Here are the best new spine surgery technologies for 2023.
Every year, Orthopedics This Week convenes a panel of top surgeons to review dozens of new technology submissions from around the world.
This award was inaugurated more than a decade ago to recognize the remarkable inventors, engineering teams, surgeons and their companies who have created the most innovative, enduring, and practical products 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.
We received a record number of submissions for 2023.
Here are the judges for this year’s awards.
The Judges
Hyun W. Bae, M.D. — Dr. Bae is a professor of surgery and director of spine education at Cedars-Sinai Spine Center in Los Angeles. He is the author of hundreds of published scientific papers and is a frequent podium presenter at spine surgeon meetings around the world.
Dr. Bae received his bachelor’s degree in biomechanics from the Columbia University School of Engineering and Applied Sciences. After graduating cum laude from Yale University School of Medicine, he completed his surgical internship at North Shore University Hospital, his orthopedic surgical residency at the Hospital for Special Surgery in New York, and his spine fellowship at Case Western Hospital in Cleveland.
https://www.cedars-sinai.org/provider/hyun-bae-568991.html
Matthew W. Colman, M.D. — Dr. Matthew Colman is a board certified surgeon specializing spine surgery and musculoskeletal oncology. He graduated cum laude with honors from Dartmouth College, earned his medical degree with honors from the University of Chicago Pritzker School of Medicine, Chicago and went on to complete his residency in orthopedic surgery at the University of Pittsburgh Medical Center, Pittsburgh.
He has been fellowship trained in pediatric and adult musculoskeletal oncology at Harvard University and orthopedic and neurosurgical spine surgery at the University of Utah.
https://www.rushortho.com/doctors/matthew-colman
Domagoj Coric, M.D. — Dr. Dom Coric spent 25 years as a neurosurgical spine surgeon at Carolina Neurosurgery and Spine Associates (CNSA) in Charlotte, North Carolina, serving 13 years as Chief, Department of Neurosurgery at Carolinas Medical Center. He’s served as Executive Medical Director of SpineFirst and Director of the Carolina Center for Specialty Surgery. Finally, Dr. Coric is the Jerry and Audrey Petty Endowed Professor of Spine Surgery at Atrium Health/Wake Forest University and is currently the Atrium/Advocate Health Director of the Southeast Spine Center of Excellence.
Dr. Coric is past-President or past-Chair of the following societies: the International Society for the Advancement of Spine Surgery (ISASS), the AANS/CNS Joint Section on Spine and Peripheral Nerves/Spine Summit, the Southern Neurosurgical Society, and the North Carolina Spine Society. He currently serves on the Board of Directors of the American Association of Neurological Surgeons (AANS).
https://isass.org/about/board-of-directors/domagoj-coric-md-2/
Han Jo Kim, M.D. — Dr. Han Jo Kim is an Attending Spine Surgeon, Professor of Orthopedic Surgery at Weill Cornell Medical College, David B Levine MD Endowed Chair and Director of the Spine Fellowship and Chair of the Fellowship Committee at the Hospital for Special Surgery in New York.
Dr. Kim has authored more than 300 peer-reviewed scientific articles and more than 55 book chapters and over 50 visiting lectureships. He was selected for the prestigious Edgar G. Dawson Fellowship in 2013 and subsequently was selected for the Scoliosis Research Society Traveling Fellowship in 2017 and served as the IMAST Chair in 2020. He is an active member of the Cervical Spine Research Society.
https://www.hss.edu/physicians_kim-han-jo.asp
Pierce Nunley, M.D. — Dr. Pierce Nunley is a board-certified surgeon, clinical researcher and thought leader behind many key innovations in spine surgery. Dr. Nunley has been Principal Investigator (PI), in more than 30 studies, author of dozens of peer reviewed clinical studies.
Dr. Nunley is the chairman of the American Board of Spine Surgery, and member Cervical Spine Research Society (CSRS), Scoliosis Research Society (SRS), Society for Minimally Invasive Spine Surgery (SMISS), North American Spine Society (NASS), American Academy of Orthopaedic Surgeons (AAOS), and International Society for the Advancement of Spine Surgery (ISASS).
He is also associate editor for The Spine Journal, and reviewer for Global Spine Journal and British Medical Journal. Dr. Nunley is Founder and Medical Director of the Spine Institute of Louisiana and is a Clinical Instructor of Orthopedic Surgery at Louisiana State University Health Sciences Center.
