It has been reported that nearly 1.7 million vertebral compression fractures are diagnosed in the United States annually, with an estimated 13.5% that result in surgeons and radiologists performing kyphoplasty or vertebroplasty procedures on these patients. Percutaneous kypho or vertebroplasty benefits the elderly, since conservative treatment bears life-threatening risk. Since PMMA has a drawbacks due to high viscosity and poor handling characteristics in addition to potentially leading to pulmonary emboli and other complications, the time has come for the medical community to look at other alternatives.
That alternative is Cortoss! Why Cortoss? Why is the SpineBlogger promoting this product again? Because if you or I had a VCFx, Cortoss would obviate many of the potential issues associated with PMMA. A low-pressure delivery system this material is hydrophilic allowing it to support existing structure rather than displace it. Since the government, insurance companies, hospitals and physicians have made healthcare a political football, isn’t it time we start thinking about how advances in technology that has been around since 1984 can truly benefit the patient and minimize the cost of care for the elderly. Retrospective data and results confirm that Cortoss is safer and as efficacious if not more so than PMMA. I’m not some fancy analyst that gets paid to put a spin on a company or a product for Wall Street. The one thing I know is that my clinical knowledge and acumen of the industry makes me more qualified to analyze a product and a companies future, as far as the SpineBlogger can see the future is now, and it goes by the name of Cortoss. The SpineBlogger wants to know what you think?
There is another low viscosity, low pressure PMMA system out that does an exceptional job of everything you state above, Confidence by Depuy Spine. Kyphon purchased the product and shelved it but when they were bought by Medtronic they had to sell the Confidence. It is a great product but most of the physicians think they need the kyphon balloon to restore height:) I had a surgeon tell me that he likes the Confidence cement with the Kyphon balloon. Good luck in that market, the Kyphoplasty boys have done a great job with the referral bases and educating the surgeons, ie creating their market.
ReplyDeleteCompeting with the "Evil Empire" is a daunting task. But fortunately, their behavior is turning surgeons and hospitals off. When they lost to Michelson, they became that ugly cousin that goes around suing everyone in the industry. Look at their suit with Globus and currently with NuVasive. In addition, they have become Senator Grassley's whipping boy. Today they behave as though they had absolutely nothing to do with the current climate in the industry. If Orthovita stays focused they should be able to be a major player in the Vertebroplasty market. Thanks for your comment, and keep on reading the SpineBlogger there are some new things in store for our readers.
ReplyDeleteDePuy website: "The CONFIDENCE SPINAL CEMENT SYSTEM™ Is a proprietary, high viscosity, radiopaque, polymethylmethacrylate (PMMA) cement and innovative hydraulic delivery system." High viscosity speaks for itself, hydraulic suggests more than low pressure, which is needed to move the high viscosity material. Confidence does not and and never can do what Cortoss does.
ReplyDeleteHydraulic is high pressure at the pump but by the time it leaves the needle it is low pressure. I said low viscosity, I meant high, sorry.
ReplyDeleteThe low pressure very thick consistency of the PMMA interdigitates within the trabecular structure instead of blowing it out like a balloon. Surgeons have been known to use Confidence cement and a kyphoplasty balloon because the Confidence cement is a much better cement. Not to mention you can do 2 levels with a single kit because of the long working time and keep the price down for the hospital.
Good Luck with the Cortoss I hope someone gives Mr. Medtronic a run~
There are much easier way to control the pressure in vertebral augmentation procedures. First, it should noted that the high pressure is really not in the vertebral but rather at the rear/proximal cannula end to force the cement thru the cannula. The IV pressure low and there are other ways to keep it low such as aspiration using double-conduit techniques which has the advantage of controlling the pressure and thus the filling but also the removal of bone tissue. Cortoss is stiff and very fragile.
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