tag:blogger.com,1999:blog-71397661336867425152023-11-15T23:30:16.924-08:00The Spine Institute in the NewsThe Spine Institutehttp://www.blogger.com/profile/14772060988122848565noreply@blogger.comBlogger30125tag:blogger.com,1999:blog-7139766133686742515.post-58934601932273695272012-11-09T14:07:00.002-08:002012-11-09T14:09:57.736-08:00Loveland's Spine Institute to Build Surgery Center<i>New 15,000-square-foot facility will open next summer in Johnstown's 2534 development</i><br />
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<span style="font-size: x-small;">By <b>Craig Young</b>, Reporter-Herald Staff Writer <a href="http://www.reporterherald.com/business/northern-business/ci_21898815/lovelands-spine-institute-build-surgery-center" rel="nofollow" target="_blank">Read the original story in the Loveland Reporter-Herald</a></span><br />
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A Loveland medical clinic specializing in spine surgery and research has bought land for a new surgery center in Johnstown.<br />
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The Spine Institute at Rocky Mountain Associates in Orthopedic Medicine purchased property in the 2534 development southeast of the Interstate 25-U.S. 34 interchange. The 1.8 acres sold Oct. 16 for $385,000.<br />
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The company moved its office to a building in 2534 a month ago, according to practice manager Dee Goodman, and then bought the adjacent property for its new Spine and Orthopedic Surgery Center.<br />
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"Our goal is to be breaking ground soon," she said, with plans to open the surgery center in July 2013.<br />
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"We'll be specializing in research, pain management, spine surgeries and biologics (<a href="http://orthopedicstemcellinstitute.com/">adult stem cell treatments</a>)," she said.<br />
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The nearly 15,000-square-foot surgery center will have three operating rooms and six convalescent rooms allowing patients to stay up to 72 hours after surgery, Goodman said.<br />
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Drs. Kenneth Pettine and Jeffrey Donner formed <a href="http://www.rmaortho.com/">Rocky Mountain Associates in Orthopedic Medicine</a> in 1991 and the <a href="http://spinerevolution.com/">Spine Institute</a> in 2004. The practice recently moved from North Grant Avenue in Loveland to 4795 Larimer Parkway in the 2534 development.<br />
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Rocky Mountain Associates employs about 25 people, including six physicians, according to Goodman, and plans to add another doctor in the near future.<br />
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The practice's owners speak nationally and internationally on innovative noninvasive spine technologies, according to the company's website, and Pettine is the co-inventor of an artificial replacement disc.<br />
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Goodman said the company chose the 2534 location because of the growth occurring there and the easy access to the interstate. "We have patients who come from all over," she said, including Denver, Colorado Springs, Wyoming and other states.<br />
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"They've heard of our spine surgeons and that they specialize in different spine cases," she said, "and we're involved in several different research studies."<br />
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The Spine Institute's new locations are directly south of Northern Colorado Long Term Acute Hospital, Northern Colorado Rehabilitation Hospital and Gonyon Cosmetic and Plastic Surgery and about a mile east of the new Kaiser Permanente clinic.<br />
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Ryan Schaefer, president of Chrisland Commercial Real Estate, which represented the seller of the land to the Spine Institute, said developers in 2534 have a goal of attracting medical facilities.<br />
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"Once the rehab hospital located there, that really created a catalyst for other medical practices to locate there," he said.<br />
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He said the Spine Institute's move to 2534 is indicative of the resurgence in the commercial and residential real estate industry that's taking hold in Northern Colorado.<br />
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"We're starting to see a rebound," Schaefer said. "It's fairly widespread."<br />
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He said the 542-acre 2534 development also is attracting the attention of retailers and primary employers, and he predicted being able to make announcements by the middle of next year.<br />
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<i>Craig Young can be reached at 635-3634 or <a href="mailto:cyoung@reporter-herald.com">cyoung@reporter-herald.com</a>. Follow him on Twitter: @CraigYoungRH.</i>The Spine Institutehttp://www.blogger.com/profile/14772060988122848565noreply@blogger.com15tag:blogger.com,1999:blog-7139766133686742515.post-26377343809674046202012-11-01T07:56:00.001-07:002012-11-01T07:56:59.041-07:00The coflex® Device Receives FDA Premarket Approval<br />
<b>Note:</b> The Spine Institute participated in the coflex® study and Dr. Pettine backs its ability to help patients with moderate to severe spinal stenosis. To learn more about coflex®, please <a href="http://spinerevolution.com/contact/" target="_blank">contact us</a>.<br />
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<h2>
<div style="text-align: center;">
Paradigm Spine Announces U.S. FDA PMA Approval of its Landmark coflex® Interlaminar Technology:</div>
<div style="text-align: center;">
The First Comparative Effectiveness Study for the Treatment of Spinal Stenosis</div>
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<a href="http://www.paradigmspine.com/sites/default/files/coflex-fda-approval-10-17.pdf" target="_blank">Read this story online</a><br />
<b><br />
</b> <b>New York, NY, October 17, 2012</b> - Paradigm Spine LLC, a provider of innovative spinal implant technologies, announces the U.S. Food and Drug Administration (“FDA”) has granted a Premarket Approval (“PMA”) Order for coflex®, a minimally invasive, Motion Preserving Interlaminar Stabilization™ device for the treatment of Moderate To Severe Stenosis With Or Without Back Pain™.<br />
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Key Points:<br />
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<ul>
<li>First PMA for the treatment of Moderate To Severe Stenosis With Or Without Back Pain™</li>
<li>First prospectively randomized comparative effectiveness Investigational Device Exemption (IDE) study that evaluated pedicle screw fusion following surgical decompression, the current standard of care for the treatment of moderate to severe spinal stenosis, as the control. This study is unique in spine because it prospectively collected Level 1 clinical, radiographic, safety and healthcare economic data. The coflex® device demonstrated better or equivalent outcomes in all major primary and secondary endpoints.</li>
</ul>
<blockquote class="tr_bq">
<ul>
<li>The coflex® patients spent 40% less time in the hospital compared to fusion (1.90 vs. 3.19 days), and coflex® surgeries were 36% faster compared to fusion (98 vs. 153 minutes)</li>
</ul>
<ul>
<li>At 2 years follow-up, 85.8% of coflex® patients showed clinically significant improvement in pain and function (measured by Oswestry Disability Index), compared to 76.7% of fusion patients</li>
</ul>
<ul>
<li>At 2 years follow-up, coflex® patients retained their pre-operative range of motion (within 10%) and translation (within 5%) at the treated level and maintained normal adjacent level motion. In contrast, fusion patients experience 62% motion reduction at the treated level, and 52% increase in range of motion at the superior adjacent level.</li>
</ul>
</blockquote>
<ul>