Dr. Nunley is also an accomplished musician performing and composing music for voice, guitar, violin and piano.
https://spineinstitutefoundation.org/our-team/investigators/pierce-nunley-md
Alpesh A. Patel, M.D., M.B.A. — Dr. Patel is the Co-Director of the Northwestern Center for Spine Health and is fellowship trained in both orthopedic spine surgery and neurosurgery. Dr. Patel specializes in cervical spine surgery and minimally invasive spine surgery. He is known for his clinical research on patient outcomes, quality and value in healthcare, and predictive analytics. Also, dedicated to creating value through strategy and innovation in healthcare.
https://www.feinberg.northwestern.edu/faculty-profiles/az/profile.html?xid=26672
Mike Sherman, M.S. Biomedical Engineering — Mike Sherman is the dean of spinal implant and instrument engineering. Sherman’s career is, in effect, the history of Modern Spine Surgery and he, above anyone else, has been part of the foundational spinal implant and instrument developments and continues to work with surgeons and companies, large and small, to advance and transform patient’s lives.
His background includes 9 years with MB Venture Partners and 16 years at Medtronic Spine (formerly Sofamor Danek). Prior to Sofamor Danek, Mike held positions at Synthes and Richards Medical. Over the course of his career, Mike has amassed over 100 issued U.S. patents on various inventions. Mike received his Bachelor of Science in Biomedical Engineering from Rensselaer Polytechnic Institute and a Master of Science in Biomedical Engineering from the University of Texas, Southwestern Graduate School. He has served on dozens of boards of directors. Mike currently owns and operates MB Innovations, Inc.
https://mbventures.com/team/mike-sherman/
The Best Technologies for 2023
(In Alphabetical Order by Company Name)
3Spine
Winning Technology: MOTUS Lumbar Total Joint Replacement
Inventors and Engineers: Scott Hodges, D.O., Craig Humphreys, M.D. and Marc Peterman, Ph.D.
Technology Description: This award winner is a ‘first-of-kind’ technology for replacing the function of the disc and facet joints using a posterior approach.
This implant and technique reconstructs the functional spinal unit and broadly addresses leg pain, back pain, and spinal instability while correcting posture and preserving freedom of movement in patients suffering from spinal stenosis, facet arthritis, and other degenerative changes.
Brand-named MOTUS Lumbar Total Joint Replacement, it received FDA Breakthrough Device Designation in 2020 and is currently tracked under CPT code 0719T.
MOTUS tackles one of the most complex technical challenges in orthopaedics—addressing the intricate mechanical problem created by the lumbar spine’s structure. While fusion techniques have evolved, fixing the spine in a singular position limits dynamic adjustments during daily activities, leading to potential degeneration at normal spinal levels post-surgery.
This device offers the same stability achieved with fusion surgery while allowing the body to adjust posture in the sagittal plane.
The implant technique adjusts segmental lordosis allowing as much as 30-degrees of correction at a single lumbar level. Sagittal correction is achieved entirely through the powered osteotomy. The implant is in a neutral position at the center of the range of motion, with the patient balanced in a standing posture.
Finally, the construct allows for 10 degrees of flexion and 8 degrees of extension beyond the neutral position, accommodating standing, sitting, and slumped sitting postures as required by activities of daily living.
MOTUS represents a significant advancement, pushing the orthopedic and medical device industry forward.
HAPPE Spine, LLC
Winning Technology: Integrate®-C Interbody Fusion System
Inventors and Engineers: Douglas Snell, Dr. Gabriel L. Converse, Dr. Stephen M. Smith, Mark Messman, Isaac Running, Robert Ball, Ryan K. Roeder
Technology Description: Imagine a spinal implant where Hydroxyapatite is fully integrated throughout a porous PEEK (Polyetheretherketone) implant. And imagine that the same implant mimics anatomic cancellous bone with interconnected spherical pores—oh, and that the hydroxyapatite is exposed on pore surfaces.
That is HAPPE (pronounced “Happy”) Spine’s award-winning invention. Brand named the HAPPE® INTEGRATE®-C Fusion Device, it is indicated for anterior cervical discectomy and fusion (ACDF).
One key feature is that it’s monolithic with porous regions which extend endplate-to-endplate because they are derived directly from the implant body—NOT sintered or coated onto the implant.
