tag:blogger.com,1999:blog-126852961571725269.post1871429180863961828..comments2024-02-24T06:25:59.743-08:00Comments on The Spine Blogger: Where Will the Next New Innovation Come From in SpineMusculoskeletal Manhttp://www.blogger.com/profile/14873819014357051373noreply@blogger.comBlogger60125tag:blogger.com,1999:blog-126852961571725269.post-60539211417143239592014-09-08T17:59:16.068-07:002014-09-08T17:59:16.068-07:00when a screw cost the patient 1000 dollars I would...when a screw cost the patient 1000 dollars I would think it should perform as used or use a 10 cent screw .Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-45489801463638488382013-03-07T03:30:00.894-08:002013-03-07T03:30:00.894-08:00Awesome information about surgeon,its good thought...Awesome information about surgeon,its good thoughts to be share.<br /><a href="http://www.spinepainbegone.com/" rel="nofollow">SSpine Center San Antonio</a> Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-79439818263558145032012-06-21T06:32:17.130-07:002012-06-21T06:32:17.130-07:00J - motion preservation in the spine involves a na...J - motion preservation in the spine involves a natural organic kinematic. Metal devices cannot mimic this organic kinematic design - plus the shock of the metal replacing soft tissue causes osteoprogenerator bone to signal new bone growth, ergo HO. Note that all metal motion preservation devices cause HO. This does not happen with fusion because the new bone caused by the shock of the metal replacing soft tissue and bone can be ReAbsorbed. This is just one of the reasons for choosing fusion over metal implant. I am not against innovation, otherwise I never would have volunteered for a clinical trial, which at the time I did not know was already in the FDA Black Box for trial device not approved or cleared for any use by FDA. I am against the medical device industry rushing dangerous fad devices to market based on corrupted research.Philomenahttps://www.blogger.com/profile/04514120963957626897noreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-26104826047432029692012-06-21T06:03:35.965-07:002012-06-21T06:03:35.965-07:00Had to be F B - Synthes Pro Disc or Medtronic were...Had to be F B - Synthes Pro Disc or Medtronic were the only two corporations that had CTD on the market. These motion preservation spinal devices are lethal death traps. I have documented stories about the CerviCore TDR study (with with photos, X-rays, Myeolgram imaging and Bone Scan) that prove how dangerous these devices are. I think the disc that caused the paralysis was the Pro Disc. The fact that the disc is NOT revealed called into question the entire Motion Preservation theory. The concept is dead in the water and a total fad that caused serious blowback injury. Note how the trend is to blame the surgeon, instead of the device. This will end up alienating ortho surgeons (which is good) and perhaps these midieval metal motion preservation scams will finally fade like the Ford Edsel. Most surgeons I have spoken too say they are no longer doing spinal implants. Now with SunShine Law kicking in soon, surgeons will not risk getting caught implanting devices that 9 times out of ten, FAIL, and risk being sued for corrupt medical mal practice. There are plenty of surgeons out there who will testify against a surgeon who went ahead and coerced a patient into consenting to an implant with all the evidence out there about the dangers of these discs. I was told by a neurosurgeon that the Prestige failed in the best candidates. Spinal Motion Preservation devices requires enert material. To date, there is no material that will not release particulates into bloodstream. This particulate release in combination with HO ( hetero topic ossification) are two issues that will automatically cause numerous other issues or adverse events to the list of causes of clinical trial failure. Most disastrous is the fact that the data in the clinical trials for the devices already on the market is beyond questionable and biased (bought and paid for statistics). Everyone knows how corrupt the medical device industry is and if anyone is interested in a good laugh, check out who MacMillan's new pay master is? And the division he will be heading up - the defunct Synthes Spine division. I fell out of my chair laughing. If J&J believes MacMillian can breathe life onto the spinal implant division they will be in for a huge surprise. Motion Preservation Spinal Disc using metal is DEAD in the water with way too many casualties. As times goes on, more and more casualties from metal motion preservation devices will be surfacing. Books for the public will be on the market explaining the dangers of these devices in laymen terms and will soon turn this snake oil device industry on it's head. Books exposing about physicians and surgeons selling out their patients for feeder fees will soon be