Wednesday, November 9, 2011

One Million and Counting

Spine Nation:



Those of us at TSB, would like to thank each and everyone of you for supporting our blog site.  As the ticker keeps ticking, TSB has reached a new milestone.  The month of November has graced us with our one millionth viewer for 2011. That's right, 1,000,000 and counting, in addition we are averaging over 60,000 unique visitors per month.  Last year we had 750,000 readers, meaning that contrary to what visionary industry analysts like Mike Matson, Joanne Wuensch, or Raj Denhoy may profess, and you all know that those boys and girls never pump up the volume, TSB may just be the fastest growing spine platform in the industry, growing with laser like precision, avoiding Japanese companies at all costs, avoiding hiring relatives to write stories on behalf of our personal interests. Yes indeed, we are humbled to provide those of you in the trenches with a forum. Whether you are a sales rep, marketing director, engineer, nurse, hospital administrator, patient, surgeon, owner of a POD, delusional CEO, or had some bad plastic surgery, we love you all.  You are what makes us get up in the morning and keep a watchful eye on the industry. We keep many of you entertained, get some of you angry, and keep some of you on your toes.  No fellow bloggers, TSB will not be erecting any Golden Arches, there will be no Spine Technology Awards, neither will we be investing in a stem cell company, there will be no analyst luncheons, no Taj Mahals being erected to honor the Spine Gods, we'll just keep on keeping' on. You know what Billy Squier once sang,

You crave attention, you can never say no, Throw your affections any way the wind blows
You always make it, you're on top of the scene, You sell the copy like the cover of a magazine
Puttin' on the eyes, 'til there's nobody else, You never realize what you do to yourself
The things we see make the daily reviews, You never get free, Everybody wants you


So in closing, there's no need to write a review on NASS.  Based on your many comments, we still feel that NASS rips off the attendees, charging, say what, how much? Whoa Baby! A G note to walk around in a drug induced stupor?  Listen to Karl Rove?  Is that where our money goes, shame on you NASS.  Boring! It would have been more interesting listening to a crash survivor from the Uruguayan Rugby Team than another political bloviator. As one of our roving reporters stated, the model in the silver outfit with the headlamp was lame, the girl with the low cut top had fame, and walking the McCormick Center caused foot pain. The Baxano and SI-Bone booth had activity, but maybe that was more of a reflection of how boring many companies have become, rather than how innovative some of those technologies really are. It was nice to see David Paul and his sidekick Tatoo walking the floor. TSB wants to know who had the best new technology?  Cervical?  Lumbar? MIS? Interbody? Pain Management? Biologics?  We want to know what our readers think?  Did anyone had technology that was ripe for the pickings? You be the judge.  Is there one company that really stands out?  Who is ripe for an acquisition?  Who will be subjected to an inquisition?  As another year winds down, it will be interesting to see who is left standing when the dust settles. Once again, TSB wants to thank you for your support, now let's finish the year on a strong note. 

115 comments:

  1. Any forum where you can anonymously insult people you don't like in front of their peers is bound to be popular. Congrats, TSB.

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  2. congratulations, TSB!

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  3. Innovators: SI-Bone, Spinewave/Globus for stackable laterals, that's it. Lots of co's whining about the FDA. I miss the good old days.

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  4. Can you start a blog for orthopedics?? Endoscopic surgery?

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  5. Congrats TSB!!!

    Was the millionth post - the "when is Globus going public" stooge???

    4:44 - I don't ever recall the MM insulting anyone or any company....he just calls them as he see them and his eyesight is always 20/20!!!

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  6. 4:44 - Dear Mr. Anonymous #1,000,001, It keeps you glued to the blog, now doesn't it? The anonymity factor is what keeps the comments raw, unrestrained, debatable and irresistible. One may insult, and one may defend. One may compliment, and one may criticize. One may simply need a forum for bad poetry. The key is, we get multiple angles, from which readers may draw their own conclusions. The truth has a knack for emerging with clarity from the labyrinths of BS. Spin Doctors are naturally frustrated here. Good work, TSB!

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  7. The line on bad plastic surgery was good! Did you get it!

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  8. Keep with the pace, TSB!