<li>First PMA to collect healthcare economic data for spinal stenosis. The study data and resulting analyses demonstrate that coflex® saves the healthcare system an average of $5,000 to $8,700 per case when used as an alternative to pedicle screw fusion1.</li>
<li>The coflex® study included a significant Medicare-aged patient population.</li>
<li>The coflex® device, now available in the United States, has more than 18 years of clinical history with regulatory approval in over 40 countries throughout 6 continents.</li>
</ul>
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The coflex® clinical trial supporting the PMA represents the most comprehensive Level 1 comparative effectiveness study for the treatment of spinal stenosis. The rigorous six year clinical trial proves coflex® as the first and only motion-preserving alternative to fusion for the treatment of moderate to severe spinal stenosis, by demonstrating better or equivalent outcomes in all major primary and secondary clinical and radiologic assessments, while maintaining natural motion at both treated and adjacent spinal levels. The study results are based on data evaluated from 322 patients, at 21 sites throughout the United States, who presented with a history of spinal stenosis that failed over 6 months of conservative therapy. The patients enrolled in the study were prospectively randomized to receive a surgical decompression and either coflex® Interlaminar Stabilization™ or pedicle screw fusion. The coflex® device outperformed fusion in nearly all clinical, radiographic, and perioperative outcomes, supplemented with healthcare economic data measured through 589 data points evaluated for each individual study subject over a 2 year follow-up period. The data compiled for this study comprised more than 55,000 patient-completed case report form pages, more than 375,000 clinical and radiographic data points, more than 12,000 patient x-rays and prospective health insurance, reimbursement payment and claims data. The rigor of the clinical trial and the robustness of its results are supported by over a 95% follow-up through two years postoperatively, among the highest follow-up rate for any PMA approved device in spine.<br />
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According to a Wall Street Journal analysis of data compiled by the Centers for Medicare & Medicaid Services, it is estimated that fusion costs the United States government Medicare system more than $2.2 billion annually2. The coflex® study is the first and only to quantify actual cost savings based on prospective Level 1 data, compared to the current standard of care, posterolateral fusion. On average, coflex® saved $5,000 to $8,700 per case compared to fusion1. These substantial cost savings were achieved through significantly shorter operating room time, faster patient recovery, less blood loss, less narcotics usage by patients, and shorter hospital stay, while producing faster and more sustained clinically successful outcomes as compared to fusion in the treatment of spinal stenosis.<br />
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The PMA process is the most stringent FDA regulatory pathway for medical devices, where approval is based on a determination by the FDA that the PMA contains sufficient valid scientific evidence to ensure that the device is safe and effective for its intended use, and that the benefits of the procedure and device outweigh its risks. The FDA’s Summary of Safety and Effectiveness Data, states “Based on the clinical study results, it is reasonable to conclude that a significant portion of the indicated patient population will achieve clinically significant results. In conclusion, the coflex® device represents a reasonable alternative to posterolateral fusion for the treatment of spinal stenosis.”<br />
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Marc Viscogliosi, Chairman and CEO, stated “This study provides the evidence insurance companies, surgeons and patients have been demanding. Insurance companies, surgeons and patients finally have an alternative to fusion which, based on independent study data, has demonstrated that coflex® produces better outcomes, a faster recovery, preserves motion and may be performed on an outpatient basis. For patients, the ability to walk without back pain and the progressive symptoms of stenosis is one of the most cherished functions of the aging population.”<br />
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Hal Mathews, M.D., Executive Vice President and Chief Medical Officer, stated “The coflex® study results represent a celebration of evidence for surgeons, their patients and the insurance community. We now have objective evidence of the detrimental clinical effects and relatively expensive costs of pedicle screw fusion on spinal stenosis patients. Although outcomes for pedicle screw-based fusions have been historically acceptable, it was the only option surgeons had for the last 25 years to provide stabilization when indicated, along with the decompression procedure. Importantly, coflex® was able to deliver better outcomes at a significantly lower cost to the healthcare system, which we believe is an important mandate of the current healthcare reform law.”<br />
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Reginald Davis, M.D.3, Principal Investigator for the coflex® study, stated “This is the first time a new spinal technology is proven to be better and more effective than the historical gold standard, and is still actually lower cost. I am excited to be able to provide coflex® to my patients without the need for fusion through a simple, motion preserving, and minimally invasive bone-saving surgical technique.”<br />
For additional information on Paradigm Spine LLC, the coflex® interlaminar technology and the coflex® procedure, please visit our new website at www.paradigmspine.com.<br />
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<b>About Paradigm Spine LLC</b><br />
Paradigm Spine LLC, founded by Viscogliosi Bros., LLC in 2004, is a privately held company focused on the design, development and marketing of solutions for the treatment of spinal conditions and diseases. The company's signature product is the coflex® Interlaminar Stabilization™ device, which has more than 18 years of clinical history with regulatory approval in more than 40 countries throughout 6 continents.<br />
About Lumbar Spinal Stenosis<br />
<br />
According to the American Association of Neurological Surgeons (AANS), lumbar spinal stenosis is defined as the narrowing of the spinal canal that compresses the nerves traveling through the lower back and into the legs. While it may affect younger patients due to developmental causes, spinal stenosis is a condition most commonly caused by degenerative changes of the spine in people age 60 and older. Its symptoms include pain, weakness, or numbness in the legs, calves or buttocks and are often associated with low back pain. More than 400,000 Americans, most over the age of 60, may be suffering from the symptoms of lumbar spinal stenosis, and as many as 1.2 million Americans have back and leg pain related to any type of spinal stenosis.<br />
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As stated by Katz et al. in the New England Journal of Medicine (February 2008), lumbar spinal stenosis is the most frequent indication for spinal surgery in patients older than 65 years of age.<br />
<br />
<b>Forward-Looking Statements</b><br />
This news release contains forward-looking statements as defined in the U.S. Private Securities Litigation Reform Act of 1995. Readers are cautioned not to place undue reliance on these forward-looking statements. Actual results may differ materially from those indicated by these forward-looking statements as a result of risks and uncertainties impacting Paradigm Spine LLC’s business including increased competition; the ability of Paradigm Spine LLC to expand its operations and to attract and retain qualified professionals; technological obsolescence; general economic conditions; and other risks.<br />
<br />