best sellers on Amazon dot com. Within ten years, the public will be educated about the medical con game and how these corporations are acting from the same level of medical fascism that was being practiced in Nazi Germany. England is now leading the world in creating registries for reporting defunct mal- metalware. You can't teach old dogs new tricks. These huge corporations are moribund and unteachable. They don't learn from their own mistakes. So fate steps in and puts down the old dogs so new puppies can be given new homes. A strange analogy, but the point is, old untrainable dogs who refuse to learn new and harmless ways of doing business that impacts the health care of billions of people will get put down as a useless crippled snarly smelly old dog. Humanity will strike back and con artists CEOs will soon eat humble pie, as in being used to head up a division that has no future what so ever. MacMillian was starting to believe his own bullshit and that is how a con man gets conned by his own BS. A decent human being couldn't get a good nights sleep knowing that his executive action caused foreseeable severe harm/ death to hundreds of patients, but a sociopath can and does.Philomenahttps://www.blogger.com/profile/04514120963957626897noreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-69050809419520336692012-06-20T23:51:43.873-07:002012-06-20T23:51:43.873-07:00What will the next big thing be in spine as reimbu...What will the next big thing be in spine as reimbursement declines for all besides the hospital?<br /><br />Not seeing a whole lot around here.<br /><br />Most products a minor modifications of eachother. Screws, rods, cages, tubular retractors, this and that.<br /><br />Biologics? Maybe, but not biologics for fusion. Arguably, the biggest and best biologic of recent and perhaps soon to be near exctinct is bmp. We can all get the spine to fuse with time tested good technique and and the patients own bone and cells.<br /><br />I think the biggest innovations will be in biologics, but biologics for disc regeneration, nuclear replacement. That is the holy grail. <br /><br />I also think that unless a company is thinking about how they can save money for the hospital, that company will not survive. Relatively large innovation and sought after innovation will be in the form of cost savings and time savings method that producers and distributors can provide to the hospitals and to the patients in terms or less risk, less time in the o.r. etc.<br /><br />These big companies that keep rolling out the latest version of a goddam screw with a new label and expect higher prices of the hospitals are completely ignorant and will fail. How many ways can we cut a thread or cut a piece of plastic and call that innovative....and then demand a premium. That is quickly becoming a thing of the past. At this point a screw is a screw and a piece of plastic is a piece of plastic and the differences are subtle and will soon not be recognised as differences worthy of even the current decreased prices demanded by hospitals.<br /><br />As many of you know, boxano has a new,' innovative' device used to dental floss the foramen. While even that device does represent some level of innovation, why would a hospital pay the 3000 in extra cost when that device is not reimbursable and alternative standard techniques and old school tools can be used?<br /><br />Real innovation will be in regeneration to prevent salvage procedures like fusion for patients and cost savings to the system, mainly the hospitals and insurance carriers.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-43033936959413834372012-06-20T03:25:53.743-07:002012-06-20T03:25:53.743-07:00Spine surgery is an invasive pain management proce...Spine surgery is an invasive pain management procedure in which a specially trained doctor (the surgeon) uses instruments to make incisions to repair damaged spinal tissues. Or in other words Spine surgery whether back or neck surgery, can be sum up as an advanced treatment option for pain and disability caused by an identifiable lesion in the patient’s anatomy that has not adequately improved with non-surgical treatments. Although spinal arthritis tends to be chronic, the symptoms are rarely progressive and rarely require surgery on the painful spinal joints.Spine Surgery In Indiahttp://www.mediese.co/noreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-61963415381739293632012-06-19T21:26:24.320-07:002012-06-19T21:26:24.320-07:00There is no profit in innovation. Let's say th...There is no profit in innovation. Let's say the industry had devices that fixed the problem right the first time, shortened recovery times and less revisions the industry would lose a large part of the market.