This annual award rewards inventors, engineering teams, surgeons and their companies who have created the most innovative, enduring, and practical products in 2022 to treat back care. To win the Orthopedics This Week Best New Technology Award for spine care, a new technology must meet the following criteria:
- Be creative and innovative.
- Bring long term significance to treating spine pathologies. Does this technology have staying power?
- Solve a current clinical problem.
- Improve standard of care
- Is cost effective
- Members of the judges panel would consider personally using it
A record number of technologies were submitted for the 2022 Best Spine Technology Award. These winners, I can assure you, had highly innovative and worthy competition. We offer our thanks and deep appreciation to the engineering teams, surgeon inventors and companies for submitting their best ideas this year.
The Judges
Christopher P. Ames, M.D. — Co-director, Spinal Surgery and UCSF Spine Center Director, Spine Tumor and Spinal Deformity Surgery Neurosurgeon. Dr. Ames’s clinical focus is on high-risk spine service and neuro-spinal disorders and performs more than 200 such procedures each year. Dr. Ames is site director for the International Spine Study Group as well as for the multicenter, international Scoli-RISK-1 study sponsored by the AO Foundation in collaboration with the Scoliosis Research Society (SRS). His pioneering research on tumor surgery, how to classify spinal deformities, and advanced technologies to facilitate safer treatment planning, including the use of artificial intelligence decision support tools for surgery has made Dr. Ames one of the world’s leading researchers and opinion leaders in these transformative technologies. He is the SRS Russell A. Hibbs Award winner—three times and twice he won both the SRS Louis A. Goldstein Award and SRS Thomas E. Whitecloud Award.
Peter B. Derman, M.D. MBA — Dr. Peter Derman, a minimally invasive and endoscopic spine surgeon at Texas Back Institute, is an honors graduate from Stanford University, a graduate of the Perelman School of Medicine at the University of Pennsylvania where, in his “spare time,” also earned a prestigious MBA from the Wharton School of Business. His residency was at New York’s Hospital for Special Surgery and his Fellowship in Spine Surgery was from Rush University Medical Center in Chicago, Illinois. Dr. Derman is one of the most accomplished young surgeons in the United States and currently practices at the renowned Texas Back Institute in Plano, Texas.
Harvinder S. Sandhu, M.D. — Dr. Harvinder Sandhu, Orthopedic Surgeon at New York’s Hospital for Special Surgery, is a leading MIS spine surgery practitioner and frequently lectures on the subjects of endoscopic spine surgery, microsurgery, computer-assisted surgery, and the study and use of spinal biologics. His training in spinal surgery was at UCLA Medical Center where he subsequently served as Chief of the Spinal Surgery Service. Dr. Sandhu has written upwards of 75 peer reviewed scientific publications. His many research awards are from the North American Spine Society, the Orthopaedic Research Society, and the International Society for the Study of the Lumbar Spine, including the prestigious Volvo Award in Spinal Research.
Michael Verdon, D.O., FACOS — Dr. Verdon is a thought leader in neurosurgery and has founded one of the leading artificial intelligence startup firms directed at some of the more difficult issues in neurosurgery. He is a practicing, community neurosurgeon and has been treating spinal disorders for over 20 years. He began his medical career as a physical therapist, started his neurosurgery practice nearly a quarter century ago and founded the Dayton, Ohio Neurologic Associates. Dr. Verdon is a Fellow of the American Osteopathic Board of Surgeons. Dr. Verdon holds two doctorate degrees and in 2018, received an award for implementing a machine learning algorithm to accurately diagnose spinal pain conditions.
Michael Y. Wang, M.D., F.A.C.S. — Dr. Wang, is chief of neurosurgery at the University of Miami Hospital, where he also serves as spine neurosurgery fellowship director and is a professor with tenure of the Departments of Neurosurgery and Rehab Medicine. Dr. Wang is also a graduate of Stanford University where he received both his BS and MD degrees. His residency was at the USC, his fellowship was at the University of Miami. Dr. Wang became the Spine Program Director and Spine Fellowship Director at the USC but in 2007 he returned to South Florida. He is presently Professor in the Departments of Neurological Surgery and Rehabilitation Medicine at the University of Miami, Miller School of Medicine. He is the Director of Neurosurgery at University of Miami Hospital and the Spine Fellowship Director. Dr. Wang has served on numerous editorial boards including Neurosurgery, The Journal of Spinal Disorders & Techniques, World Neurosurgery, Acta Neurochirurgica, Spinal Cord, the Journal of Spinal Cord Medicine, Neurosurgical Focus, Contemporary Spine Surgery, and the Journal of Neurosurgery: Spine. He has edited 9 medical textbooks and authored over 600 publications.