It comes in multiple footprints, lordosis and heights. It is also radiolucent and radiovisible.
Clearly, the HAPPE® INTEGRATE®-C Fusion Device, with all of these features, creatively meets a well-defined, practical and understood cervical spine fusion clinical need. Single-level ACDF fusion rates are typically >90%, but pseudoarthrosis rates increase in multilevel ACDFs to 24% for two levels and 56% for four levels (Epstein, SNI, 2019).
HAPPE Spine has its sights set beyond ACDFs, however, as the HAPPE material is viewed as a platform for a variety of future implants for the lumbar spine and even more broadly across orthopaedics.
IncludeHealth
Winning Technology: IncludeHealth
Inventors and Engineers: Ryan Eder, Chris Slee, Brandon Eder, Ryan Hefner, Jon Black, Ron Yuhas, Annume Ayaz, Sharal Britto, Jake Donese, Mel Grubb, Ben Hamilton, Brady Jacobsen, Rick Schmittgen, Grant Southwood, Caleb Sharp
Technology Description: What if you could increase your patient’s post-op physical therapy engagement from an average 30% to 80%? What would that mean to your outcome and patient satisfaction rates?
That is precisely what IncludeHealth offers, and why it was voted as one of the Best Spine Technologies of 2023.
Spine care is moving to a process and data-based future. IncludeHealth digitizes physical therapy and delivers personalized, measured care in patients’ homes—and does not require sensors, downloads, or passwords. In short, more accessible, and convenient post-op rehabilitation program.
IncludeHealth’s device is also HIPAA compliant and registered with the FDA.
The device operates in 4 steps: build, send, perform, and review.
The result is more convenient care delivery, 80% engagement rates (vs 30% in standard plans) and one that may be used across all MSK diagnosis. Further, it can be operationalized under Remote Therapeutic Monitoring and Value-Based Care.
Essentially, IncludeHealth dismantles the obstacles to patient engagement (like time, distance, and cost) with its virtual, affordable, and personalized PT service.
IncludeHealth’s award winning technology promises to revolutionize the way home exercise programs (HEPs) are delivered and managed.
MiRus, LLC
Winning Technology: MiRus MoRe® Anterior and Lateral Lumbar Plating System
Inventors and Engineers: Jay Yadav, MD, Mahesh Yadav, Wayne Gray, Dennis Moreno, Jordan Bauman, Jacob Carter
Technology Description: Thinnest anterior and lateral lumbar plating system on the planet—2.0-2.5mm—yet, 3-4 times stronger and fatigue resistant than what you are probably using now, namely the standard 6 to 8mm thick Titanium and Cobalt Chromium plating systems.
This award-winning technology is based on MiRus’s novel proprietary metal alloy, Molybdenum-47.5Rhenium (MoRe®, ASTM F3273-17).
This remarkably strong and biocompatible metal (brand-named MoRe®) is composed purely (99.99%) of molybdenum and rhenium—no Nickel. Biomechanical and biological testing has shown MoRe® to be stronger, more fatigue resistant than Titanium and Cobalt Chromium.
Which means the thinnest, strongest and most ion release resistant and fatigue resistant implants on the market.
What are the benefits of smaller profile and stronger implants? Increased biomechanical stability, less soft-tissue disruption, reduced risk of neural injury, less blood loss, decreased operative time, less post-op pain, shorter hospital stays and quicker recoveries.
Why stick with 6mm to 8mm constructs when stronger 2.0mm and 2.5mm anterior and lateral Lumbar plates are available?
MiRus’s MoRe® anterior and lateral lumbar plates are, bottom line, a Best New Spine Technology for 2023.
Proprio
Winning Technology: PARADIGM™ System
Inventors and Engineers: The Proprio Co-founders: James Youngquist, Joshua Smith, Ph.D., Dr. Samuel Browd, M.D., Ph.D., Kenneth Denman, Gabriel Jones
Technology Description: Robotic and navigation assisted systems seem to be leap frogging each other these days in an attempt to incorporate the latest in computing and algorithmic power on behalf of spine surgeons.
One of this year’s Best Technology in Spine award winners is one of those companies—Seattle, Washington based Proprio and its Paradigm™ system.
The Paradigm™ system, synthesizes data from multiple sensors, creating a real-time, interactive 3D canvas of human anatomy during spine surgery. It also incorporates the latest in light field imaging, AI, and computer vision.