<br /><br />I have to agree with you Fat Bastard. The products they offer are laughable. I had a friend do to Germany for a disk replacement procedure and a revision surgery for some butchering he got in the states. He's doing great now. We totaled up all his expenses related to his botched surgery and over the years it was probably $40K. If he had had a revision here it would have been another $40K and they probably would have botched that too.<br /><br />It's shameful greed.CG Bradyhttps://www.blogger.com/profile/04442450502258835773noreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-83869568365573222402012-06-15T21:12:37.870-07:002012-06-15T21:12:37.870-07:00There is no data that suggests Zimmer Spine has 3%...There is no data that suggests Zimmer Spine has 3% market share. They haven't reported quarterly growth in almost 4 years. They are barely a $200M sales worldwide. Globus reported $330M. <br /><br />Z spine is dead. It's thrift store junk.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-79779232655867275382012-06-15T13:21:47.035-07:002012-06-15T13:21:47.035-07:00Your company instituted a system that offered &quo...Your company instituted a system that offered "premiums" to hospitals and you facilitated these agreements and your pontificating to us on how the medical industry is corrupt? Wow! You are a idiot of the highest order. <br />Instituting a policy, in which, you are well aware is incentivising an institution or the members of that institution is the exact same thing, you are preaching, is wrong with the medical industry. <br />It appears that when the medical world was paying your check, personal ethics and morals did not matter. Now that the medical world has stepped on your toe, or more probably denied your incredibly ADR, your ethical standards are so high you can criticize the same system that you participated in, willingly. <br />When and if you ever have a patient come to your office and thank you for restoring their quality of life, you may speak to Surgeons motives. Oops, I must have forgotten that your mothers basement does not have a office.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-15642680489154405432012-06-15T11:38:56.502-07:002012-06-15T11:38:56.502-07:00ADRs have been around since the late 1950's. I...ADRs have been around since the late 1950's. Infuse has been a disaster and Medrontic furthered that disaster by selling it off label in spite of numerous FDA warning letters.<br /><br />Screws are an innovation? LOL! The only screwing that is an innovation is how the patients get screwed. That has become quite novel.<br /><br />Here's the innovation. Medicine went from a profession guided by doctors and the Oath to an industry run by corporatists who managed to commercialize and monetize disease. In doing so that took America, the true leader in health care and took it from number one to 37th in the world.<br /><br />Corporate funded research sucks. Profit motivated health care sucks! The industry/FDA revolving door sucks!!Fat Bastardohttps://www.blogger.com/profile/03839915109115122588noreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-22702640392451494392012-06-15T07:02:10.816-07:002012-06-15T07:02:10.816-07:00Philemonas words not mine that - "motion pres...Philemonas words not mine that - "motion preservation spine devices are a fad". <br />I see you left out ProDisc which is a similar-constrained TDR. <br />Show me any data for a TDR that is constrained and has a shock absorbing capability that has been tested for 1 million plus cycles (approximately 10 years of motion). Let us all know at what point the mechanical bond between the gel type material and the endplates failed. <br />If you or anyone else can overcome the stresses of sheer, tensile and torsional loads which can get a patient out further than five years then you will have a winner. <br />FB, if you design and are able to prove out the efficacy of your device then I and a lot of others will personally congratulate you. But please do not continue your absurd remarks of any two hardware store employees can design a TDR. All you do is expose yourself to be a simpleton who loves to make derisive statements and little knowledge to back it up. <br />JAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-54072483305118003512012-06-15T04:03:16.330-07:002012-06-15T04:03:16.330-07:00How many truly innovative products have there been...How many truly innovative products have there been in spine surgery? You could say pedicle screws for segmental fixation, Infuse for de novo bone growth, artificial disc replacements,and what else? Hasn't most everything else been line extensions of current 510 K products calling them new product launches? Except for the PMAs for cages, Infuse, and artificial discs where is the data? Payers are pushing back even for 510 K products because there is no evidence. With the FDA and regulatory hurdles, the reimbursement requirements for evidence (little in spine surgery because companies refuse to invest in