The last decade has provided the industry with technological and scientific advancements in materials, dynamic stabilization, total disc arthroplasty, minimally invasive surgery and biologics including stem cells. Similar to the automobile industry of yesteryear, the industry has exploded with companies claiming that not only were these products innovative, but that these products would improve upon the patient's quality of life. Nearly ten years ago, the clinical mantra from the podium focused on anterior motion preservation utilizing the first commercially available artificial disc in the U.S. marketplace, whereas today, thought leaders have shifted their focus to the tri-complex of the spine to address pain relief. One has to wonder if the practitioner resects enough of the patients anatomy and replaces it with anterior, posterior and interbody hardware with biologics, will the patient have pain relief? Minimally Invasive Surgery was the marketing buzz word for companies to differentiate themselves from their competition, soft-tissue preservation became important in enhancing the healing process. Today there are more dynamic stabilization systems with variations in design that claim one over the other even though many questions remain as to what constitutes the optimal design. In addition to many of these wonderful technologies, an entire new mind set developed due to economic forces affecting the industry. Questions remain unanswered about the true intent of some of these ventures. Were and are some of these technologies looking for an indication? The commercialization of medicine, and especially spine, has changed the way we once did business. No longer was it honorable to build a foundation and establish a business, entrepreneurial fever became an epidemic in the earlier part of the decade. The acquisition of the ProDisc by Synthes, and Charite by DePuy set off an entrepreneurial frenzy. "If they could do it, why can't we?" Unfortunately, timing and serendipity are important factors in becoming rich in today's economic environment.
So, what does TSB expect as we move into the next decade? Industry consolidation will become key if the we are to survive the many unexpected changes that are in store with the enactment of a new healthcare bill. Research and development along with manufacturing will be exported to countries with a cheaper labor force and product cost as a response to the ever increasing pricing pressures in the US market. The business development model will evolve based on investors need to increase or sustain margins resulting in a more direct-to-consumer (the hospital) by- passing the old sales model. Product development will become more focused. Transparency and accountability will become a tenet of the industry. Money will be always be available, but there will be greater scrutiny in providing capital. This will not be a bad thing, because it will force the industry out of its comfort zone, one that has layered companies with the same executives that still continue to do the same thing over and over expecting different results. TSB wants to know what our readers think?