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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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Elegance in Spine: Extracavitary Approaches
The delicate task of dealing with spinal problems is getting a bit less complex, says Dr. Francis Shen. Orthopedists can now remove a section of rib and approach the front of the vertebrae from the back in an oblique direction.

Endotec Beats FDA, Strikes Blow for Innovation
Endotec has struck a blow for every orthopedic surgeon who wants to develop a better device. See how the company’s founders took on the FDA and got a federal judge to charge the agency with “stymieing progress and technological advancement.” How did they do it? Read on.

From Obesity to Osteoarthritis, the Carpal Tunnel Connection
It’s certainly no surprise that Carpal Tunnel Syndrome (CTS) is an exceedingly common orthopedic malady. But, as PearlDiver’s data show, the linkage between obesity, osteoarthritis and other conditions to CTS is most surprising. Check it out.

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.

OsteoGeneX Inc. Adds Board Members, Acquires $1.4 Million in Funding
By Elizabeth Hofheinz, MEd, MPH
August 9, 2008

OsteoGeneX Inc., a Kansas-based biotech company focused on bone building technologies, announced that it has recently received funding with a $1 million NIH (NIAMS) Phase II Small Business Innovation Research Award and a matching award of $375,000 from the Kansas Bioscience Authority. The funds will advance its work in developing a treatment to stop the advance of osteoporosis.

In addition, three leading industry experts will join the advisory board.

John P. Harrington – 39-year international corporate orthopedic/spine veteran with Johnson & Johnson (J&J), VP Operations Strategic Initiatives and Global Supply Chain, J&J, Cork, Ireland

Harrington told OTW, “In my former roles within J&J's Orthopaedics and Spine organizations I had a number of opportunities to provide leadership and guidance to smaller ‘start-up’ operations which were brought to us either through acquisition or internal development. As a result, I have a good perspective on what it takes to move an organization from early development stages on to commercial success. I also have a good understanding of what a larger organization might be looking for in considering a potential partnership with or other arrangement with a smaller developing organization. Should a future strategy of OGX involve a move in the direction of an arrangement with a larger organization I can offer some perspective on making this successful.”

Mark D. LoGuidice – 27-year veteran of the medical device industry, CEO Spine Wave, Inc.

Commenting to OTW, LoGuidice noted, “I have experience raising money for early stage ventures and I am familiar with what investors are looking for in the field of spine. When the time comes for OsteoGeneX to interact with the venture community, I hope this experience will be an asset for them.”

Enrico Picozza – Pioneer of life science technology, HLM Venture Partners

Of his new role, Picozza told OTW, “Over the past 23 years I have successfully combined and monetized both my technical and business skills. During this time period I have completed numerous academic relationships and large corporate transaction from both the corporate side as well as the entrepreneurial side. I have fund raising as well as funding experience as further emphasized by my appointment as a venture partner with HLM Venture Partners in Boston. In addition to the traditional sources for funding I successfully raised significant non dilutive dollars from corporate partnerships as well as granting agencies, key to early stage companies. My corporate development expertise is broad and includes international locations such as Japan where I was successful in raising corporate non dilutive financing while expanding our development effort with their internal corporate resources. My technical skills yielded 10 issued patents and multiple technical papers. Finally my experience in cell therapy for regenerative medicine is complimentary to the objectives of OsteoGeneX. I hope that OsteoGeneX will be able to leverage my 23 years of corporate and serial entrepreneurial experience combined with both my technical and business successes as they approach the many different stages a company goes through during its growth.”

In the news release, Debra Ellies, Ph.D., President, CEO and Founder of OsteoGeneX, stated, “The national and international leaders join the board at a pivotal time for OsteoGeneX. Their respective expertise and insight will be invaluable as we open up discussions with publically traded pharmaceutical partners to out-license our osteoporosis solution.”

 

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