now commaditized 510 K products), where is the next truly innovative product coming from? The days of 15 new product launches each year saying this is "innovation" are over. The is no ASP traction like the past (spine grew 15% a year from product line extensions until 2005 when payers learned to not pay for Charite). Company marketing teams desparately try to define product attributes that do not make any clinical difference in outcomes (because there is no data)and call their products "innovative." So with pricing pressures, a market flooded with "me too" products, no evidence to push back with payers to continue coverage, and only a hand full of PMAs in the near future...might I suggest the company that learns to navigate in this changing market will win market share. Let's face it, evidence and comparative effectiveness will rule in the near future, and companys that understand this process and joint ventures with payers will define "innovation" of the future. This is the essence of "process innovation."Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-1122672615653881462012-06-15T02:02:51.372-07:002012-06-15T02:02:51.372-07:00AnonymousJune 14, 2012 2:02 PM
Just when I start ...AnonymousJune 14, 2012 2:02 PM<br /><br />Just when I start thinking some of your posts have 10% rational thought, you go and prove me wrong again. Things are not always black and white, no matter how many ding dongs you eat. The good comes with the bad and that goes for any industry. Unfortunately, I do agree that patients should be more educated on who they go to see and for what.<br />As a Sales Representative in this industry, I do whatever I can to avoid situations that I feel would compromise my personal ethics. Believe it or not, plenty of the guys that view this forum are in this industry for the right reasons.<br />Being a fanatic is no way to go through life son...<br /><br />++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++<br /><br />Here is what is Black & White: <br /><br />J&J/Depuy has been fined billions. They repeatedly break the law and all they get is fined.<br /><br />It is the 21st century and Americans still do not have a shock absorbing motion constrained ADR.<br /><br />It sounds to me like you've been drinking a lot of industry koolade. The sales literature is fiction and you believe it. <br /><br />The medical industry is corrupt. No gray area there either.Fat Bastardohttps://www.blogger.com/profile/03839915109115122588noreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-38667932908217087892012-06-15T01:48:59.910-07:002012-06-15T01:48:59.910-07:00Anonymous June 14, 2012 5:59 PM lied and said
Phi...Anonymous June 14, 2012 5:59 PM lied and said<br /><br />Philomena you are soooo correct. After all, that quack motion preserving total hip and knee surgery is just a fad. I can't for the life of me understand why patients would not want to get a girdle stone procedure instead of a faulty, likely to fail total hip that allows you to get back to normal function. And how about those crazy total knees. A good old fashion knee arthrodesis never had to deal with poly wear or the surgeon having to go back in and replace the poly after 14 years. People used to just gimp along and make do. Crazy times we live in.<br />What stupid statement. The spine is made up of motion segments, and it only makes sense to try and restore/maintain motion in the spine while addressing abnormal pathology. Your buddy Fat Bastard sure thinks its a good idea or he wouldn't keep talking about his great, unknown super top secret TDR." <br /><br />---------------------------------------------------------<br /><br />Neither Philomena not I am against TDR or AJRs. We are against junk and engineering done my idiots/doctors.<br /><br />Medronic's junk and Depuy's junk are mechanically unsound. They are not motion constrained so the only thing that stops the segment is what? It's the facet you moron.<br /><br />There are no valid reasons for why the DCI, NeoDisc and and M6 are not available to Americans. <br /><br />A moron can design an ADR and the morons at Depuy and Medtronic designed 2 of them and they suck.Fat Bastardohttps://www.blogger.com/profile/03839915109115122588noreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-32582636010703913072012-06-15T01:24:24.673-07:002012-06-15T01:24:24.673-07:00The way we bribed was simple. We offered the insti...The way we bribed was simple. We offered the institution "premiums". If the department head wanted it to go to the hospital he could fill out the paper work and have it sent to the hospital or have it sent some place else. It was up to them whether to be dishonest or not.<br /><br />We were completely above board. <br /><br />This works with all sorts of crooks. It has been used on purchasing agents for years. Today you little weasels don't have to be so subtle.