Becker's Spine Review

9 SPINE SURGEONS 9 key updates in spinal cord injury treatment in 2021 By Alan Condon E ach year, 250,000 to 500,000 people worldwide suffer a spinal cord injury, which can stem from trauma, disease or degeneration, according to the World Health Organization. Spinal cord injury is associated with a risk of developing secondary conditions that can be debilitating, and in some cases, life-threaten- ing, such as deep vein thrombosis, urinary tract infections, osteoporosis, chronic pain and respiratory complications. Acute care, rehabilitation and ongoing health mainte- nance are essential for the prevention and management of these conditions. Here are nine key updates in spinal cord inju- ry treatment in 2021: 1. Patients injected with stem cells derived from their own bone marrow saw improve- ment in motor functions aer spinal cord injuries, according to a study published February 2021 in the Journal of Clinical Neu- rology and Neurosurgery. irteen patients with nonpenetrating spinal cord injuries re- ceived an intravenous injection of their stem cells. More than half of them had significant improvements in key motor functions, and no major side effects were reported. 2. e National Institutes of Health award- ed the University of Louisville (Ky.) and Medtronic a $7.8 million grant to study epi- dural stimulation for the treatment of spinal cord injury in March. Medtronic and scien- tists from the university are developing so- ware applications for spinal cord injury that integrate with its Intellis spinal cord stimula- tor system. e five-year project, conducted at the university's Kentucky Spinal Cord In- jury Research Center, focuses on developing technology to improve control of locomotor and bladder function. 3. Vanta, Medtronic's recharge-free implant- able neurostimulator, received the green light from the FDA in June. Vanta has a battery life of up to 11 years, includes Medtronic's SureS- can technology, which provides full-body MRI access, and its AdaptiveStim allows for automatic adjusting stimulation to maintain each patient's optimal dose, according to the company. It also features Snapshot, a data in- sights system that records patient activity lev- els to facilitate objective health conversations with clinicians. 4. e Upgrade study, which enrolled its first of up to 1,700 patients in February 2021, is examining long-term, real-world outcomes to understand the effect of Medtronic's Dif- ferential Target Multiplexed programming for spinal cord stimulation patients. Admin- istered via Medtronic's Intellis platform, ther- apy is a programming option used to treat patients with chronic pain. e multiplexed programming was developed by Stimgenics, which was acquired by Medtronic in 2020. 5. e FDA cleared Nevro's Senza spinal cord stimulator system for the treatment of chron- ic pain associated with painful diabetic neu- ropathy in July. Senza is the only FDA-ap- proved spinal cord stimulator with a specific indication to treat painful diabetic neuropa- thy, according to Nevro. 6. New York City-based Mount Sinai Health System's department of rehabilitation and human performance received a $2.3 million grant to support its spinal cord injury pro- gram in September. e health system will use the grant to help its Icahn School of Med- icine expand research into patient care and collaborate with other centers on the effects of spinal cord injuries on patients' livelihood and how interventions can affect neurological and functional recovery. 7. Virginia Commonwealth University's Center for Rehabilitation Science and Engineering, Central Virginia VA Health Care System and Sheltering Arms Institute, all in Richmond, formed the State Consortium for Spinal Cord Injury Care. e collaboration helped the commonwealth earn federal designation as one of 14 spinal cord injury model systems centers in the U.S. Research at the facility focuses on the use of noninvasive electrical stimulation and identifying health inequities aer spinal cord injuries. 8. Scott Falci, MD, launched the Falci Insti- tute for Spinal Cord Injuries at Swedish Med- ical Center in Englewood, Colo., in October. e center provides specialized neurological care for spinal cord injury patients, including spinal deformities, post-traumatic spinal cord tethering and post-traumatic syringomyelia. 9. e Pennsylvania Department of Health awarded $1 million to six spinal cord injury researchers in September. e grants, part of the department's Commonwealth Universal Research Enhancement program, provide financial support to further research for the functional improvement of those with spinal cord injuries. n AMA accepts CPT add-on code for 2nd level lumbar disc replacement By Carly Behm The American Medical Association accepted a new CPT add-on code for the second level of lumbar total disc replacement procedures. The new code will go into effect in January 2023, according to a Nov. 16 news release. Once in effect, physicians can use the code for two-level lumbar total disc arthroplasty via an anterior approach. "Approval for a second level-specific CPT code is a critical milestone for lumbar total disc arthroplasty and reimbursement plays such a major role in whether patients have access to life-changing technologies," Centinel Spine CEO Steve Murray said in the release. Centinel Spine's Prodisc L is the only total disc replacement system approved in the U.S. for two-level lumbar spine surgery. n

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