Tuesday, December 14, 2010

The Circle Game - Back to the Future

Life imitates art.  Like art, there is a cycle in any relationship from its beginning to end.  Every relationship has a turning point. Back in 1968 Joni Mitchell wrote, "and the seasons they go round and round and the painted ponies go up and down, we're captive on the carousel of time, we can't return we can only look behind from where we came and go round and round in the circle game."  With today's announcement that Wenzel Spine had hired Jon Luedke as EVP, TSB thought it be interesting to get our bloggers take on a device that is touted as simple, dependable and proven, or is that the company mantra?  Could Joni Mitchell have been incorrect when she sang that "we can't return, we can only look back from where we came and go round and round in the circle game?"  Are we going back to the future?  Marty and George McFly would be proud.  Wasn't that another father and son team?  Could this be another American science-fiction comedy?  Many years ago the industry attempted to market the cylindrical cage as a panacea for degenerative back disease.  For those that have been in the industry less than five years you probably don't realize that the cage as you know it today evolved from carbon fiber and titanium alloys into PEEK.  Back in its heyday, when spine surgeons stumbled upon the hammer, everything became a nail, especially neurosurgeons.  Some were attempting to implant the cylindrical cage without augmenting it with posterior fixation.  The procedure was better known as the "stand-alone cage."  Based on the Wenzel website, it seems that the VariLift is attempting to take the industry back in time when gasoline was $2.00 a gallon and a half of gallon of milk was $2.69.  If the VariLift is a proven alternative to traditional spinal fusion does this make it a non-traditional alternative?  Why is everyone looking for the holy grail claiming that they are simplifying surgery when there is nothing simple to begin with?  TSB must admit that Mr.Luedke has an ominous task ahead of him, if his new employers believe that this is new technology.  At best, its an old technology with a new spin, besides there are other patents out there for expandable cages that are sitting on some people's shelves collecting dust.  Could Marty be attempting to convince us that he is from the future and asking for our help to return back to 2001?  This time machine may need a little more than 1.21 gigawatts of power.  It may take a bolt of lightening to awaken everyone at Wenzel to bring them back to the future.  TSB wants to know what our bloggers think, is this something old, something new, something borrowed, or something blue or just a silver six pence in their shoe?

14 comments:

  1. Great point TSB, but in this market you never know. The pendulum keeps swinging... I am thinking about resurrecting chymopapane. Do you think that can fly? What about the nucleotome?

    The Varilift expandable threaded cage doesn't address extension. Extension is still the achilles heal of the TFC design. They work early on when there is tension on the annulus, but when you get settling in the endplate over time (and you will) ligament tension is lost and so is resistance to extension.

    We've been down this road and it isn't pretty. John should know this with his BAK days, but one does not know the situation that brought him here. I hope they have something more in the Q or the past may haunt him.

    Stand-alone has evolved into a new species and it has built-in internal fixation.

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  2. I would be embarrassed to approach a customer with that device.
    It has every negative trait you could want in an interbody device. Titanium, threaded, prior reaming, posterior placement.... terrible!

    There will be many dural tears and nerve injuries, along with subsidance from hell, totally worthless in my opinion.

    RAY, BAK and WENZEL = BUNK

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  3. What is the price point on this device? I would assume at least 4k each.

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  4. Let's see...(1) company run by a former finance guy with zero medical device and significant ethical issues, (2) staff consisting mostly of people with zero medical device experience (example: their Chief Technology Officer came from Texas Instruments) and a Zimmer refugee who was canned from Warsaw (I wonder why?), and (3) a Centinel Spine guy who couldn't do the job at his former employer?

    Sounds like a WINNING combination to me!

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  5. Why not a Cloward dowel? I probably have an old instrument set in my garage. OOPS, may have just given away my age.

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  6. This seems to be a trend in bringing people in from outside the industry. I note one is from Dell computer. No wonder so many start ups flounder.

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  7. So are you suggesting that the same old usual suspects are clearly going to do better (this time) than someone from outside who may or may not have some actual business acumen?

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  8. Well you may have a point. Their most recent hire was from within the industry. Marketing manager for Zimmer Biologics, Marketing manager for Raymedica's artifical disc, and Marketing manager for Centinel's STALIF. Now he is promoting VariLift. Where are those products now?

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  9. The point 7:22 was probably making is to say Dell Computer would probably not hire a VP from a spine company to run their computer/server sales efforts. Industry experience does count.

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  10. The reason why people are bringing people from outside is because many veteran industry pros are jaded. We hired a 20 year vet to sell a new product. He could easily tell you 10 reasons why we could sell the product. We then hired an outsider with good professional skills who would tell you ten reasons why we could sell the product. In his first year-and-a-half his region outperformed three other regions and within three years he became V.P. of Sales. The 20 year vet was sacked after 1 1/2 years.

    Many so called vets are drifters who hide at companies for 1-2 until it is discovered that they bring no value. Its the individual. Those with ego + drive succeed. Those with one but not the other sometimes succeed and sometimes Fail. Those with neither alway lose.

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  11. Well hey that settles it. Only fools hire those with experience in the industry. Clearly in 5;28's example his line was simple enough to not need it.

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  12. 6:24 - I appreciate your point. There is nothing better than industry experience with talent and a good track record. But thats not to say that outside talent can't become good as well. I am trying to make a point that just because a candidate is outside the industry doesn't mean that they can't make a meaningful impact. Afterall, we were all outside at one point and were given an opportunity to prove ourselves.

    I think if you are selling commodities then relationships are the key. But if you are selling new concepts maybe inside experience isn't the key, particularly if the experienced person is frozen in old ways. Its surprising how difficult it is for experienced people to do something different today than what they did yesterday.

    I am just defending the knock that if the person is "outside" then the company is doomed to fail. Kyphon came from the outside and resulted in the greatest M & A in spine. They created a new market with reps that came from the outside. I don't think a rep with 15 different suppliers of identical screws can think outside the box.

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  13. 8:12 GREAT POINTS!!!

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