The Remarkable John Barrett: Creative Ortho Problem Solving

After CoAlign…Changing Pediatric Spine Surgery

“After CoAlign, I was looking around for new projects and new companies,” said Barrett. “In the spine world, I didn’t see a lot of real innovations.” Barrett, ever the innovator, saw only what he calls “me too” products and incremental technology development. While he understood their value in terms of marketability, he wasn’t satisfied. He saw no true “game changing” tools, technologies or innovation. Until, that is, he focused on pediatric spine fusion as an area with a significant need for creative thinking.

Fusion surgery on children is deeply invasive and creates permanent spinal change. “Fusion was still this thing that was so automatic and pervasive but still so traumatic,” explained Barrett. “It’s just one of those surgeries that every time you observe one you’re like, I can’t believe we still do this…almost medieval.”

“I met a couple of pediatric surgeons and I became familiar with a procedure called vertebral body tethering,” Barrett said. Some surgeons had devised this new technique as a less invasive alternative to fusion. “This was a very clever approach where you essentially used the growth of the kids to help straighten their spines,” said Barrett.

Several years ago, surgeons were looking for motion sparing and less invasive alternatives to fusion. They looked seriously at a system of anchoring one side of the spine with a tether to guide spinal growth as the child grew. At the time, this was an off-label procedure. Barrett said, “I saw a couple of these procedures done and thought, wow. this is what we need to do.”

Barrett knew “clearly there was a better way to do this procedure” and set out to figure out how. He partnered with Mohammad Diab, M.D., of University of California San Francisco. “I thought, I can marry that technology with another technology that was used in growing rods and combine them and create this new dynamic vertebral body tethering system,” Barrett told OTW. Together with Diab and his team from CoAlign, Barrett formed a new company called Auctus Surgical.

The Auctus Surgical team, including orthopedic surgeons Steven Hwang, M.D., and Harsh Grewell, M.D., of Shriners Hospital in Philadelphia, took notes from the tethering procedure developed by pediatric orthopedic surgeon Dr. Amer Samdani, who many regard as the father of vertebral body tethering technique.

“Tethering is such an elegant procedure when you see it, compared to fusion surgery,” said Barrett. Especially in the treatment of the pediatric spine, where surgeons are often eager to engage in a less aggressive surgical approach.

Auctus Surgical’s dynamic, adjustable vertebral body tethering system is now headed toward initial clinical trial. Barrett and his team also see a pathway for its use in young adults, who they feel it could benefit.

But wait, Barrett has still more.