Thursday, July 16, 2009

What is Innovation?

Recently, Arutz Sheva, an Israeli National News platform ran an article featuring what was called an innovative implant. As usual, the SpineBlogger asked the proverbial question: Is it new? Is it true? Will it make a difference?

Scorpion Surgical Technology (I'll even give them some press) has developed a spinal anchoring device with the intent of replacing fusion and stabilization procedures. The General Manager claims that the technology has particular value for osteoporotic patients. Question: Based on our current state of affairs in spine, have we really had bad outcomes with osteoporotic patients? One of the claims made is that the device is expected to prevent loosening of the construct and revisions. Question: Why does loosening of Pedicle Screws occur? What are the revision rates for primary fusions?

The device is supposedly geared towards minimally invasive applications. The interesting part of the video includes a Trocar Drill Guide that is part of a miniature Crane -like device. Rather than utilize a pedicle screw, this implant is called a "Curved Nail" that is cannulated and is inserted over a guide wire (I would call this percutaneous insertion) and it looks like the nail has some type of perforations for boney ingrowth. Could this be a problem if it is perforated and the surgeon needs to perform a revision? The concern that I have when I assess this technology is whether the design is really cutting down on operating room time and does it have too many parts for assembly?

But the question that SpineBlogger needs to ask is whether Israeli start-ups have an affinity for developing technologies that address questions that are not of major concern in the US Market? Example: Disc-O-Tech's Inflatable Nail or IP? At best they made some money selling the IP. Expanding Orthopaedics Expandable Pedicle Screw for osteopenic patients, Mazor Technologies, around for years, and now the Scorpion device.

Adjacent disc degeneration is a biological and chemical phenomenon that our industry believes can be minimized by designing different products with effective biomechanical variations. The question that must be asked is, will this product make a difference? The SpineBlogger will be keeping a watchful eye on this company. For those investors that are looking for a return on their investment, I have some property along the Pacific Coast Highway that might make a better investment.


  1. It is certainly and interesting device. Would love to get my hands on it to see how the parts all go together. Some things I see that I have to question:

    1. the tips of the implants touching and will create wear metal wear debris. how will this affect the vertebral body?
    2. the "screw" does not have cortical contact. will micromotion in the cancellous bone cause loosening?
    3. what is the locking mechanism? seems to be some kind of crimp.
    4. also, doesnt seem to be much surface contact on the rod. what sort of torsional and axial load strength is there?

  2. It seems like an over-complicated screw system (sans screw), that uses compression sleeves
    and aircraft cable (can be found at your local Home Depot). Too many parts, too many modes of failure...
    Engineers should ask the question, "Would I want that thing in my body?"

  3. This is a solution looking for a problem. It is another in a long line of over-engineered, overwrought spine systems that will never be used by independent, real world surgeons.

    The most successful systems are idiot-proof. This device seems VERY idiot-sensitive.

  4. SpineDoc1: Thanks for your input. Sometimes we have to call a spade a spade!

  5. I am wondering what does Musculoskeletal Man think about the Aspen Interspinous Process Fusion device by Lanx

  6. Hi: I had an accident one year ago that fractured three vertebrae and three ribs. A virulent form of bacteria moved into the fractures. It had the T-8, T-9 & T-10 for lunch! Then it ate my spinal cord for desert leaving me paralyzed from the waist down!

    I was lucky enough to check into Rabin Medical Center where Dr. Ohanna implanted the Scorpion… Today I am walking and I have full range of motion! Six months of use with the scorpion…. I can touch the floor with my hands. Can anyone with the traditional appliances complete with screws say as much?

    If I had a million dollars I would invest in this product

    Michael Snidecor