Kenneth S. Yonemura, M.D. — Dr. Yonemura, who received his medical degree from the Jefferson Medical College in Philadelphia, Pennsylvania, is a practicing neurosurgeon and Medical Director of the Neurospine Institute of Park City, Utah. His neurosurgical residency was at University of California, Irvine Medical Center (UCIMC), where he would later serve as Assistant Clinical Professor in the Department of Neurological Surgery, and his spine fellowship was at the Barrow Neurological Institute in Phoenix, Arizona. He later joined his UC Irvine chairman, Dr. Ronald F. Young, in private practice in Seattle. Dr. Yonemura focuses on complex spine and peripheral nerve disorders. He has been an FDA investigator for both lumbar and cervical interbody fusion cages as well as motion preservation techniques that include artificial disc and facet replacement technology. He is also actively involved in the development minimally invasive techniques for the treatment of cervical and lumbar disc disease including the design.
The 10 Best Spine Technologies for 2022
(In Reverse Order of Scoring)
− 10th −
Kuros Biosciences
Winning Technology: MagnetOs Flex Matrix
Inventors and Engineers: Nathan W. Kucko, Ph.D., Huipin Yuan, Ph.D. Charlie Campion, Ph.D., Florence Barrère-de Groot, Ph.D.
MagnetOs Flex Matrix is a fibrillar collagen bone graft; unlike other collagen bone graft products which are highly cross-linked, the collagen in MagnetOs Flex Matrix is open and fibrillar, providing optimal exposure of the MagnetOs Granules surface structure (NeedleGripTM) to the host tissue.
Because it features the fibrillar structure, MagnetOs Flex Matrix retains its strength and shape, isn’t brittle when dry, does not break-up or become soggy when wet, and is versatile and convenient to handle.
Tear it, mold it, and fold it to fill irregularly shaped bone defects, gaps, and voids. MagnetOs Flex Matrix also carries and retains a higher volume percentage of granules compared to other bone grafts. The granules don’t shed easily, even when hydrated. MagnetOs Flex Matrix resorbs over 4-6 weeks, meaning that the graft remains cohesive and constrained at the implantation site. Additionally, MagnetOs Flex Matrix has exceptional wicking properties and absorbs ten times as much BMA as competitors’ bone grafts.
− 9th −
Stryker Corporation
Winning Technology: Q Guidance System with Spine Guidance Software
Inventors and Engineers: Emeric Umbdenstock, Ingmar Wegner, Alexander Schöebel
Stryker’s Q Guidance System’s new camera (FP8000), new software (Spine Guidance), advanced algorithms (Smart Segmentation), integrated imaging (Airo TruCT) and various handheld instruments make it the new surgical eco-system standard for spine surgery.
KEY DIFFERENTIATORS
- First and only spine guidance software cleared for use with pediatric patients aged 13 and older.
- Both active and passive optical tracking methods in one system to simplify clinical implementation by enabling automatic image registration with Airo TruCT.
- Automated registration. Automatic screw planning based on individual patient anatomy all confirmed by the surgeon. Minimize variability in screw size selection. Automatic sizing and suggestions.
- Exceptionally powerful computational and camera capabilities. Reduced latency engineered for today and tomorrow.
- Reduced patient radiation. Airo TruCT imaging enables long construct scans without the need for multiple image acquisitions (i.e., long, complex deformity cases).
- Fully integrated tracking of instruments and tools. Personalized settings. Expansive software capabilities. Configurable by surgeons to address their procedural needs and unique clinical challenges.
And so much more. Stryker’s Q Guidance System with Spine Guidance Software represents a major improvement over freehand surgical technique, conventional C-arm guidance, and standard 3D navigation—all with a highly responsive, multi-modal tracking FP8000 camera and not one, but two low latency computer systems that are engineered for both today and tomorrow.
− 7th (Tie) −
Medacta International
Winning Technology: NextAR Spine
Inventors and Engineers: Prof. Bernhard Meyer, Dr. Maria Wostrack, Francesco Siccardi, Meinrad Fiechter, Massimiliano Bernardoni, Tobias Schwägli Denny Sindoni, Daniele Ascani, Pascal Wettmann
The NextAR Spine Platform is a real-time surgical guidance and augmented reality platform for open and MIS spine surgery approaches. It incorporates personalized 3D planning tools and a single-use tracking system which are comprised of compact sensors in an integrated delivery system. The system is designed to deliver a secure and stable connection for fast and accurate real-time tracking.
