As Michael Buble would sing;
It's a new dawn, it's a new day, it's a new life for me
Yes fellow Spineophiles, TSB must pose the $640 million dollar question, is the state of Minimally Invasive Surgery moving fast enough? Based on recent marketing data, it seems that MIS is not moving fast enough. Why? Considering that preserving the patients biology has become a priority, one would believe that more companies would be following NuVasive's lead. It is estimated that by the year 2015, an estimated 30% of all spinal procedures will be performed utilizing an MIS or minimally open approach. Today, at least nine companies are vying for a piece of the pie in MIS. Where are the rest of the laggards? NuVa is the market leader, followed by Medtronic, DePuy/Synthes, Stryker, Zimmer, Globus, Trans1, and the infamous Others.
Contingent on the patients diagnosis, MIS can reduce operative time, contribute to early mobilization, reduce one's hospital stay, and reduce post operative pain. Yet, the biggest factor that has contributed to the increase in MIS is preservation of the patient's biology. Granted not every patient is a candidate for MIS. Yet, one must admit that by not stripping or de-vascularizing the soft tissues, the end result is a happier patient. Patients heal faster, and there is a decrease in infections at the site of the surgery.
So why don't more surgeons take to learning a technique that enhances the potential outcome? Some of the retractor systems are simple to use with an inordinate amount of flexibility. Could it be that some surgeons are not flexible? Could it be that the older surgeons are not willing to learn something new? Could it be that its just simpler to filet someone open, and get it over as quickly as possible? Recently, TSB watched a young surgeon perform an MIS procedure with as much depth and quickness as those surgeons using an open approach. As open procedures start to decline, an educated public will benefit from MIS growth.
If Nuvasive, Medtronic and DePuy have over 90% of the Lateral and MIS market, where are all the innovative start-ups, and why do they have an inability to execute? Anything above L5-S1 is game for a lateral approach, though there has been some skepticism surround L4-L5. But the question that must be posed to our readers is, what will it take for a competitor to come in and disrupt the current leaders in the marketplace? Does anyone believe that the new VEO Lateral Fusion System can disrupt the current market?
So who has the best MIS system? Is it AlphWreck? DePuy? Medtronic? NuVasive? Stryker? Globus? K2M? Lanx? Pioneer? Or could it be, Trans1? You be the judge, let our readers know.