Monday, October 12, 2009

Why are We Expanding Orthopedics?

Recently, one of our readers e-mailed TSB regarding a company by the name of Expanding Orthopedics. After carefully reviewing their website, our favorite set of questions came to mind; is it new, is it true, and will it make a difference? With the commercial launch of another pedicle screw system, the industry now has 550 pedicle screws and counting. But the bigger question looms; why in God's name do we need another pedicle screw, let alone one that expands? Is this truly novel technology?

Historically, the first implant designed that had expanding capabilities (no distal locking bolts) was the Biomet Brooker-Wills Nail. For those of our readers that are not aware, EO is not the first Israeli Company that offered the industry expanding locking capabilities. Disc-O-Tech (now defunct, sold their IP to Kyphon) was the first Israeli Company that brought an expanding humeral, tibial and femoral nail to our market. They attempted to use surgeon consultants from The Hospital for Special Surgery in New York City to no avail. So why do we need an expanding pedicle screw?

I suppose the argument will be made that this will benefit the surgeon when treating a patient with osteopenic bone. Yet, TSB must ask; based on the current state-of-the art, are surgeons having trouble with pedicle screw that don't expand? I think not! TSB believes that most of the people involved with EO are probably very nice people, but the question must be asked, why now? For those investors that infused capital into this venture, if your money was burning a whole in your pocket you can always make a charitable contribution to TSB. What do our readers believe, what do our readers think?


  1. The spine has 25 screwable vertebrae (C2-S2), so lets limit the number of pedicle screw systems to 50. Looking at the screws on EOs website; ones like this from Home Depot don't work too well in drywalls. Why would these work better in osteoporosis than a litte cement, and how many more parts can break and fail? BTW, the latest news on EO's website is a year old. Are they still there?

  2. cerevertebral: I ran into them about a year ago! I know that they hired Manley about a year ago or so. Robin Young is involved as a Board Member. If their still around they are probably hanging on by the skin of their teeth.

  3. So we should expect a glowing report in Orthopedics This Week, something like The Picture of Success? That should make more fascinating reading.

  4. Given the poor reception of this company's tech platform in this forum (and likely elsewhere), and considering that the frequenteurs of this forum are educated, updated industry pros, and noting that VCs are often as well, and keeping in mind that these VCs often have MBAs, JDs, PhDs, and scientific advisory boards, (oh yeah, these guys are ALSO entrusted with MILLIONS of dollars from their limited partners) it raises the question: what the hell are (these) VCs looking at? Do they really think that a newfangled screw is going to impress enough docs to yield a legit ROI? It really makes you think.

    Also, EOs phone number, when called, goes straight to a generic voicemail...for what it's worth.

    Discussion question: who is the most successful VC in ortho/spine other than the VBs? Who's the up-and-comer? Who's the down-and-outer?

  5. I have been reading this board for several months now and agree with most everything you've posited on the industry. Congratulations on your increasing readership. The forum is needed.

    As dynamo asks, who are the people making investment decisions? The investment community has grown fearful of FDA, reimbursement, DOJ, uncertainty over health care reform etc. While this is understandable, it creates new opportunities for ethical, responsible companies to address these issues with clever products. With few exceptions, I have yet to see the professional investors put their dollars behind novel ideas that work to benefit patients in a meaningful way and contain costs. Dynamic systems are obviously not the holy grail and don't limit costs but provide another option for surgery/sales (e.g. future fusion).