    Thanks to you, we keep on following the adventures of the Beagle Boys 167-761, 761-176 and 716-167 aka Tony, Marc and John.

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  9. Do you expect this crew to believe those stats are accurate?

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  10. I love this blog because I can say anything about anyone!!

    TSB you rock!!

    Regards,
    ANONYMOUS

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  11. 8:06 - Of course we expect the stats to be accurate.

    Sincerely,
    JoePa and the PSU AD Office

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  12. 7:03 - you mean the x-Spine sales veep?

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  13. Ahhh,, A PSU shot, nice.

    This blog shows no mercy & certainly shows no boundaries.

    A true example of the beauty of the 1st amendment. TSB is a genius!

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  14. @5:49 and @6:23
    I am not the first poster but I would venture to guess that he was referring to the comments section as the 'forum to insult people' that TSB provides.

    I'm not surprised that would go over your heads, most spine reps are low-tier state school meatheads anyways.

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  15. 8:48 Are you the "pot" calling the kettle black?

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  16. over/under on how many more TSB views before Globus goes public?

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  17. TSB:

    Did the VB's have a booth representing their BBQ business at NASS?

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  18. 9:53 - 4.5 is the under/over

    Sincerely,
    SEC Football Players

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  19. "It was nice to see David Paul and his sidekick Tatoo walking the floor." LMAO!

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  20. I agree, an ortho blog would be a welcome sight for the few of us that cut across all ortho disciplines. Orthoworld is tired and CafePharma is, well CafePharma.

    TSB can morph into TOB

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  21. Who is the sidekick tatoo?? I work for Globus and I'm not sure who this could be.

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  22. Ha, ha 3:53
    That means it's you! Da Plane! Da Plane!

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  23. Valentine has Pat Miles at Nuvasive, it's only fitting that David Paul has a sidekick too. Isn't his entire MO to copy everything in the industry?

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  24. One of my docs told me the only interesting new technology was from a company named spine view. Anyone see them there? I am not familiar with them.

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  25. spine view has some disposable endoscopic lateral approach for discectomies and foraminal decompression. Same stuff as Tony Yeungs Richard Wolfe but more expensive because its disposable. Don't think it will take off as the far lateral endoscopic stuff has been around for some time with very limited adoption and pretty poor outcomes.

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  26. 8:48 - sorry not all of us had parents who could pull strings to get us into the Ivy League. Clearly, your presence here tells me that whatever efforts Mom & Dad made on your behalf were wasted. Else, you'd be in politics, right? Good to see that you were able to take time and dirty your hands at this here humble blog. Also nice to see that your blue-blooded ass has to scratch out a living in the trenches just like the rest of us.

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  27. Side note -

    What do you think Jonbenet Ramsey and Caylee Anthony are talking about?

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  28. So ASS, I mean NASS charges people exorbitant sums to attend this blowfest and then pays political hacks like Karl Rove to speak on the state of healthcare, what a bunch of assholes. Aren't these the same people that aided and abetted in bringing this country to its knees, incredible how ridiculous this organization has become. The only word to describe next years meeting is boycott.

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  29. TSB - The big question is will you have a reveal at let's say 2M or 5M hits per year? Do you have any plans to come out of the...well, out in the open...eventually?

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  30. 5:54
    The same people that aided and abetted in bringing this country to it's knees?

    Aren't you do back on wall street for clean-up duty?

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  31. Depuy, Synthes, Stryker, Nuva and MSD will continue to lead in the spinal landscape. All others be prepared for consolidation.

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  32. 5:56 you didn't happen to be an English major in college? Thank the sweet lord Jesus tat you sell fora living.

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  33. I saw some really neat head lamps at NASS. LED, runs off a sony video cam battery. Saw lots of purple lanyards. Saw the girl in the silver jumpsuit (not the best booth babe I've seen, but she caught my attention, her headlights were nice, too). A guy had some cool spine models for patient education that showed how the disc protrudes. Other than that, nothing groundbreaking.

    7:03, of course the big box companies will continue to lead, but will also continue to lose share. It will be several years before they arent leading anymore. There will be little consolidation of companies with core product offerings. Baxano and the like may find a buyer, lets just hope for their sake it isn't Stryker (the wet dream fucker upper).