1 These results were obtained from analyses of intraoperative, postoperative, perioperative, narcotics and supply costs, and were derived from actual costs reported by study sites, supplemented by estimates or assumptions where actual numbers were not or could not be obtained.<br />
2 Carreyrou, J, & McGinty, T. Top Spine Surgeons Reap Royalties, Medicare Bounty. Wall Street Journal. Retrieved October 12, 2012 from http://online.wsj.com/article/SB10001424052748703395204576024023361023138.html.<br />
3 Dr. Davis provides training and education services for Paradigm Spine LLC. Dr. Davis does not receive any royalty income from, and is not an investor in, Paradigm Spine LLC.The Spine Institutehttp://www.blogger.com/profile/14772060988122848565noreply@blogger.com0tag:blogger.com,1999:blog-7139766133686742515.post-51856083972323764532012-09-06T08:36:00.001-07:002012-11-09T14:11:56.599-08:00The Promise of Regenerative MedicineKenneth A. Pettine, MD<br />
Co-founder of <a href="http://spinerevolution.com/" target="_blank">The Spine Institute</a> and founder of the <a href="http://orthopedicstemcellinstitute.com/" target="_blank">Orthopedic Stem Cell Institute</a><br />
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<i>Dr. Kenneth Pettine of the Orthopedic Stem Cell Institute provides a preliminary but promising report on allogeneic mesenchymal precursor cells.</i><br />
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Administering undifferentiated stem cells to an injured disc has made adult stem cell regenerative medicine in spine a reality. Adult stem cell regenerative medicine holds the promise of stabilizing or even reversing the degenerative changes associated with aging or following traumatic injury. Current clinical use of stem cells is very limited, in part by the cumbersome approval process. The use of concentrated bone marrow aspirate (BMC) as a “stem cell” preparation is currently the simplest and safest way of utilizing the regenerative potential for mesenchymal stem cells (MSCs) to promote tissue regeneration. In fact, stem cells concentrated from bone marrow have been shown to stimulate the formation of bone, cartilage, ligament and tendon, and dermal tissues.<br />
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Conservative treatment options for lumbar and cervical pain associated with discogenic disc disease (Pfirrmann Grades 3-6) are limited. Treatment options include pain medication, steroids, physical therapy, and chiropractic care. Reversal of disc pathology has not been achieved with current available treatment modalities. Failure of these nonoperative treatments may leave surgical intervention as a treatment option.<br />
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The goal of utilizing MSCs is to not only potentially provide pain relief from the painful degenerative disc, but to reverse the degenerative process. There are three methods for placing MSCs into the painful nucleus pulposus.<br />
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The use of allogeneic mesenchymal precursor cells (MPCs) is currently being evaluated as a part of an FDA Phase I clinical trial. Extracted from donors and expanded in number by tissue culture, this process isolates and grows the stem cells into pure MPCs which are injected into the nucleus pulposus. This technology does not have FDA approval.<br />
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Utilizing expanded, autologous MSCs for injection into the painful disc is the second method. Federal regulations require the approval of an Investigational New Drug application supported by prospective, randomized clinical trials for the use of expanded autologous MSCs. The FDA has not approved this technology.<br />
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The third method involves autologous point of care therapy. This technology does not require FDA approval. The patient’s own MSCs are directly injected into the nucleus pulposus of the symptomatic degenerated disc(s) using standardized two needle discography technique. This requires fluoroscopic visualization and 2-3cc of MSCs are slowly injected into the symptomatic nucleus pulposus.<br />
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I have used Celling Biosciences ART21 technology to perform autologous point of care therapy since October 2011. To date, I've performed 72 autologous MSCs injections in the lumbar and cervical spine.<br />
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Research conducted at the Spine Institute includes an IRB approved, prospective, two-arm study to evaluate the treatment of discogenic low back pain with intradiscal injection of autologous bone marrow-derived cells.<br />
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Early analysis of the research data reveals the average lumbar pre-treatment Oswestry Disability Index (ODI) was 56.5% and improved to 22.4% at three-month follow-up (P=0.0001). The average lumbar pre-treatment Visual Analogue Scale (VAS) for pain was 7.9 (on a scale of 1-10) and improved to 4.2 at three months (P=0.0005).<br />
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There have been no complications associated with the iliac crest aspiration or disc injection. Thus far no patient in the study has undergone spine surgery following treatment. Results obtained with this technique suggest its potential clinical efficacy in the treatment of moderate to severe degenerative disc disease. These results require verification with longer follow-up and randomized prospective studies.<br />
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For more information regarding treatment options please visit our websites at <a href="http://spinerevolution.com/">SpineRevolution.com</a> or <a href="http://www.orthopedic/">OrthopedicStemCellInstitute.com</a>.<br />
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<br /></div>
<div>
See this article online on the <a href="http://www.isass.org/news/spine_movement_pettine_regenerative_medicine.html" target="_blank">International Society for the Advancement of Spine Surgery</a> website.</div>
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The Spine Institutehttp://www.blogger.com/profile/14772060988122848565noreply@blogger.com9tag:blogger.com,1999:blog-7139766133686742515.post-3022616937797433972012-08-24T12:59:00.001-07:002012-08-24T12:59:58.887-07:00Spine Surgeon Dr. Kenneth Pettine to Co-Host Meeting on Ambulatory Spine Surgery<h3>
Leading spine surgeons, ambulatory surgery center experts<br />to gather in Dallas in October</h3>
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<b>LOVELAND, Colo. – August 23, 2012</b> — Kenneth Pettine, MD, founder of The Spine Institute and Loveland Surgery Center in Colorado, is pleased to announce an upcoming meeting and cocktail reception supporting spine surgery in an ambulatory surgery center.<br />
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The meeting will take place October 25, 2012, from 5:30-7:30 p.m. in the West End Room at the Omni Hotel in Dallas, Texas. It is hosted by Dr. Pettine and Paradigm Spine. Two panels of nationally recognized spine surgeons and ASC financial experts will discuss a number of topics, including the benefits of spine surgery performed at an ASC, how to build and operate a successful ASC, education on insurance approval for spine surgeries at an ASC, current research and advanced technology.<br />
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The panelists scheduled to speak are as follows: Dr. Kenneth Pettine; Dr. Donald Johnson II, founder of Southeastern Spine Institute in South Carolina; Dr. John Peloza, founder of Center for Spine Care in Dallas; Dr. Alan Villavicencio, founder of Minimally Invasive Spine Institute in Colorado; Kenneth Hancock, president of Meridian Surgical Partners; Jeff Leland, CEO of Blue Chip Surgical Center Partners; Marc Viscogliosi, CEO of Paradigm Spine; and Robin Young, founder of Pearl Diver.<br />
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"I am very pleased to host this symposium. It will bring together some of the most prolific spine surgeons and ASC experts to discuss quality and financial topics on outpatient spine surgery," said Dr. Pettine. "Attendees will come away with a greater understanding of the clinical and economic benefits for patients, payers and surgeons when spine surgery is performed at an ASC."<br />