Features include real-time implant placements visualization without intra-op CT scans. Specifically, Proprio’s system uses advanced light field technology to capture high-definition multimodal intraoperative images and then fuse that data with machine learning segmented preoperative scans. Using PARADIGM, surgeons can “see” the surgical field in a completely new way—an effect they describe as “looking around corners”.
With PARADIGM, surgeons can move beyond microscopes, loupes, monitors, and radiological imagery, that all take up valuable space in the operating room and impede workflows without enabling surgeons to access the data they need live and in 3D.
Finally, Proprio will be leveraging data to inform more predictive and prescriptive surgical decisions and thereby deliver significant value to the entire surgical ecosystem by unifying preoperative imaging and planning with intraoperative performance data—all without any harmful radiation or impediments to workflow.
Ruthless Spine
Winning Technology: RJB
Inventors and Engineers: Shane S. Pak, M.D.; Karlton E. Spindle, Rick Schue
Technology Description: Can’t justify a million-dollar robotic assist system for pedicle screw placement?
Then this single use, disposable spine navigation tool may be just what you are looking for.
From the folks at Ruthless Spine (the only thing ruthless about this company is what their award-winning technology might do to million-dollar navigation systems) comes a single use disposable instrument (packed with computing power and software) which slides into any instrument with a shaft and ‘talks’ via Bluetooth and Android/iPad tablets to the surgeon, giving precise angles, location, and other critical navigation information.
RJB does not require CT scans (no radiation), relies on a built-in accelerometer to measure angles and orientation which it then streams real-time via Bluetooth to a tablet app that translates through a patent pending software algorithm, pedicle screw trajectory information.
Registration is simple.
- Open the single use sterile packaging at the sterile back table,
- v pull out the battery tab, rep scans barcode off the box That’s it. RJB syncs with the RJB app on the Android/iPad tablet in 10 seconds.
Slide the module into the RJB compatible instruments and you are ready to go with one or more modules in less than 1 minute—no additional training needed for the surgical techs. No space taken up in the OR’s crowded hallways. No capital investment.
Spinal Stabilization Technologies
Winning Technology: PerQdisc
Inventors and Engineers: W. Loren Francis, Mark A. Novotny, Jake Ganem, Nadi Hibri, James Lutz
Technology Description: This award-winning technology is designed to address the underlying causes of discogenic back pain – not with fusion—but rather with an implant that behaves similarly to the native disc.
It could be the missing link between conservative care and end-stage segmental fusion.
Brand-named PerQdisc™, this technology from Spinal Stabilization Technologies is currently in clinical study. The implant replaces the physical space formerly occupied by a degenerated nucleus with a material which, when contained by the annulus, can restore natural biomechanics of the motion segment.
The PerQdisc has been designed for a lateral traspsoas, retroperitoneal (i.e., anterolateral) or posterior lateral surgical approach to access the disc space. To prepare the disc space, surgeons perform a nuclectomy. Once the disc space is ready, the surgeon then inserts PerQdisc through an access cannula into the enucleated disc space.
The PerQdisc comes with two chambers, one for contrast media and one which contains the curable polymer with barium sulfate to allow for imaging of the implant. Each chamber helps give PerQdisc good visualization and real-time monitoring of fill pressure. The PerQDisc’s polymer cures in situ within ten minutes at body temperature creating a custom implant.
This is intended to be an alternative to bigger surgeries like fusion or total disc replacement—but with no bridges burned. The goal of the PerQdisc procedure is to recreate physiological motion while also redistributing the weight bearing forces and mechanical properties of the disc in a more natural fashion.
One of the reasons PerQdisc received such good scores from the surgeon panel is because it appears to have overcome many of the shortcomings of prior nucleus replacement technologies. Spinal Stabilization Technologies is presently enrolling patients in a PerQdisc clinical trial. Early results, say the company, are encouraging.
SurgiSTUD
Winning Technology Name: SpineSTUD Surgical Simulator
Inventors and Engineers: Dr Michael Bohl; Sarah McBryan
Technology Description: Here is a non-cadaver, cadaver. Brand named SpineSTUD, this is a synthetic anatomical model that encompasses boney and soft tissue structures which recreate patient/cadaveric anatomies for surgical simulation.
The models use patient imaging data to create a myriad of complex anatomical and surgical scenarios—normal, degenerative, scoliosis/deformity, tumor, etc.—which facilitate and more realistic surgical training experience.