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  34. A Viscogliosi Goes A Huntin’ Armed with experience in backwoods Michi- gan—oh, and a large rifle—John and Marc Viscogliosi (now city boys)— recently went on a hunting excursion with a friend. John Viscogliosi told OTW, “We were out in Colorado, and it was our first time elk hunting. The first day we saw a large elk but we didn’t get in any shots. On the second day I spot- ted an elk in a thicket of Aspen trees. Our friend saw the rack on the elk and said, ‘You have to get this one.’ I was about 80 yards away...and I actually dropped it in one shot. Apparently, this is exceedingly rare. Our hunting mate told me that of the 36 elk he had got- ten in the last four years he had only dropped one with a single shot. The antlers are soon to be delivered to my

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  35. VB issue hunting garb
    http://www.militaryuniformsupply.com/ultraviolet-purple-camouflage-bdu-cargo-pants

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  36. Seems like it would have been more sportin if the elk had a high-powered rifle also.

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  37. The Nuvasive folks should have been making the rounds with their resumes rather than practicing their "perfect cheer" in the booth.

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  38. The future of our industry is gender solution Luque rods. Blue and pink options. Anyone?

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  39. This was the best NASS ever. My company had us wear scrubs and sneakers! It was GREAT! Like pajamas and slippers baby!

    I suggest NUVA reps actually wear cheerleading outfits next NASS. Now that would be fun to see..........

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  40. Will a cheering NUVA squad make it to next year's NASS?

    Will Ferrel & Cheri Oteri to lead the "perfect" cheer?

    N-U-V-A,, GOOOOOOOOOOooooooo NUVA!! (hand clap)

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  41. Did Nuva booth really do a cheer? Really?

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  42. Yes, Rumor had it that Alex lead the cheer w/ his 7 person personal-assistant entourage.

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  43. There was no cheer. It was a closing address. Funny how you are always calling out NUVA reps. How much business have we taken from you over the years? It must suck being a second class reps.

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  44. Purple pussy NUVA lover

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  45. 2:13, At least we're selling products that we own, not designs and branding stolen from other companies. How many lawsuit licks does it take to get to the center of a b-s company? One, two, three!

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  46. @2:13 That's ok, continue to believe the lies that are told to you from the top. Wasn't it Alex who told you that "everything would be ok" & that "Medtronic will not file an injunction to stop the sales of our products"?

    I would bet the house that Nuvasive is your 1st job in spine and you simply don't know the difference between truth & fiction.

    Karma is a bitch my friend and with Nuvasive's current trend, you may just find yourself working for some other company sooner than you think.

    Your CEO should spend less time pushing his political agenda & promoting his musical and more time paying attention to the obstacles that his company now faces.

    But then again, you're the perfect fit for the ogrnaization, as you're blind & clueless and clearly have believed everything that you've been told which makes you the biggest fool on this board.

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  47. 5:47 is clearly misinformed and is making a pathetic attempt to convince us that Nuva is in a downward spiral. Alex specifically addressed the possibility of MDT seeking an injunction and called it a certainty. What he further said was, and rightfully so, that they would be unlikely to be granted an injunction.

    And to identify any "current trend" at Nuva as being anything other than one of very few spine companies continuing to grow sales and take market share would be foolish.

    Please keep focused on Alex's assistants and broadway shows while I keep taking your business.

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  48. It appears a number of companies are bringing back titanium cages.

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  49. Laughing at 634

    Love the arrogance at Nuvasive & the ignorance toward the shortcomings of the company. Do you think you continue to "take" business and lose none yourself? Cohen, Cappucino, Nunley, Sandhu, the list goes on & on of the number of surgeons who have now moved on to greener pastures, taken their business elsewhere and have gone on to develop the lateral systems that will now eat you alive. As for your comments about growing business & taking share,, WHO CARES? The compnay continues to bleed money and its stock is now trading at a level lower then it did 6 years ago when it went public. Be happy being #3 for now, you'll continue to eat the dust of DePuy & Medtronic for the forseeable future.

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  50. Medtronic's Mantra:
    Steal, sue, acquire. They will buy Nuva for pennies after breaking their backs on the suit.

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  51. Nuvasive is going down. MultiPle xlif copycats because they didn't method patent it. Only pma's will create separation in spine. It's amazing how fast nuvasive will blow up.