KEY FEATURES:
- Accurate and Personalized Surgical Plan. Pre-operatively plan and customize the surgery using Medacta’s advanced network of digital solutions.
- Improved Patient Focus. No alternating between screen and patient/implant/instrument. Augmented reality smart glasses feed the surgeon with real time workflow information, implant/instrument position, planned trajectories, and more.
- Drastically Reduced Line of Sight Problems. NextAR TS, Medacta’s novel tracking system, drastically reduces line of sight problems between camera and instruments. Small, disposable targets and cameras use infrared signals to communicate. Data transfers to the navigational computer using Bluetooth. Medacta’s proprietary target-to-camera infrared tracking system, NextAR, drastically reduces camera/target distance.
- Sustainable and Less Expensive: NextAR requires limited capital investment, its single-use instrumentation delivers a lower cost per case. Also, the host software covers multiple applications. Once an intraoperative scan is acquired, steps to start navigation are simple. Smaller capital outlay than most stereotactic navigation platforms.
- Flexibility: NextAR is the only multi-disciplinary orthopedic navigation system where the same control unit and disposables can be used in a spine, hip, knee, or shoulder procedure.
− 7th (Tie) −
MIMEO MEDICAL GmbH
Winning Technology: TANTO® – Pedicle Blade
Inventors and Engineers: Frank Heuer, Ph.D.
TANTO® has the biomechanical in-bone fixation similar to bone cement enhanced pedicle fixation, but without the complications that can accompany injectable plastics (bone cement). This novel implant has the potential to lower clinical risks and complications, improve outcome for patients, shorten OR-time, and represents a novel in-surgery option for spine and neurosurgeons.
- TANTO has the potential to eliminate the biological and clinical risk of using bone cement!
- TANTO offers unrivaled stability against toggling in vertebral bodies.
TANTO pedicle blade implant is a bone anchoring shaft with two lateral wings. The blade-like wings run from the proximal to the distal direction in a helix and are twisted at about 90°. The blade-like wings are arranged proximally in such a way that they are supported on the cranial and caudal cortical areas of the oval pedicle wall of cortical bone.
Distally, the TANTO pedicle blade has a large bone contact area due to the core and the lateral blade surfaces. This bone contact area is significantly larger (approx. three times) than that of a pedicle screw.
In an in-vitro preliminary biomechanical study it has been investigated that the TANTO blade offered 55% more stability against toggling compared to non-cemented pedicle screws in human specimens with reduced bone quality. This increase in toggling stability of the TANTO blade was comparable to cemented pedicle screws.
The TANTO Blade is anatomically optimized to maximize multiplanar, mechanical resistance to intrapedicular and intra-vertebral body toggling. With a multitude of fixation options to accommodate differing patient anatomy and quality of bone, the TANTO Blade technology platform represents a true replacement, or alternative, to cemented screw augmentation.
The TANTO blade comes with a polyaxial pedicle screw head, which can be connected/combined with regular pedicle fixation anchors, like pedicle screws and hooks. TANTO blade is a unique addition to posterior rod-screw systems.
− 6th −
MTF Biologics / Orthofix Medical
Winning Technology: Virtuos™ Lyograft
Inventors and Engineers: Amy Chang, Michael Kubik MSc., Kevin Wu, Brooke Catalfamo, Huy Truong, Subha Bhattacharyya Ph.D., Eric Semler Ph.D., Yen Chen Huang Ph.D.
VirtuosTM Lyograft is a shelf-stable, complete autograft substitute that can be stored at ambient temperature for a validated shelf life, while also maintaining inherent proteins and, importantly, the viability of endogenous bone-forming cells upon rehydration.
Virtuos Lyograft has all the features of autograft by using a novel preservation process. The convenience of ambient storage, excellent handling and quick preparation is one of the primary reasons it is a Best Technology for 2022.
MTF Biologics is the exclusive processor of these novel grafts, and brought to market in partnership with Orthofix. The proprietary preservation method which protects key native biologic components of the bone that minimizes degradation and stress during lyophilization.
Preclinical evaluation by MTF demonstrated elevated levels of certain key inherent proteins and cytokines that are known to influence osteoimmunomodulation, angiogenesis and bone formation, which are all important events in the bone healing cascade. Osteoimmunomodulation is linked to the ability to create a favorable inflammatory environment and may be beneficial when treating compromised patients that have dysregulated or chronic inflammation.