<br /><br />H-Pylori is cured with bismuth and penicillin. This has been known since the 60's. <br /><br />Polio and small pox were eradicated in the 50's. <br /><br />Everything else is "managed" HIV and cancer and RA are big money makers. <br /><br />Alpha-TNF was discovered in 1968 by Dr. Gale A Granger from the University of California, Irvine. <br /><br />Compared to what was spent in medicine then and now it's disgusting. <br /><br />The answer to what has been cured in the past 50 years is little and nothing.<br /><br />Your list is very unimpressive.Fat Bastardohttps://www.blogger.com/profile/03839915109115122588noreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-72825408778098581162012-06-15T00:48:26.654-07:002012-06-15T00:48:26.654-07:00What companies' disks were used? Let me guess,...What companies' disks were used? Let me guess, Depuy and Medtonic?Fat Bastardohttps://www.blogger.com/profile/03839915109115122588noreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-84401618644857116612012-06-14T17:59:18.101-07:002012-06-14T17:59:18.101-07:00Philomena you are soooo correct. After all, that q...Philomena you are soooo correct. After all, that quack motion preserving total hip and knee surgery is just a fad. I can't for the life of me understand why patients would not want to get a girdle stone procedure instead of a faulty, likely to fail total hip that allows you to get back to normal function. And how about those crazy total knees. A good old fashion knee arthrodesis never had to deal with poly wear or the surgeon having to go back in and replace the poly after 14 years. People used to just gimp along and make do. Crazy times we live in. <br />What stupid statement. The spine is made up of motion segments, and it only makes sense to try and restore/maintain motion in the spine while addressing abnormal pathology. Your buddy Fat Bastard sure thinks its a good idea or he wouldn't keep talking about his great, unknown super top secret TDR. <br />JAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-9500763466894496312012-06-14T16:07:41.973-07:002012-06-14T16:07:41.973-07:00Good point fat bastard 11:46. Tbat's why Capp...Good point fat bastard 11:46. Tbat's why Cappuccino.signing with Lanx was so huge.. Signing om a reputable ethical surgeon like him really boosted their company.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-63722847105768232762012-06-14T15:52:48.590-07:002012-06-14T15:52:48.590-07:00Cervical Myelopathy Following Cervical Total Disc ...Cervical Myelopathy Following Cervical Total Disc Arthroplasty: Case Report and Literature Review<br /><br />http://journals.lww.com/spinejournal/Abstract/publishahead/Cervical_Myelopathy_Following_Cervical_Total_Disc.98478.aspx<br /><br />Objective. This paper reports two cases in which the patients accepted revision surgery following CTDA due to iatrogenic neurological injury.<br /><br />Summary of Background Data. Cervical total disc arthroplasty (CTDA) has been increasingly investigated to treat cervical degenerative disc disease. However, there are limited reports focused on its complications, especially the neurological complications following the procedure.<br /><br />Method. A 52-year-old male underwent total disc arthroplasty for C5-C6, but immediately after surgery, he was suffering from paralysis of his upper and lower limbs. Radiographic images indicated residual compression to the spinal cord in the level of C5-C6. Another patient, a 60-year-old male, underwent total disc arthroplasty for C4-C5. Afterwards, he suffered severe neck pain, and paralysis of upper and lower limbs. He was unresponsive to conservative treatments, thus, a laminectomy was performed 3 months later. However, little improvement was observed. Radiographic images indicated kyphosis and spinal cord compression at the level of C4-C5. Furthermore, both cases showed a high signal in the spinal cord by T2-weighted MR image, suggestive of spinal cord injuries.<br /><br />Results. Revision surgeries were performed in both cases. Cervical implants were first removed by the anterior approach, and fusion was then performed after a complete decompression. Motor exam of patient in case one showed Grade 3 strength in both his hands and feet 6 months after revision surgery. In case two, the patient's severe neck pain was resolved at the early postoperative stage. Motor exam showed Grade 1 strength in both his both hands and feet 3 months after revision surgery.