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  52. Mako surgical is the new slim shady in ortho

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  53. @ 7:51 I had not seen that company before, have spine blinders on I guess.

    Thats pretty slick!

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  54. 7:03. Sandhu is still doing business with nuvasive and he is getting paid by k2m and not nuvasive...

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  55. Nuva-bash all you want but they have some very good products, and are growing in a down market. Unfortunately for Nuva, Medtronic's doing what it does best and found the only way to slow them down: lawsuit. Will be interesting to see how it all works out.

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  56. Medtronic should sue Sandhu for the Kyphon mess

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  57. Can a company who chose purple really last for very long? fad.

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  58. I like the use of the word "growing". A 68 mill loss last quarter--nuff said.
    Have they ever turned a profit?

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  59. When you show growth - but spend much more to get said growth... I would hardly call that positive organic growth. Could this growth be coming from paying outrageous guarantees to competitive reps to come over to NUVA and bring short term gains? Hardly and long term strategy in my mind. Investors should be nervous and dig a little deeper.

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  60. 8:10 AMEN.

    It has been & continues to be a shell game there. Just take a glance at their stock price as I assure you that the large investors on Wall St. are far more savy regarding this turd than anyone on this board. The fact that investors can't run fast enough from Nuvasive's stock tells you all you need to know.

    For those that crow on & on about "We're taking your business, etc.", who cares if you're a $5B company, if nobody wants your stock because they know what a fraudelant sham of a company Nuvasive actually is.

    Over 6 yrs. since going public and continuing to hover around record lows, yep, GREAT company to invest in for "growth".

    Sad & pathetic.

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  61. I've been a nuva rep for a little more than 4 years. I'm new to this board and am curious to know why there is so much company bashing. There is a misperception that this board is more informative than cafepharma, but from what I can see it is just as worthless. What difference does it make to a non-Nuva employee whether or not Alex has more than one assistant or if they pay a competitive rep a guarantee (just like all companies do)? Get over it. This board has great potential to unite to our common interests against PODs and hospital pricing pressures, etc. Instead this seems like useless watercooler gossip.

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  62. It's enplate preservation stupid. Globust

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  63. 12:25PM

    Sometimes the biggest office secrets go public around the water cooler.

    Your Truly

    Nuva Hater

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  64. 12:25,

    All companies pay competitive reps a guarantee? I think you know that is not true. It is true that Nuva has experienced growth in a stagnant market, but at the expense of what? The company can't get out of it's own way to turn a profit. This latest Medtronic debacle isn't going away like Alex would like it to. The Nuva reps that I talk to in my area are not happy working for that company. Just keep an open mind and realize that every company out there gives propaganda to their reps. Every company.

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  65. Integra has ruined SeaSpine. Anyone else agree?

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  66. Agreed. They all play rah rah games at NSM's, but so what? As long as they reliably provide me with a product to sell, that when used properly doesn't hurt patients, and my paycheck gets deposited on time, what difference does it make what Alex Lukianov's political leanings are?

    And yes, all spine companies that I have been contacted by (Synthes, Nuva, MDT, DePuy, Stryker, Zimmer, Alphatec), offer some competitive reps guarantees to get them to change teams.

    All I'm saying is that this blog has the potential to help us all advance our interest as device professionals. There is too much gossip, and too little substance.

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  67. @1:45

    So then contribute something meaningful instead of simply trying to defend the company that you work for currently.

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  68. It's a scary time for a scary industry. Save as much of your commission checks as you can for as long as you can. It was fun while it lasted.

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  69. Agree with 1:45, this blog has potential to advance the interests of the industry and share meaningful and useful information. If you required registration in order to post, I believe that you would see the credibility and utility of the forum increase tremendously. The number of posts may go down, but maybe not for long. As people recognized that the forum had become a legitimate forum for the discussion and exchange of ideas, then it would become more popular, not less. It would also require more work, so I can see why you might not want to do it.