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The symposium's main sponsor is Access MediQuip, with additional support provided by<br />
Meridian Surgical Partners and Blue Chip Surgical Center Partners.<br />
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To learn more about the meeting and RSVP, contact Kay Roberts at (970) 286-1329 or<br />
<a href="mailto:kroberts@spinerevolution.com">kroberts@spinerevolution.com.</a><br />
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<i>Note:</i> This symposium is not part of the official program as planned by the NASS Annual Meeting Program Committee.<br />
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<b>About Dr. Kenneth Pettine</b><br />
Kenneth Pettine, MD, is founder of The Spine Institute and Loveland Surgery Center in<br />
Colorado, and co-founder of the Society for Ambulatory Spine Surgery. He has an extensive background in spinal surgery, research and rehabilitation; is co-inventor and co-designer of the Maverick artificial disc, a disc replacement device for the low back; and is co-inventor of the Prestige cervical artificial disc. He is the principal investigator for a dozen FDA studies involving non-fusion spine technology. <a href="http://www.spinerevolution.com/">www.spinerevolution.com</a>The Spine Institutehttp://www.blogger.com/profile/14772060988122848565noreply@blogger.com3tag:blogger.com,1999:blog-7139766133686742515.post-23520682107140132582012-07-11T12:12:00.002-07:002012-07-11T12:13:19.513-07:00Mesoblast Interview: The Best Adult Stem Cell Technology in the World?<br />
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As published on www.propthink.com Read article online <a href="http://www.propthink.com/mesoblast-interview-the-best-adult-stem-cell-technology-in-the-world/" target="_blank">here</a>.</div>
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Mesoblast (<a href="http://finance.yahoo.com/q?s=msb.ax" style="color: #005790; text-decoration: none;">MSB.AX</a>) (OTC:MEOBF) CEO Silviu Itesu speaks on his company`s adult stem cell technology, particularly mesenchymal precursor cells, and the low-cost manufacturing capabilities that the technology implies. Itesu discusses development compound Revascor for use in congestive heart failure and details the latest Phase II results. In 60 patients the drug saw no adverse events and a 0% event rate (hospital visits, mortality) compared to 20% in a control group; the company is planning to initiate a 1500-patient Phase III study in the coming few months. The trials are funded entirely by Teva (<a href="http://finance.yahoo.com/q?s=teva" style="color: #005790; text-decoration: none;">TEVA</a>), says Itesu, but the company`s financial situation would allow for a few years of `solo` operation.</div>
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Itesu briefly compares Mesoblast`s production strategies to those of Dendreon`s (<a href="http://finance.yahoo.com/q?s=dndn" style="color: #005790; text-decoration: none;">DNDN</a>) Provenge, and explains how Mesoblast`s production will be significantly less expensive. The conversation also covers two more pipeline products, a Type-2 diabetes treatment and an intervertebral disc treatment, both of which have shown promising results in Phase II studies. </div>
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Click <a href="http://www.propthink.com/mesoblast-interview-the-best-adult-stem-cell-technology-in-the-world/" target="_blank">here</a> to view the video interview of Mesoblast CEO Silviu Itesu.</div>The Spine Institutehttp://www.blogger.com/profile/14772060988122848565noreply@blogger.com0tag:blogger.com,1999:blog-7139766133686742515.post-2758194088531835892012-06-21T14:23:00.000-07:002012-06-21T14:23:22.909-07:00Eight ASCs in the United States Embracing Medical TourismWritten by Laura Miller | <a href="http://www.beckersasc.com/asc-turnarounds-ideas-to-improve-performance/8-ascs-in-the-united-states-embracing-medical-tourism.html" target="_blank">Becker's ASC Review</a> | June 21, 2012<br />
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<span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">Here are eight ambulatory surgery centers that have embraced medical tourism in the United States and attract patients from other countries. </span><br />
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<span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif;"><span style="font-size: 12px; line-height: 18px;"></span></span><strong style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">Red Rock Surgery Center (Las Vegas). </strong><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">Red Rock Surgery Center reaches out to its Las Vegas community as well as patients from around the world with their medical tourism branch. The surgery center was founded more than 10 years ago and surgeons perform approximately 1,000 procedures there annually. The center includes three operating rooms and one minor laser procedure room, allowing surgeons to perform a multitude of cases at the ASC. Medical staff at the center includes ophthalmologists, plastic surgeons, pain management physicians, hand surgeons, general surgeons and podiatrists. Red Rock Surgery Center is accredited by the Accreditation Association for Ambulatory Health Care and owned by David Malitz, MD.</span><br />
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<strong style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">The Surgery Center at Doral (Doral, Fla.).</strong><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;"> The Surgery Center at Doral includes interventional pain management, urology, general surgery and hand and upper extremity surgery. Alejandro Badia, MD, founded Badia Hand to Shoulder Center which works with the International Orthopedic Group to serve inbound medical tourist patients, who have their surgeries at The Surgery Center at Doral. The surgery center has three operating rooms, arthroscopic equipment and family waiting room. After traveling for their surgery, patients are able to stay at a hotel located near the center for recovery, often accompanied by a recovery room nursing staff. The patients are able to have rehabilitation and follow up visits while staying for a few days in the area.</span><br />
<strong style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;"><br />Legacy Neurosurgery Spine & Brain Specialists Outpatient Surgery Center (Little Rock, Ark.).</strong><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;"> Legacy Neurosurgery Spine & Brain Specialists has served patients who travel across the country to have their surgery performed at a lower cost than it would be at their local hospital. They often serve cash-pay or high deductible patients traveling long distances. Led by Scott Schlesinger, MD, the team of neurosurgeons performs minimally invasive spine surgery as well as non-operative pain management procedures. The brain disorders they treat include brain tumors, aneurysms and arterial venous malformations. Additional services at the center include physical therapy.</span><br />
<strong style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;"><br />Orthopedic Surgery Center of Orange County (Newport Beach, Calif.).</strong><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;"> The Orthopedic Surgery Center of Orange County is owned by the Orthopedic Specialists of Southern California and Hoag Hospital. It is a medical tourism facility associated with Patients Without Borders and has been an accredited ambulatory surgery center since 1999. Surgeons perform several procedures at the center, including ACL reconstruction, meniscus repair, shoulder surgery and spine surgery. The center is contracted with major insurance companies and will bill non-contracted payors. </span><br />
