A Georgy.
Interventional Radiologist Valley Radiology Consultants Assistant Clinical Professor University of California, San Diego

SPONSORED BY:


Procedure of the Month Sponsored by DePuy Spine, Inc.


 

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Using DNA to Predict Scoliosis
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Should I Become a Physician-Employee?
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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
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PearlDiver Data Raises New Questions About Synovial Injections
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Orthopedic Incubators: Where Little Ideas Grow Up
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Facet Solutions, Inc. Completes Combination Facet Joint and Disc Replacement Study
By Elizabeth Hofheinz, MEd, MPH
May 8, 2008

It’s the motion in Miami…Facet Solutions, Inc. is announcing the successful completion of a scientific evaluation for a total joint reconstruction in the lumbar spine. The study evaluated the combination of Facet Solutions’ Anatomic Facet Replacement System (AFRS™) with a semi-constrained disc replacement device in a finite element model. The details of this study will be presented by Professor Vijay Goel, Ph.D. at the Spine Arthroplasty Society meeting in Miami, Florida.

Commenting to OTW, Dr. Goel stated, “This specific combination of a polymeric semi-constrained disc device with an anatomic facet device resulted in biomechanics that were very similar to the intact spine.” He continued, “As more 360 degree arthroplasty combinations are investigated, it will be interesting to see which provide the optimal biomechanical solution to total motion segment replacement.”

In the news release, Mr. Geoff Pardo, President and CEO of Facet Solutions, Inc., stated, “The use of facet replacement in combination with repair of the anterior column of the spine will have dramatic implications on how we treat patients with degenerative diseases of the spine. The finite element model shows how properly designed, anatomically shaped implants work in harmony with one another. The degenerative cascade in lumbar spine affects both the anterior and posterior elements, and Facet Solutions is committed to bringing solutions for the entire articulating joint to the millions of patients with this need.”

Facet Solutions previously issued a press release regarding the receipt of a landmark patent issued by the United States Patent and Trademark Office (USPTO) providing claims related to a combination of an intervertebral disc and a facet joint prosthesis.

The AFRS™ was designed to provide patients with lumbar spinal stenosis and facet degeneration with a motion preserving alternative to lumbar spinal fusion. The AFRS™ procedure includes replacement of the diseased facet joint with an anatomic implant that restores the natural motion, stability, and balance to the lumbar spine. AFRS™ is an investigational device in the United States. It is limited by United States (U.S.) Federal Law for investigational use only.


 

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