While autologous bone grafts and cellular bone allografts (CBAs) represent current standards of care for bone grafting, these options have limitations that can be addressed by Virtuos Lyograft. There is substantial benefit to hospital logistics with the ability to be shipped and stored at ambient temperature, providing convenience and a sustainable solution with Virtuos Lyograft.
− 5th (Tie) −
Aurora Spine, Inc.
Winning Technology: DEXA Technology™
Inventors and Engineers: Laszlo Garamszegi, Trent Northcutt, Jeff Brittan, Jeremi Leasure
Aurora Spine’s DEXA Technology™ allows physicians to perform a bone density (DEXA, DXA) scan (to determine the bone quality) before surgery. Using the resulting T-Score, surgeons can pick the bone density range-matched implants manufactured with DEXA Technology from three unique, color-coded versions.
This is a first of its kind and, of course, winner of the 2022 Best New Technology in Spine. The purpose of DEXA Technology is to ensure that each patient receives the device optimized for their personal bone quality.
Aurora Spine designed the DEXA Technology implants to simulate the lattice structure of human cancellous bone, with a similar modulus of elasticity, and personalized to match each patient’s bone status across the BMD continuum.
Native vertebral bone trabeculae orient spatially in response to the direction of axial compressive forces, forming a web-like structure of cancellous bone with exceptionally high load-bearing capacity. All DEXA Technology implants have an open, porous structure that supports osseointegration and vascularization.
This is the world’s first patented, color-coded implant material technology matched for different bone densities.
Osteoporosis affects 200 million people globally. Every spine surgeon understands the problem. “Fit-for-all” spinal implants don’t address bone density. Aurora’s patient Matched DEXA Implants™ show two to six times better performance characteristics in independent biomechanical testing.
− 5th (Tie) −
Mighty Oak Medical, Inc.
Winning Technology: Cervical Navigation Guides
Inventors and Engineers: Caleb Voelkel. Dr. George Frey, Adam Jensen, Sean Starkman
This is Mighty Oak’s 4th Best Technology in Spine Award. No other company has been so routinely successful. What is their secret? All four winning technologies are derived from 3D printing: a porous pedicle screw and precision, patient-customized navigation without the OR fiddle factor, or radiation exposure — and at an attractive cost. Four times a Winner of the Best Technology in Spine.
This year, Mighty Oak won for their new Cervical Navigation Guide Platform (CNG). CNG also just received FDA clearance for use from C1 to T3. Using CNG, surgeons can safely navigate C1 lateral mass screws, C2 pars/pedicle screws, C3-C7 sub axial pedicle screws, and upper thoracic (T1-T3) pedicle screws during posterior cervical fusion procedures.
The CNG kit includes a drill bit with a 3D printed depth stop feature, 3D printed anatomical bone model, and 3D printed, patient-specific guides which mechanically constrain surgical instrumentation along a pre-surgically planned trajectory. All 3D printed components are manufactured using a biocompatible nylon material.
CNG also includes a detailed, concierge presurgical plan, which calculates optimal screw trajectories and sizes and aligns the tulips. The plan, displayed on a monitor, coordinates the OR staff to have the proper screw inventory ready and loaded on the driver for maximally efficient screw placement, which can reduce OR time and blood loss.
The entire system is a single-use disposable and is compatible with all qualified cervical screw systems. It delivers precise, accurate screw placement without the huge upfront capital expenditure or annual maintenance fees common with other navigation platforms. Intraoperative radiation is NOT required.
For surgeons looking for navigation that safely delivers reliably stronger, more stable constructs, Mighty Oak’s CNG’s customized approach could become the preferred choice and standard of care for cervical spine fusion navigation.
− 5th (Tie) −
Whitecloud Technologies, LLC
Winning Technology: MoeBetta Pedicle Implant System
Inventors and Engineers: Frank Castro, MD
MoeBetta is a spinal fixation implant which was designed for patients with below average bone mineral density. The reason MoeBetta won the 2022 Best Technology award is due to its very novel design. Unlike highly polished threaded pedicle screws which are round in the coronal plane, MoeBetta implants are oval or oblong in the coronal plane and are patient specific.