<strong style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;"><br />Surgery Center of Oklahoma (Oklahoma City).</strong><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;"> Surgery Center of Oklahoma is a 32,535-square-foot facility that is owned and operated by surgeons and anesthesiologists in central Oklahoma. The facility has been accredited by the Accreditation Association for Ambulatory Health Care since 1998 and includes prices for their services on the ASC website to attract patients of self-pay, self-insured or high-deductible plans. Surgeons at the ASC perform orthopedics, general surgery, ophthalmology, and ENT procedures. There are multiple lodging areas near the surgery center for patients to stay after their procedures. According to the ASC's website, they are able to offer lower prices since they don't have to process claims and there is no risk of non-payment.</span><br />
<strong style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;"><br />Concord (N.H.) Ambulatory Surgery Center.</strong><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;"> Concord Ambulatory Surgery Center is accredited by the Accreditation Association for Ambulatory Health Care and provides ENT, orthopedics, plastic surgery, general surgery and pain management procedures. The facility has two operating rooms, four bed preparation areas and eight station recovery areas. Concord Ambulatory Surgery Center provides complete coordinated care to Canadian patients, which includes scheduling appointments, travel, accommodation and transportation to the facility. The procedures offered to medical tourism patients include knee arthroscopy, ACL reconstruction, liposuction, tonsillectomy and rotator cuff repair.</span><br />
<strong style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;"><br />Loveland (Colo.) Surgery Center. </strong><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">Kenneth Pettine, MD, spine surgeon and co-owner of Loveland Surgery Center, noticed that patients were traveling to India and Germany to pay cash for procedures such as lumbar artificial disc replacement, which some insurance companies do not cover, although the technology is cleared by the FDA and surgeons in the United States can perform them. He felt he could provide these patients the same quality procedure at Loveland Surgery Center at a lower price if the patients were willing to pay cash. The cash price includes implant, surgeon, facility and anesthesia fees. Loveland Surgery Center is a Joint Commission-accredited facility.</span><br />
<strong style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;"><br />Squaw Peak Surgery Center (Phoenix). </strong><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">Squaw Peak Surgery Center was founded in 1998 by Anthony Yeung, MD, and has two operating rooms. The surgeons perform endoscopic spine surgery and a dorsal endoscopic rhizotomy surgery invented and developed by Dr. Yeung. The surgery center can accommodate cash pay patients and Dr. Anthony's practice, Desert Institute for Spine Care, offers to coordinate care for medical tourists. The surgery center also has negotiated discounted rates at area hotels for their patients. The surgeons are team spine surgeons for several professional athletes, including the Arizona Diamondbacks, Colorado Rockies, Kansas City Royals, Seattle Mariners, Los Angeles Dodgers and Cincinnati Reds.</span><br />
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<span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;"><a href="http://www.beckersasc.com/asc-turnarounds-ideas-to-improve-performance/8-ascs-in-the-united-states-embracing-medical-tourism.html" target="_blank">Read this article online</a></span>The Spine Institutehttp://www.blogger.com/profile/14772060988122848565noreply@blogger.com3tag:blogger.com,1999:blog-7139766133686742515.post-2393593279640521062012-06-20T07:32:00.002-07:002012-06-20T07:32:30.628-07:00Key Challenges, Opportunities for Growth in Spine SurgeryWritten by Bob Spoerl | <a href="http://www.beckersasc.com/orthopedic-spine-driven-ascs/key-challenges-opportunities-for-growth-in-spine-surgery.html" target="_blank">Becker's ASC Review</a> | June 18, 2012<div>
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<span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">At the 10th Annual Orthopedic, Spine and Pain Management-Driven ASC Conference in Chicago on June 15, <b>Kenneth Pettine, MD, a spine surgeon at the Loveland (Colo.) Surgery Center</b>; Larry Teuber, MD, a spine surgeon and president of Medical Facilities in Rapid City, S.D.; and Timothy T. Davis, MD, DABNM, DABPMR, DABPM, a spine surgeon and director of interventional pain and electrodiagnostics at The Spine Institute in Los Angeles, discussed trends in spine surgery and ideas for improving profitability and outcomes of spine programs. Scott Becker, JD, CPA, partner at McGuireWoods, moderated the session. </span><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">Mr. Becker kicked off the discussion by asking the spine surgeons some of the top spine surgery trends on their minds.</span><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">Dr. Davis said he sees a growing trend of spine centers and surgeons needing to meet certain criteria to get surgeries covered. He compared the trend to what he said has happened to cardiology.</span><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">"I think it's going to come down to really having to follow a strict algorithm of spine care, he said. "We already have to do this in the worker's compensation environment."</span><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">Electronic medical records will become increasingly important for spine surgeons to ensure every procedure has been tried and standards are being followed, which is critical for reimbursement.</span><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">Dr. Pettine said he's seeing a trend in payors denying spine procedures, what he called a "dramatic change" in spine surgeons' ability to get surgeries authorized. He suggested all orthopedic surgeons study insurance plans' guideline packets, which state the requirements needed to get procedures authorized.</span><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">"If you don't understand the rules, you can't play the game," he said. </span><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">He predicted the total number of spine procedures performed could drop by as much as 30 percent in the next year because of payor denials. </span><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">Dr. Teuber echoed the notion by saying the backlog of pre-authorizations for spine surgeries is huge.</span><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">Later in the conversation, Mr. Becker asked the panel about some of the most exciting developments they're seeing.</span><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">"Biologics are far and away the next frontier of spine," Dr. Davis said. He was referring to the use of biologics both in surgery and prior to it. He said it's the "biggest single improvement in spine care."</span><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">Dr. Teuber agreed and added "implants will always be a growth area too.”</span><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">Dr. Pettine discussed the future in terms of where spine procedures happen. "Spine care in an ASC setting is absolutely the future," he said. It's the place where "all of the modern minimally invasive techniques for spine" can be utilized.</span><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">"The hospitals absolutely cannot compete with an ASC," he added. "We can provide this care [for] significantly less."</span><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">In order to be profitable over the next five years performing spine surgery, Dr. Pettine said spine centers should seriously look at case rates. There's an opportunity for ASCs to pick up potential spillover patients from other surgeons who sign with hospitals but lack the time to perform as many surgeries, he said.</span><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">"As far as hospitals purchasing doctors, I think that's great. The minute the hospital purchases several neurosurgeons, then he's no longer competition," he said.</span>