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  70. Stryker is laying off 5% of their sales force by the end of 2012. Here's a $7 billion dollar company trying to get out in front of the Medical Device Excise Tax coming in 2013. If they are feeling the economic pressure, what makes you think the Nuvasives, Globus, K2M's etc will be sustainable. It's coming, I look for all 3 of those companies to be gobbled up

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  71. workforce, not salesforce. you put that same attn to detail into your job...

    http://www.freep.com/article/20111111/BUSINESS06/111110345/Stryker-cut-5-workforce?odyssey=mod|newswell|text|FRONTPAGE|s

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  72. The sales force is where companies trim the fat

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  73. 6:49pm, Why on earth do you think that companies will be making cuts to their sales force? Sales reps are the ONLY employees in this biz that do not have to worry about being "trimmed". We get paid commission based on the amount of business that we bring to the table. No business = no commission. Stryker and the rest of the med device companies will be making cuts in R&D, Marketing, Admin, etc... They will simply pile more responsibility on the plates of the employees that do not get fired, and the train will keep moving on down the track.

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  74. 7:35 Clearly you ARE just a sales person and lack the capacity to see the big picture. In any organization where the reps are direct, they are an INCREDIBLE expense. Benefits & expenses alone cost the comapny millions of $$ each year for these folks. Trim them, trim the expenses. Additionally, not only will some comapnies begin to trim sales people, but they will also begin to reduce commissions. In effect, they will handover business to other reps and those reps will now be expected to manage more business w/ a reduction in pay.
    These are all standard industry moves.

    When was the last time you were part of an ogrnaization where quotas remained relatively flat & commission % went up year over year? It doesn't happen that way my friend.

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  75. Then the exodus continues to smaller companies willing to pay good commission.

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  76. 7:35

    Case in point - Trans1. They hacked a ton of their direct reps and are moving to a distribution model (which of course won't work either since you'll try to sell other stuff in your bag the second you get push back and objections when you try and sell AxiaLIF).

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  77. When did they start caning direct reps? They were just hiring direct reps as of September.

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  78. They have one of their reps now in charge of national sales and heard a hiring freeze is in place till the reason for the subpoena they received comes to light.

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  79. 6:28am, what you describe should not be referred to as a "layoff". Switching from a direct to distribution model does not necessarily mean that all of the direct reps are being fired. They are simply going to work for someone new...a distributor. And just so we are all clear, the company ends up paying MORE commission when this change takes place. The savings come from not having to pay for area/regional/divisional management.

    The above, of course, only applies to the larger companies in our biz. I think you might be right when it comes to the smaller companies like Trans1 when they switch from a direct to distribution model. A lot of those reps are probably left standing without a job when the dust settles, unfortunately. It all goes back to relationships in the end. Most likely the Trans1 reps, for example, did not have the opportunity to generate a large volume of business due to the limited nature of their product portfolio which means that they probably did not have the opportunity to build relationships that were strong enough to secure a place with the new distributor in the end. It really isn't their fault. That's just the nature of the beast.

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  80. Would love to see this industry start to trim some of the dead wood from the landscape. I'm not sure there is another industry where so many people are making the kind of money they are in spine who are so under-qualified for the positions they fill.

    Just for the hell of it, I actually interviewed someone during NASS who has been in spine for 2+ years who acted as if they had been the industry for a decade plus. They knew little about anatomy, the spine, complex surgery, etc,, it was actually sad.

    Bottom line is that this individual had been in radio advertising sales previously, but was the nephew of a prominant surgeon, so a distributor in their area offered them a job in hopes of flipping business.

    Pathetic.

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  81. where are people going when they leave spine? I know if I left I would still troll this board and I am very curious to see what draws folks away and where they end up.

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  82. Stryker laid off 100 people at their Orthopaedics office last week in NJ. It was marketing, R&D, Quality and Manufacturing people and some sales managers. Some very smart people were let go. I agree with 4:33PM. Save your money now... you never know...

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  83. I just saw Biomet's new TLIF set and everything says "Made in Biomet China" maybe that is where the jobs are headed.

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  84. NuVasive "Re-Structuring"coming soon.... Layoffs in Marketing & R&D coming. Also. No Executive restructuring except the hiring of more Medtronic "movers" like Brad Coates. BAWAHAHHAWAAHHAA. How "mad" is Medtronic for losing these latest guys. Russell Powers. Brad Coates. Etc. Nuva is really building a powerhouse now from the start-up to the "Billion Dollar Start-up" with the old Medtronic BOYZ. Can't wait to see who the next is.