Each MoeBetta implant is fabricated using the patient’s pre-operative CT scan data and artificial intelligent software which personalizes each fixation device to the patient’s own dimensions. The MoeBetta leading tip extends 7-10 millimeters into the vertebral body. Its middle portion replicates the exact dimensions of the subcortical bone within the pedicle. Finally, the implants “wings” or swellings abut the pedicle’s entrance thus preventing over-insertion, increasing the surface area for bone ingrowth, and dissipating the transmitted loads over a greater surface area.
MoeBetta’s larger diameter stems will also reduce the fracture rate at the area where most implant failures occur. MoeBetta’s 7 millimeter diameter post extends 15 millimeters posterior to the entry site. Side loading connectors couple one implant to another via 6 millimeter rods. The side loading feature allows continued access to the cannulated center. And there is more.
MoeBetta was designed for one of the more challenging patient types—patients with poor bone quality (bone mineral density below zero), unstable spine due to deformity (dynamic spondylolisthesis or decompression) such clinical symptoms as neurogenic claudication.
− 2nd −
Centinel Spine
Winning Technology: prodisc C Vivo, C SK
Inventors and Engineers: Prof. Dr. Rudolph Bertagnoli, Dr. Thierry Marnay, Ed McShane, Tim Bertone, others
And how would you like your prodisc, Doctor? With keel, without keel, small central keel? The innovation that, yet again, won Centinel Spine the Best Technology Award for the Year was to take its award winning, proven prodisc motion preserving design—the most popular in the world—and make it fit according to each surgeon’s, indeed also patient’s, requirements. No longer is prodisc one size fits all.
prodisc now comes in three new cervical “flavors”—while, of course, maintaining prodisc C original.
prodisc C Vivo has keel-less endplates and a convex, superior endplate to match concave patient anatomy. The implant incorporates unique spikes for primary fixation which allows the surgeon to reproducibly implant the device using minimal steps.
prodisc C SK has flat endplates so as to better match flatter degenerated vertebral endplate anatomy, but then incorporates small central keels for primary fixation and includes a simplified insertion process.
prodisc C Nova also uses flat endplates, but uniquely incorporates a tri-keel design to fit patients with concave inferior vertebral endplates.
Of course, all of these choices have the trademark articulating CORE technology that has been the hallmark of the prodisc technology platform over more than 30 years.
A recent independent survey found that 85% of U.S. spine surgeons believe it would be valuable to have access to different cTDR implant options to address patients’ anatomical variations (ref. TDR Landscape Report, IQVIA 2021).
Too many surgeons fight the patient’s anatomy intraoperatively to accommodate a one-size fits all implant design. Centinel Spine’s innovation was to realize the need for surgeon cTDR optionality.
− 1st −
Surgalign, Inc.
Winning Technology: HOLO Portal™
Inventors and Engineers: Kris Siemionow, M.D., Ph.D., Cristian Luciano, Ph.D., Paul Lewicki, Ph.D.
Surgalign received more votes than any other submitting company for 2022’s Best Technology in Spine. The overall winning technology was the world’s first artificial intelligence (AI) driven augmented reality (AR) guidance system for spine.
Brand named HOLO Portal™, the system combines machine learning software, 3D tracking, and 3D display technology to generate a holographic visualization of the patient’s internal anatomy and provide surgical guidance to the surgeon.
The HOLO Portal system is an aid for precisely locating anatomical structures in either open or percutaneous orthopedic procedures in the lumbosacral spine region. Powering the system are several AI networks, which automatically perform registration, anatomic segmentation, and propose a pedicle screw plan for review by the surgeon. Most navigation and robotics systems require manual screw planning and anatomical labeling. HOLO Portal changes that paradigm by using artificial intelligence powered programs.
First, the intra-operative 3D image is acquired and registered to the patient using AI detection of the HOLO Portal registration grid. Next, AI performs an automated segmentation which helps to visualize specific anatomic structures in surgery.
Finally, the AI performs screw planning, automatically suggesting trajectory, length, and diameter for each pedicle screw.
Surgeons then view the AI generated segmentation, screw plan, and orthogonal navigation information through the patented HOLO Portal holographic display—which projects directly onto the patient. No bulky headsets are required. The optics of the HOLO Portal display are such that it eliminates vergence accommodation conflict, or motion sickness/headaches commonly associated with AR/VR.
HOLO Portal is designed to make planning and navigation more efficient for the surgeon by providing richer, more intuitive information automatically. In addition to HOLO Portal, Surgalign is developing AI for medical imaging, pre-op planning, and post-operative assessment, which it believes will transform the treatment of spinal disorders.
All winners photos are courtesy of RRY Publications LLC