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<span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;"><a href="http://www.beckersasc.com/orthopedic-spine-driven-ascs/key-challenges-opportunities-for-growth-in-spine-surgery.html" target="_blank">Read this story online</a></span></div>The Spine Institutehttp://www.blogger.com/profile/14772060988122848565noreply@blogger.com1tag:blogger.com,1999:blog-7139766133686742515.post-42353585084852556322012-06-20T07:28:00.002-07:002012-06-20T07:28:57.460-07:00Dr. Kenneth Pettine: Four Points on Performing Spine Surgery in ASCsWritten by Laura Miller | <a href="http://www.beckersasc.com/asc-turnarounds-ideas-to-improve-performance/dr-kenneth-pettine-4-points-on-performing-spine-surgery-in-ascs.html" target="_blank">Becker's ASC Review</a> | June 18, 2012<br />
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<span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">At the 10th Annual Orthopedic, Spine and Pain Management-Driven ASC Conference in Chicago on June 15, Founder of The Spine Institute and Loveland (Colo.) Surgery Center Kenneth A. Pettine, MD, gave a presentation titled "Everything You Need to Know to Successfully Perform Spine Surgery in an ASC." In his presentation, Dr. Pettine touched on several factors that will make it easier to bring spine procedures into an ambulatory surgery center in the future. </span><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">"My goal is to move 50 percent of inpatient hospital spine surgeries in the United States to an ASC," Dr. Pettine said. "I would encourage everyone to be involved in the Society for Ambulatory Spine Surgery. We need to change current Medicare ASC guidelines, which will allow us to perform more cases in the ASC. We've seen this trend with arthroscopies."</span><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><strong style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;"><br />1. Negotiate down implant costs. </strong><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">It's important to negotiate down implant prices to retail prices, if they aren't already there. "It's not difficult to negotiate 40 to 60 percent discounts on implants," said Dr. Pettine. "Share that discount with spine surgeons."</span><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">Also consider implant cost when negotiating for payor contracts. "Don't leave implant money on the table," said Dr. Pettine. "Have appropriate contracts to perform spine surgery at the ASC."</span><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><strong style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;"><br />2. Give surgeons the numbers.</strong><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;"> If surgeons in your community are dragging their feet about bringing cases into the surgery center, give them data to show them the impact it could make on their practice. "Surgeons are rather reticent to change their practice patterns," said Dr. Pettine. "They do the same procedures they did 10 to 20 years ago. One of the ways you can convince them to change is with data. With numbers is power."</span><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">The most important data to highlight includes:</span><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">• Turnover times, which should be around 10 minutes in the ASC compared to 45 minutes in the hospital</span><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">• Implant income with percentage over cost</span><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">• Infection control data</span><strong style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;"><br /><br />3. Build a convalescence center.</strong><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;"> A convalescence center allows patients who need extra recovery time to stay 23-plus hours in the facility after outpatient spine surgery. If constructing a convalescence center isn't possible, consider partnering with other facilities for discharging patients who aren't quite ready to return home.</span><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">"You can accomplish the same thing as a convalescence center with a rehabilitation facility or nursing home," said Dr. Pettine. "There are ways to accomplish this same type of facility in states where surgery centers can't get a convalescence license." </span><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><strong style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;"><br />4. Procedures performed in a surgery center</strong><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">. Right now, typical procedures performed in the surgery center include anterior lumbar interbody fusions, posterior lumbar fusions, artificial disc replacements and sacroiliac joint fusions. "Currently, these are not controversial procedures to perform in an ASC because we have gathered effectiveness data," said Dr. Pettine. "We've done about 1,700 non-instrumented cases in the ASC and because of published data they aren't controversial."</span><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">Dr. Pettine also participates in clinical trials using biologics during spine surgery. "There are approximately 20 different types of adult stem cells in your body," said Dr. Pettine. "In orthopedics, we use mesenchymal stem cells. The goal is to harness the natural healing potential of stem cells. I am unaware of any adverse effects of using the patient's own stem cells."</span><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><br style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">After harvesting the stem cells, they are processed and then implanted back in the patient to promote fusion. The FDA considers the procedure the same as blood transfusion. "Results of the study are extremely promising," said Dr. Pettine. "The more you learn about this technology, the more optimistic you become."</span>
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<span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;"><a href="http://www.beckersasc.com/asc-turnarounds-ideas-to-improve-performance/dr-kenneth-pettine-4-points-on-performing-spine-surgery-in-ascs.html" target="_blank">Read this story online</a></span>The Spine Institutehttp://www.blogger.com/profile/14772060988122848565noreply@blogger.com1tag:blogger.com,1999:blog-7139766133686742515.post-8878169677709219792012-06-20T07:25:00.000-07:002012-06-20T07:29:13.188-07:00Five Trends in Orthopedic and Spine Devices and ImplantsWritten by Taryn Tawoda | <a href="http://www.beckersasc.com/orthopedic-spine-driven-ascs/5-trends-in-orthopedic-and-spine-devices-and-implants.html" target="_blank">Becker's ASC Review</a> | June 18, 2012<br />
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<span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">In a session titled "New Developments in Orthopedic and Spine Devices and Implants" at the 10th Annual Orthopedic, Spine and Pain Management-Driven ASC Conference in Chicago, Chris Zorn, vice president of sales at Spine Surgical Innovation, and <b>Kenneth A. Pettine, MD,</b> founder of the Spine Institute and Loveland Surgery Center, discussed trends and developments in orthopedic and spine implants. </span><br />
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<strong style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">1. The focus is on developments that inspire innovation.</strong><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;"> Mr. Zorn said he has seen devices developed with an emphasis on making the healthcare system more efficient and less costly, particularly since reimbursement is under tremendous pressure. "What can we do to help make the procedures less traumatic for patients, easier for the surgeons and less expensive for the healthcare systems paying for all of this?" he said. "Delivering surgery in an ASC is obviously different from surgery in a hospital. You have to keep an eye on what you're doing and look for incremental changes that can help you or your patient in the OR, and changes that you can get paid for."</span><br />
