Becker's Spine Review

10 SPINE SURGEONS 15 insights into MIS spine — Market analysis, strong vendors & surgeon predictions By Megan Wood B acked by strong supportive evi- dence, the minimally invasive spine approach continues to gain steam in 2018. Device companies are making splashes in the industry with novel MIS technologies and spine surgeons are increasingly leverag- ing the technique. Here are 15 insights into the MIS spine land- scape. 1. An April 2016 Spine study found patients undergoing minimally invasive fusions expe- rienced 88.7 percent lower blood loss than the open procedure group. Additionally, the study found hospital stays among the minimally in- vasive group were 64 percent shorter than hos- pital stays in the open procedure group. 2. e global minimally invasive spine sur- gery market will likely grow at a 7.57 per- cent compound annual growth rate through 2020, according to a Healthcare Market Re- ports analysis. While the growing number of spinal disorder cases will boost the market, a dearth of experienced MIS surgeons will slow market expansion. 3. e global minimally invasive surgical device market is anticipated to exceed $18 billion by 2021, medGadget reports. Ad- vancements in minimally invasive surgery, reduction in healthcare costs and an increase in the geriatric population will drive the mar- ket during the forecast period. 4. In the coming years, market competitors will need to overcome the decrease in reim- bursements for minimally invasive spine pro- cedures, according to Future Market Insights. 5. According to an Apex Market Reports anal- ysis, the top device companies in the global minimally invasive spine surgery market are DePuy Synthes, Medtronic, NuVasive, Stryker, Zimmer Biomet, Aesculap Implant Systems and Alliance Spine. 6. e global XLIF surgery market is poised to reach nearly $2.56 billion by 2024, accord- ing to a Reports Monitor analysis. e mar- ket was valued at $1.64 billion in 2016, and is expected to grow at a compound annual growth rate of 5.7 percent. Key market driv- ers include the increase of minimally invasive procedures and number of spinal disorder cases. In 2017, the XLIF interbody cages seg- ment led the space, capturing 75.8 percent of the global market. 7. In January 2018, Blue Cross Blue Shield As- sociation updated its quality evidence recom- mendation for minimally invasive sacroiliac joint fusion using triangular implants. BCB- SA upgraded its BCBSA rating to "moderate" quality evidence, indicating the prevalence of sufficient evidence to determine the effects technology has on health outcomes. BCBSA believes individuals with SI joint disorders treated with sacroiliac fusion or fixation with a triangular implant results in a meaningful improvement to the net health outcome. 8. Paradigm Spine published its European study of coflex and decompression alone two- year trial results in the Journal of Neurosurgery: Spine. e study included 225 patients at seven sites throughout Europe with two-year fol- low-ups. Researchers found the coflex patients experienced higher composite clinical scores, 0.017, compared to the decompression alone group. Additionally, decompression alone pa- tients reported greater loss of foraminal and posterior disc height maintenance compared to the coflex group. At the two-year follow up, the decompression alone group was 1.4 times more likely to be using opioids. 9. Minneapolis-based Inspired Spine report- ed surgeons have performed more than 500 Oblique Lateral Lumbar Interbody Fusions. e minimally invasive procedure uses an incision of 15 mm and incurs 80 percent less blood loss compared to a traditional fusion. Following the learning curve, a surgeon will likely perform OLLIF in less than one- third of the time a traditional fusion takes. A study published in Cureus found OLLIF saved hospitals an average of $9,500 per case compared to transforaminal lumbar inter- body fusion. 10. In February 2017, Kern Singh, MD, founded the Minimally Invasive Spine Study Group. Dr. Singh serves as co-director of the Minimally Invasive Spine Institute at Mid- west Orthopedics at Rush in Chicago. A 501(c)(3) nonprofit organization, MISSG in- tends to promote research and advancement of MIS spine. e group features an online patient registry, REDCAP, containing data from 3,000 unique patients treated with MIS approaches. Frank Phillips, MD, co-director of the Minimally Invasive Spine Institute at Midwest Orthopaedics at Rush, and Sheer- az Qureshi, MD, associate professor at New York City-based Hospital for Special Surgery, join Dr. Singh on the board of directors. 11. Tampa, Fla.-based e BioSpine Insti- tute opened the doors of its new clinic in Or- lando, Fla., Feb. 5. is clinic represents the in- stitute's third location, with one in Spring Hill, Fla., and the other in Tampa. Orthopedic spine surgeons Frank Bono, DO, James Ronzo, DO, and Roderick Claybrooks, MD, perform mini- mally invasive spine surgeries at e BioSpine Institute. 12. Renew Spine Care and SpineMark Corp. en- tered into a strategic alliance agreement in October 2017 to establish a mutually aligned mission of improving patient diagnosing, inte- grating minimally invasive spine surgery pro- tocol and merging medical technology. Renew is composed of spine surgeons specializing in MIS, treating multiple spine levels, bilaterally, in the lumbar, cervical and thoracic regions. SpineMark Destination Centers promote a multispecialty holistic care approach for di- agnosis, operative, non-operative and conser- vative treatment, striving to create a universal standard for early intervention of spinal pain. 13. In January, Robert Masson, MD, found- er of Ocoee, Fla.-based Masson Spine In- stitute, shared key spine technology trends likely to take hold in 2018 with Becker's Spine Review. He noted, "e trends toward in- creased prevalence of minimally invasive sur- Patients undergoing minimally invasive fusions expereinced 88.7 percent lower blood loss than the open procedure group.

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