    It is amazing that a management team that made videos, called names, poked fun at the "500 lb gorilla" continues to hire more and more of the old Medtronic Good Olde Boyz. Nuva in the single digits by Q2.

    Where is the Nuva board. Anyone? You sales boys better wake up and smell the purple puke you are drinking. The core of this apple is rotten.

    Where is the "$50 stock" at these days? Where is the talk from the beginning of the year of Nuva being bought and consolidated? How is it that the entire Nuva leadership was caught off guard by the Medtronic win? How the hell did TSB turn into nothing but sales inputer? Nuva sales crew enjoy Cheetah Ball. Take a look at your corporate "bretheran" and see how much heart they have left... Oh thats right, you don't care as long as you are making your $$$$.

    Next...

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  85. Did anyone hear that I-spine facet screws being recalled.....

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  86. Would anyone recommend going to Stryker spine? Are they going to keep commission percentages the same for 2012?

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  87. I would defiantly recommend going Stryker. I work for one of the companies consistently bashed on this site and am also thinking of making the switch. The way I see this market playing out, I see Stryker making some big acquisitions in the very near future. They have solid stuff and are not going anywhere anytime soon.

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  88. I was with a major and see the advantage of job security and knowing they are not going anywhere. The problem is they are not adapting to the market changes, rather cutting employees and compensation. This helps the bottom line but is not a good strategy to retain talent and grow market share. After meeting with several companies at NASS I feel the European companies are better positioned in terms of COGS, margin and innovation. They are profitable and do not have to make drastic commission adjustments as margins erode. I met with SpineArt and was very impressed. They are based and manufacture in Switzerland and are very innovative. They are new to the U.S and have little marketshare so it's a big risk but they are not another POD out of the Southeast. I think I am going to give it shot when my contract is up in January. Has anyone seen them around or currently distribute them?

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  89. 11:48

    Nice try Trent!

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  90. hahahaha, 11:48 is totally Trent!

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  91. 11:59, 1:08 Actually it is not Trent and I did not deal with him, rather the owner directly. I would actually like to hear from someone who currently sells the line. I met with several other companies but they were the most interesting.

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  92. Who were the other companies if you don't mind? Is SYK like NuVA as far as culture? Everyone seems to just be sick of NUVA and the culture of short sightedness.

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  93. LDR seemed like a good company but very limited in products. I met with Pioneer and Amedica as well but I am not a fan of their model and products. SpineArt was something new and different and they have most of the products, but still lack some key systems. It's very hard to find a company that isn't surgeon owned or suffering from a tainted reputation.

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  94. I am a first year spine surgeon, who was offered IP on every product in the SpineArt line. Nothing to be impressed with - how many times do people need to write there is NO INNOVATION in spine these days. The next two jumps will be (1) biologics - both diagnostic/predictive and therapeutic and (2) a disruptive innovation in instrumentation - cheap pedicle screws, fewer trays, etc. As hospital systems move towards a more cost aware purchasing strategy, surgeons will be forced to use the companies the hospital wants - unlike now, when surgeons and companies are wedded because of financial interest, or "comfort". FWIW, I passed on Spine Art.

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  95. If we're talking metal plastics tans tri calcium phosphates innovation is bs. Only data matters. Spine has been so wronged with pedicle screws that no one understands.

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  96. We would all be wise to stop focusing on the "who" and start focusing more on the "what". Stryker laying off 5% of it's workforce (regardless of what type of employees they will be) is a DIRECT result of the Obamacare legislation pushed through congress last year. Why are the Republican presidential candidates not jumping all over this? Obama claims that his #1 priority is to create jobs, but his actions/policies have the complete opposite effect. Thousands of jobs in our industry will be lost when this is all said and done, and what will we have to show for it? Will the American people be "healthier" and "happier"? No! Will we have a balanced federal budget? No! Will we have several thousand more hard-working Americans collecting unemployment? Yes! TSB, do you disagree with me? I would love to hear your take on all of this. An apocalyptic collapse is coming. There is no doubt about that. We need to stand up and fight now while we still have the chance. I know that this probably comes off as a bit dramatic, but it is the truth. Times have changed. Do you think that the citizens of the Great Roman Empire ever thought in their wildest dreams that someday the party would end? No, much like modern day Americans, they felt as though they were invincible. They were not.