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<strong style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">2. Innovative spine implants in the U.S. are hindered by a complicated regulatory process. </strong><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">A lengthy FDA approval process can delay many innovative implants in the U.S., said Dr. Pettine. "I am extremely optimistic about the future of spine surgery in ambulatory surgery centers, but I'm very pessimistic about the future of really innovative spine implants in the U.S.," he said, adding that the U.S. is behind in implant developments compared to other parts of the world. "Europe is at least three to five years ahead of us in terms of spinal implant technology. In the U.S., a study will take at least one year, then there is a two year wait for data, and then the FDA may sit on data for five years."</span><br />
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<strong style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">3. Venture capital money is declining. </strong><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">According to Dr. Pettine, venture capital money for new devices is draining, and the lengthy FDA device approval process is largely to blame. "When people invest in something, they're expecting a minimum five-year turnaround with that money," he said. "But in the U.S., we’re looking at seven to 10 years before a device gets approval, so this venture capital money is going elsewhere."</span><br />
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<strong style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">4. Reimbursements for disposables are low.</strong><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;"> Disposable supplies are not reimbursed well, said Dr. Pettine. "You can get reimbursed for an implant, but not disposables, in an ASC setting," he said. "So if a technique is associated with a lot of disposables, may not work for you at your surgery center."</span><br />
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<strong style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">5. Using more disposables can save money long-term.</strong><span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;"> "Some countries want you to do everything disposable," said Mr. Zorn. "Since the pressure is on everybody to deliver more for less, switching your capital investment into a disposable method makes a lot of sense. The problem is that disposables are still outrageously priced in the U.S."</span>
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<span style="color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;"><a href="http://www.beckersasc.com/orthopedic-spine-driven-ascs/5-trends-in-orthopedic-and-spine-devices-and-implants.html" target="_blank">Read article online.</a></span>The Spine Institutehttp://www.blogger.com/profile/14772060988122848565noreply@blogger.com0tag:blogger.com,1999:blog-7139766133686742515.post-56699353059375422582012-06-06T13:42:00.000-07:002012-06-20T07:29:45.056-07:0010 ASC Industry Leaders to KnowFrom <a href="http://www.beckersasc.com/asc-leaders/10-asc-industry-leaders-to-know.html" target="_blank">Becker's ASC Review</a><br />
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<span class="author" style="background-color: white; color: #797979; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 11px; line-height: 18px;">Written by Rachel Fields | </span><span style="background-color: white; color: #797979; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 11px; line-height: 18px;"></span><span class="createdate" style="background-color: white; color: #797979; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 11px; line-height: 18px;">June 02, 2012</span>
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<span class="createdate" style="background-color: white; color: #797979; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 11px; line-height: 18px;"><br /></span><br />
<span class="createdate" style="background-color: white; color: #797979; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 11px; line-height: 18px;"><span style="color: #292929; font-size: 12px;">Here are 10 profiles of notable leaders in the ambulatory surgery center industry. </span><br style="color: #292929; font-size: 12px;" /><br style="color: #292929; font-size: 12px;" /><strong style="color: #292929; font-size: 12px;">1. Dr. Stephen Hochschuler of the Texas Back Institute. </strong><span style="color: #292929; font-size: 12px;">Stephen Hochschuler, MD, is co-founder of the Texas Back Institute in Plano, which began in 1977 in partnership with Ralph Rashbaum, MD. Their joint vision for the institute was to create "an integrated multispecialty spinal clinic that included prevention, conservative care, surgical care, rehabilitation and research and development." Thirty-five years later, the center is heralded as one of the premier organizations for spine healthcare, becoming the first institution in the United States to prescribe outpatient myelography and the first to lead an FDA study of the artificial disc and artificial disc replacement.</span><br style="color: #292929; font-size: 12px;" /><br style="color: #292929; font-size: 12px;" /><strong style="color: #292929; font-size: 12px;">2.</strong><span style="color: #292929; font-size: 12px;"> </span><strong style="color: #292929; font-size: 12px;">Barry Tanner, CEO of Physicians Endoscopy. </strong><span style="color: #292929; font-size: 12px;">Mr. Tanner joined Physicians Endoscopy in 1999 and co-authored the company's business plan with CFO Karen Sablyak. He currently oversees the company's partnership development activities, as well as strategic direction and services management. He also helps in the day-to-day management and governance of some of Physician Endoscopy's partnered facilities. Before joining PE, Mr. Tanner served as CFO of Navis Radiology Systems, a physician practice management company in Miami. As the co-founder and CFO, he was responsible for developing a business plan. He helped grow the company from zero to over $75 million in revenues during his time as CFO, including the acquisition of seven professional radiology practices and a major diagnostics company.</span><br style="color: #292929; font-size: 12px;" /><br style="color: #292929; font-size: 12px;" /><strong style="color: #292929; font-size: 12px;">3. Dr. Kenneth Pettine of Loveland Surgery Center. </strong><span style="color: #292929; font-size: 12px;">Kenneth Pettine, MD, is a spine surgeon and the founder of the Spine Institute and Loveland (Colo.) Surgery Center and Rocky Mountain Associates in Orthopedic Medicine. Dr. Pettine is board certified and a member of the American Academy of Orthopedic Surgeons, the North American Spine Society and the Arthroscopy Association of North America. He received his fellowship training at the Institute for Low Back Care in Minneapolis, completed his residency and his master's degree in orthopedic surgery at the Mayo Clinic in Rochester, Minn., and was awarded his MD from the University of Colorado School of Medicine.</span><br style="color: #292929; font-size: 12px;" /><br style="color: #292929; font-size: 12px;" /><strong style="color: #292929; font-size: 12px;">4. Michel Kulcyzcki of The Joint Commission. </strong><span style="color: #292929; font-size: 12px;">As executive director for The Joint Commission's Ambulatory Care Accreditation Program, Mr. Kulczycki is responsible for overseeing the strategy and business development for the Ambulatory Care Accreditation Program. Prior to joining The Joint Commission in 2002, Mr. Kulczycki served as principal officer at Oak Park, Ill.-based M.Carl Enterprises, a provider of management consultant services to non-profit organizations. He also served as president and CEO of The Alliance for Healthcare Strategy and Marketing in Chicago for two years and as executive director of the Illinois Home Care Council, also in Chicago, for seven years.