Much like cadaver training, with SpineSTUD, surgeons practice hands-on surgical approaches, retraction, exposure, resection, etc. for diverse patient demographics, spanning infants to adults and a variety of bone qualities which mirror real-world scenarios.
Every model is 3D printed using patented processes to ensure high anatomical and biomechanical fidelity. SpineSTUD mimics pedicle screw insertion, pull-out strength, range of motion, and haptic fidelity. It also integrates with CT and fluoroscopic imaging, navigation, and robotic surgical systems.
SpineSTUD can be used outside of cadaveric lab spaces—because it’s not a cadaver!
Finally, SpineSTUD’s customized models seamlessly integrate with existing training frameworks, enhance curricula, and establish focused learning pathways based on individual proficiency and goals. The models can grow in a stepwise function: increasing difficulty and complexity with the users’ experience level.
VUZE Medical Ltd.
Winning Technology: The VUZE System, Ver. 2.0 (“VUZE 2.0”)
Inventors and Engineers (in alphabetical order): Ran Cohen; Sigi Elazar; Rivay Mor; Asaf Omer; Levona Schriger; Yoav Stein; Sasha Steinberg; Neta Stern; David Tolkowsky; Koby Zakaeim
Technology Description: This winning technology embodies a novel approach to surgical navigation, one which uses just software on an off-the-shelf PC to create a tool-independent guidance and verification navigation system for minimally invasive spine surgery.
Brand-named VUZE, the system uses proprietary real-time image processing to overlay unmodified surgical tools as seen in live 2D X-Rays onto vertebral cross-sections from a standard pre-operative CT or a prior in-OR 3D scan.
Indeed, AP X-Rays are entirely sufficient, and no lateral images are required. The OR display is updated instantly for each new X-Ray.
There are no cameras, markers, references, tool modifications, mandatory lines of sight, lengthy preparations, dependence on a specific tool or imaging vendor, etc., with VUZE.
VUZE has been employed in more than 30 minimally invasive thoracolumbar fixations and augmentations. In each of these cases, VUZE has demonstrated extremely high accuracy. Similarly, VUZE has been demonstrated extensively in cadaveric workshops with hundreds of tool insertions by a dozen surgeons. Which is impressive given the simplicity, affordability, and tool neutrality of VUZE. VUZE 2.0 is currently pending FDA clearance.
Importantly, VUZE is not susceptible to errors due to reference shifts (there are no references), segment shifts (focus is in the treated area) or tool bending (focus is directly on the tools’ distal portions).
The enduring prevalence of X-Ray guidance is due to its simplicity, affordability, and tool neutrality. But X-Rays provides only top (AP) and side (lateral) 2D projection views. The views needed most during tool insertion, namely vertebral cross-sections, are unavailable.
The VUZE System adds those missing axial and sagittal views within the existing X-Ray guided workflow. VUZE provides the online images that surgeons need most and currently do not have. No capital investment required. It’s just software.
Woven Orthopedic Technologies, LLC
Winning Technology: Ogmend® Implant Enhancement System
Inventors and Engineers: Dr Alexander M. Jones
Technology Description: Harware fixation—whether for spine, trauma or other indications—is fundamental to long-term patient outcomes.
This award-winning technology—an implantable screw sleeve—helps surgeons achieve strong screw fixation in challenging surgical scenarios where poor bone or bone healing, complex injuries or deformities, and high-stress reductions and distractions is a concern.
It won the 2023 Best Technology in Spine award due to its design elegance, speed, and cost-effective way of enhancing the screw-bone interface to strengthen fixation and support the healing process over time.
Brand-named Ogmend®, the screw sleeve reduces and distributes force away from high-stress zones and enables bone growth up to the screw root to increase fixation and maintain that fixation over time.
The system is available in two sizes that accommodate screws from 3.5mm in diameter to 10.5mm in diameter.
Ogmend® is made from biocompatible Polyethylene Terephthalate (PET), which has been FDA approved for human use for over forty years. It can withstand extreme torque, will mold to unique bone environments, accommodates a range of screw types and diameters, fully embeds without damaging soft tissue, and reduces high-stress points by distributing stress away from screw threads.
Finally, Ogmend® is sterile packed, can be pulled off the shelf when needed, prepared and implanted in under 2 minutes, used with any spinal fixation system and, importantly, is affordable. Best new spine technology for 2023.