    ~A.Tex

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  97. Two decades of no clinical data must end. Other areas of medical devices are evolving.

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  98. 1:54...
    You obviously missed several other companies not mentionrd so did the others not buy into your BS or maybe already knew you could not deliver whatever you stretched the truth in what you could bring to the table? Just saying....

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  99. 1:54 I have been in the industry for 17 years have 15 employees and do more business in a year than you will do in a decade. So go back in you closet, put the bozo makeup on, the belt around your neck and continue to jerk off to pictures of B. Arthur while your fat wife makes giraffe noises and sh*ts on your feet...just sayin.....tool! You have no right to judge; things are changing and the current companies are not reacting fast enough.

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  100. Last message was directed at 4:56. Now You can go back to the closet activities and I am sorry for calling your wife fat. She is probably just husky.

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  101. YIKES! C'mon man, Give a brother a break,, I'm sure he's got Betty White on his mind & not B. Arthur.

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  102. 2 questions

    What smaller spine company has a nice low profile cervical plate?

    Also, is pioneer's lateral worth anything?

    Thanks in advance

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  103. I agree with first year surgeon. Low cost implants for basic ACDF's, 1-2 level TLIF and PLIFS. Sub $500 pedicle screws are coming.

    Biologics, however, are definitely the future. Hardware attempts to fix a problem yet can cause other problems. Biologics are a cure and have the potential to solve degeneration before it happens. Regenerative medicine will play a roll in fusing bone, regrowing the posterior tension band post interbody work, and healing wounds more effectively.

    Hardware will still have a roll in trauma and scoli cases, but degen business will be moving away from hardware...it's coming.

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  104. Sub 200 screws are coming. Once the hospitals decree that there is no reason to have a company person present to explain basic anatomy to a surgeon, they will buy them in bulk at True Value.

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  105. Screws cannot be sold at $200 unless the hospital is willing to buy the instrument sets and their own inventory of implants. Hospitals should be more concerned about being integrated. They must bring MRI, X-ray and other services back into their AR and away from doctors or outside centers. The only way to be profitable is to follow the Kaiser model and control everything. Implants are a fraction of their annual expenditure, but it's the lowest hanging fruit and doens't require a lot of thought. They can have the screws for free and their problems will not go away.

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  106. 7:54 - RSB Cervical InterPlate is the answer. www.paradigmbiodevices.com

    Pardon the plug!

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  107. Did anyone see DTRAX? Cervical implant for percutaneous fusion. Company looks pretty small but the booth was packed. What's the scoop on these guys?

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  108. Anyone have any info on NuVasive's new perc screw, Precept?

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  109. Precept is a slick minimally invasive deformity perc system, has some similarities to DePuy's Viper 3D

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  110. problem with those systems is that while they are awesome, so few surgeons have the skill/patience to use them. I mean Lenke still cuts people wide open and he is the president of the SRS for god sakes.

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  111. Dtrax, safe and innovative MIS procedure. Bilateral perc distraction that will fuse, disposable instrumentation. I saw one today and was very impressed. keep it going Jeff

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  112. Nuvasive Precept is a Revolve knockoff just like Alphatech's MIS system. Alphatech uses cannulas to pass screws through which is in violation to a Michelson, sorry Medtronic patent so it's only a matter of time if they are truly protecting patents or just trying to slow down the bleeding.
    Precept uses the same screw to sleeve connection as the Revolve system.

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  113. Outside the Box:

    Nuva CEO stays in the most expensive hotel when in NYC. St Regis on Central Park South. Not Good.

    DePuy Spine; time to wake up. I mean really. The Medtronic, "one" program is going to take your screw business. Get with it you have a solution. Time to act.

    For all you midwesterneers and left coasters that think the VB's are Mafia; please get a life. Not every Italian in NYC is related to one of the 5 Families...ok. None of them have made their bones ok. They make money on Park Avenue. Period.

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  114. WTF was †hat previous comment regarding?

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  115. Whitewashing following the Olympus disclosures. So it's not Mafia, could it be Yakuza?

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