<br /><br />Conclusion. Based on presented cases and other reports, the surgical goals in these patients were prioritized as follows: 1) safe and adequate neurologic decompression, 2) establishment and maintenance of cervical sagittal balance. Moreover, a criterion for selecting patients undergoing CTDA needs to be established in order to reduce the occurrence of neurologic complications associated with the procedure.Philomenahttp://spinesupport.org/simplemachinesforum/index.phpnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-34443324967694887092012-06-14T15:11:54.110-07:002012-06-14T15:11:54.110-07:00Okay, here is a list just off the top of my head, ...Okay, here is a list just off the top of my head, Fat Bastard: ALL (acute lymphocytic leukemia); peptic ulcer disease caused by H. Pylori; stage I prostate CA; significant improvement in M&M (morbidity and mortality related to MI and stroke); polio eradicated; smallpox eradicated; HIV/AIDS is now survivable (progress in just 20 years, from universal fatality); Rheumatoid diseases & AS (ankylosing spondylitis) nicely managed with alpha-TNF...now, if only we we could cure obesity and out-of-wedlock procreation, so that you would go "poof".Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-74134481736451372752012-06-14T14:45:10.684-07:002012-06-14T14:45:10.684-07:00Pro Disc may not be classic metal on metal like Ce...Pro Disc may not be classic metal on metal like CerviCore, but it has enough metal in it to cause serious metal hypersensitivity. As for the paralysis, the abstract stated that the patient was immediately paralyzed upon implantation of the Pro Disc.Philomenahttps://www.blogger.com/profile/04514120963957626897noreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-14506487168049774912012-06-14T14:32:31.609-07:002012-06-14T14:32:31.609-07:00You are dead on the money FB. Do not allow these s...You are dead on the money FB. Do not allow these sales reps twist the facts. They are in the biz to pay their bills, not to save lives or protect their practice. They will sell a cart of horse manure to any surgeon dumb enough to think horse manure was FDA approved for spine surgeons. Necessity is the mother of all innovation - motion preservation spine devices are a fad that surgeons are discovering cause way more harm than the theoretical benefit. Fusions are the Gold Standard - why reinvent the wheel? Physicians knew as far back as the early 60s that metal on metal was NOT doable or scientifically sound. Then comes Medtronics with their European knock off and suddenly the race is on! The race is NOT for the patient to win - the race is for the stockholders to hold cheer leading rallies for the CEO that makes them richer. And here is where the physician should make him self invisible if he or she is ethical and takes the Oathn seriously. We expect CEOs and sales reps to be a bit jaded and in it for the bucks, but the surgeon must have "clean hands", otherwise there is no firewall protection for the patient and it is what it is - a very lucrative medical device racket. Good for you FB. We are both on the same pagePhilomenahttps://www.blogger.com/profile/04514120963957626897noreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-69907861819015925152012-06-14T14:10:12.604-07:002012-06-14T14:10:12.604-07:00"I knew who was on the take and I used a meth..."I knew who was on the take and I used a method for bribe and kickbacks that was totally untraceable"<br />"I didn't feel bad about it because we had a superior service and they were taking bribes anyway"<br />"My company was on the up & up. We could have scammed but the money was so good we didn't have to and our industry was fairly clean at the time"<br /><br />So your company was on the "up and up" but you used a untraceable way to bribe and deliver kickbacks to your clients? It appears we have an oxymoron here, FB. <br /><br />You are however right, in my opinion on the legal law suits. From my understanding of the medical device industry, possible legal costs are calculated into the pricing of the widget. As is most other industries, including childrens toys, vehicles, etc...Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-90627088555234474112012-06-14T14:02:06.776-07:002012-06-14T14:02:06.776-07:00Just when I start thinking some of your posts have...Just when I start thinking some of your posts have 10% rational thought, you go and prove me wrong again. Things are not always black and white, no matter how many ding dongs you eat. The good comes with the bad and that goes for any industry. Unfortunately, I do agree that patients should be more educated on who they go to see and for what. <br />As a Sales Representative in this industry, I do whatever I can to avoid situations that I feel would compromise my personal ethics. Believe it or not, plenty of the guys that view this forum are in this industry for the right reasons. <br />Being a fanatic is no way to go through life son...Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-126852961571725269.post-3039947233490899642012-06-14T13:43:14.115-07:002012-06-14T13:43:14.115-07:00Can someone, who knows what they are talking about...Can someone, who knows what they are talking about, give me the reimbursement scenario for SI joint fusion.Anonymousnoreply@blogger.com