Becker's Spine Review

September, 2017 Becker's Spine Review

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60 Executive Briefing Sean Hensler, PA-C (Neurosurgical Physician Assistant/Founder/Inventor) and Thomas Melin, MD (Neurosurgeon/Co-Founder/In- ventor) created Hensler Surgical Products in 2011. With personal experience in thousands of cases, the team observed a recurring theme of intraoperative inefficiency. They reasoned that the implementation of new ideas and technology would improve efficiency and afford overall cost reduction. This goal has lead to the creation of Hensler Surgical Products, that develops, engineers, and brings new innovative surgical devices and products to the market. is significant bone present in each. There are also some specimens with prominent staining of BMP 2 and 7, which is very important in bone formation. This staining predictably is contained in the surrounding blood clot but is certainly present in the graft material. The photos show positively stained specimens for each of the markers described above. For synthetic bone graft utilized ~ 5 cc's, cost can be reduced by $500 to $4,000 + using the bone press and/or bone collector. The savings is substantial to the patient, hospital, and health system. Q: Why did you develop these devices? TM: From the day that I first entered practice, I attempted to collect and save all bone removed during spinal surgery for use as graft material — both "bone dust" and bone chips. Sean joined me after I had been in practice for 10 years and he was frustrated by the methods we were then using. So building upon what we were already doing lead to the conceptualization of these two devices. SH: For each device, we identified a problem with the surgical process or procedure and then came up with ways to fix the issues. We kept in mind everyone who touches the instruments. The HBP has been used in 13,000 cases globally over the past five years. We launched the bone collector in July; there have been over 20 cases performed with a nearly 100 % satisfaction rate. Expounding on the highlights of the bone collector, it procures bone chips from the rongeurs. Those bone chips have significant fusion properties, as evidenced in multiple clinically relevant papers. We add the mixed bone chips to the scaffolding for fusion. The second arm is safety; as long as I've been doing this, the assistants would clear their instruments with their gloved hand. They use their hand or a sponge, which could lead to infection via cuts or micro-tears in the gloves. The bone collector removes the human hand from cleaning the instruments (Kerrison and Leksell Rongeurs), and accelerates the cleaning process. As a result, surgeons get the instruments returned to them faster, and techs can assist with the case. Q: How are these devices unique to the market niche? TM: The HBP is unique because it is the only "bone dust" collection device on the market that actually works. The HBC is unique because, at least to my knowledge, there is no other device that performs the same function. SH: The HBP is unique in the bone graft market because of its extremely effective and user-friendly method. The HBC is even more unique, given we are not aware of any other device in the world that does what our device is designed to do; harvest bone chips and clean various surgical instruments quickly and safely. We have exceptional results. Multiple device companies have visited us and tested their hardware to see how it integrates with our devices, and it works very well. The bone press has a special niche for high-speed bone drills, whether in cervical surgery with corpectomy, or lumbar surgery with laminectomy. There is nothing similar to the bone collector — the need is massive. Q: Is the device reimbursable? If not, what are the economic advantages of using these devices? TM: There is no direct billing for either device. However, all of the alternatives to autograft harvested with either the HBP or HBC are more expensive than these devices. SH: The code that surgeons can use is CPT 20936, which is the harvest of autograft from the same surgical site. The HBP and the HBC do not have a reimbursable code for the device itself, but it does create huge savings by reducing, if not eliminating, the requirement for synthetics and biologics. Even if the bone alternatives are used, the graft need for the fusion is much less. The 1:1 savings comes into play, which can save thousands per case. Some insurance companies will accept it and some will not, but the biggest economic advantage comes from the decreased need to use allograft or synthetic (an alternative to the patient's own bone). Insurance approvals for fusion surgery, especially the spine, have barriers that range from instrumentation to graft choices. Mentioning what will be used is now a part of nearly every approval process. The sheer mention of Allograft and/or biologics have created barriers to approval or needed fusion cases for the patient. One significant advantage is not having to rely on bone alternatives, thus a massive hurdle is eliminated. Q: How do these devices fit into value-based care? TM: That one is simple. The use of these products allows the surgeon to provide the "gold-standard" for spinal fusion. autograft, at a cost that is less than all other inferior more costly alternatives. SH: Both devices save time in the OR, as well as reduce costs. The average OR time costs $30 to $50 per minute. Having the ability to harvest and process local bone quickly without sacrificing the autologous yield needed for the case, this is a direct savings in time and product. Our devices fill two major needs: improve patient care and provide a real value proposition for each patient and hospital. The Hensler Bone Press™ creates huge value without sacrificing patient care. We collected data from multiple surgeons on the bone collected during their procedures and found that during one-level anterior cervical partial-full corpectomies, surgeons typically collect 8-12 ccs of bone. During two-level lumbar fusions, surgeons collect 20 – 30 ccs, and during three-level procedures surgeons, multiple cases have collected well over 50 cc. In short, the HBP is an invaluable device that has proven itself to be both a win for the patient and the system. We are very excited to continue to grow our line everywhere and I'm extremely humbled and privileged to be a part of so many patients surgical care. n

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