</span><br style="color: #292929; font-size: 12px;" /><br style="color: #292929; font-size: 12px;" /><strong style="color: #292929; font-size: 12px;">5. Brent Ashby, administrator of Audubon Surgery Center. </strong><span style="color: #292929; font-size: 12px;">Brent Ashby is the administrator of </span><span style="color: #292929; font-size: 12px;"><span style="color: black;">two surgery </span>centers — Audubon Surgery Center <span style="color: black;">and </span>Audubon ASC at St. Francis,<span style="color: black;"> both </span>located in Colorado Springs, Colo.</span><span style="color: #292929; font-size: 12px;"> The two Audubon centers contain 15 operating rooms and four procedure rooms between them and perform an estimated 19,000 cases annually. Mr. Ashby has led the surgery centers through several successful initiatives, including a staff profit-sharing program and a boycott of payors who are unwilling to offer reasonable payment rates. He said the physicians in his centers are highly involved and offer their support during difficult administrative decisions.</span><br style="color: #292929; font-size: 12px;" /><br style="color: #292929; font-size: 12px;" /><strong style="color: #292929; font-size: 12px;">6. Dr. John Cherf of Vanguard Chicago Center for Orthopedics. </strong><span style="color: #292929; font-size: 12px;">John Cherf, MD, an orthopedic surgeon, is the president of the Chicago Institute of Orthopedics, president of OrthoIndex and clinical advisor to Sg2, a healthcare intelligence and information services company. Dr. Cherf, who has more than 20 years of clinical experience in orthopedics and sports medicine, completed his medical education at Northwestern University in Chicago, where he also obtained a Masters in Public Health and Masters in Business Administration. He also completed his internship and residency at Northwestern and then completed a fellowship in sports medicine and knee surgery at The Orthopedic Specialty Hospital/Sports Medicine West in Salt Lake City. </span><br style="color: #292929; font-size: 12px;" /><br style="color: #292929; font-size: 12px;" /><strong style="color: #292929; font-size: 12px;">7. Dr. Joseph Banno, founder of Peroria Day Surgery Center. </strong><span style="color: #292929; font-size: 12px;">Joseph Banno, MD, founder of the successful Peoria (Ill.) Day Surgery Center and past ASC chairman, is committed to providing quality healthcare all over the world. He helped pioneer the development of the world's first mobile ASC, a self-contained surgery unit that allows physicians to provide medical and surgical treatment in remote areas of the world. The unit can provide "rural outreach, hospital renovation replacement facility, international health care delivery, mobile intensive care, mobile dialysis" and a variety of other services, Dr. Banno said in an interview with </span><em style="color: #292929; font-size: 12px;">Peoria Magazine</em><span style="color: #292929; font-size: 12px;">.</span><br style="color: #292929; font-size: 12px;" /><br style="color: #292929; font-size: 12px;" /><strong style="color: #292929; font-size: 12px;">8. Luke Lambert, CEO of ASCOA. </strong><span style="color: #292929; font-size: 12px;">Luke Lambert became CFO of Ambulatory Surgery Centers of America in 1997 and was promoted to CEO of the company five years later. He previously held positions at Smith Barney, Booz, Allen & Hamilton and Ernst & Young. His background includes experience in finance, strategy and operations and he has worked in venture exploration and reengineering business processes. Mr. Lambert was one of the founding members of ASCOA, an ASC management and development company that has started or turned around more than 60 projects in the United States. Within ASCOA’s management model, surgeons maintain the majority ownership of the center while the company holds a minority share in each center it turns around or develops.</span><br style="color: #292929; font-size: 12px;" /><br style="color: #292929; font-size: 12px;" /><strong style="color: #292929; font-size: 12px;">9. Joe Zasa, co-founder of ASD Management. </strong><span style="color: #292929; font-size: 12px;">As the co-founder and managing partner of ASD Management, Joe Zasa focuses on turning around existing surgery centers and helping physicians and hospitals develop new ASCs. An expert in surgery center profitability, Mr. Zasa is keenly aware of some of the ways ASCs fail: by failing to look at case costs, letting supply expenses run out of control and depending on poor payor contracts. Prior to founding ASD Management, formerly Woodrum ASD, Mr. Zasa served as corporate counsel for Premier Ambulatory Systems, where he was responsible for acquisitions and physician development. He also served as regional director of surgery operations for ProSurg, a division of American Ophthalmic.</span><br style="color: #292929; font-size: 12px;" /><br style="color: #292929; font-size: 12px;" /><strong style="color: #292929; font-size: 12px;">10. Alfred McNair, MD, founder of Digestive Health Center. </strong><span style="color: #292929; font-size: 12px;">Alfred McNair, MD, a gastroenterologist, founded the Digestive Health Center in 1980 on the Mississippi Gulf Coast, where he has been practicing ever since. He sees patients at four different offices in the area and performs colonoscopies, esophagogastrodeudenoscopies and Enterynx. He also has a special focus on liver disease and hepatitis illness. Dr. McNair earned his medical degree at Columbia University College of Physicians and Surgeons in New York City and completed his residency at New York Presbyterian Hospital. His additional training includes a fellowship at Stanford University in Palo Alto, Calif.</span>
</span>The Spine Institutehttp://www.blogger.com/profile/14772060988122848565noreply@blogger.com0tag:blogger.com,1999:blog-7139766133686742515.post-34498473218377341492012-04-19T07:38:00.000-07:002012-04-19T10:21:55.932-07:00Spine Leader to Know: Dr. Kenneth Pettine of The Spine Institute<span class="itemAuthor" style="background-color: white; color: #797979; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 11px; line-height: 18px;">Written by <a href="http://www.beckersorthopedicandspine.com/spine-leaders/itemlist/user/96-bobspoerl" target="_blank">Bob Spoerl </a></span><span style="background-color: white; color: #222222; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;"></span><span style="background-color: white; color: #222222; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;"></span><span class="itemDateCreated" style="background-color: white; color: #797979; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 11px; line-height: 18px;">| April 17, 2012 | <a href="http://www.beckersorthopedicandspine.com/spine-leaders/item/11594-spine-leader-to-know-dr-kenneth-pettine-of-rocky-mountain-associates-in-orthopedic-medicine" target="_blank">Becker's Spine Review</a></span><br />
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<a href="http://spinerevolution.com/dr-kenneth-pettine/" target="_blank">Kenneth Pettine, MD</a>, is co-founder of Rocky Mountain Associates in Orthopedic Medicine and <a href="http://spinerevolution.com/" target="_blank">The Spine Institute</a> in Loveland, Colo. In addition, he co-invented and co-designed the Maverick Artificial Disk as well as the Prestige Cervical Artificial Disc.</div>
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Throughout his career, Dr. Pettine has focused on innovation and was among the first spine surgeons to perform a minimally invasive lumbar disc procedure using the Mesoblast Limited technology. The procedure was performed in a Phase 2 clinical trial of the adult Mesenchymal Precursor Cell product for treating patients with low back pain and degenerative disc disease.<br />
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He performs outpatient spine surgery in a surgery center and has predicted that over the next several years, 50 percent of spine procedures could move into the outpatient setting. He also provides cash pay for spine surgery at his center.<br />
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"We were noticing many patients were considering going to Germany or India where they could pay cash for an ADR," Dr. Pettine says. "We felt we could offer these patients a cash price similar to what they would pay overseas but allow them to have their surgery close to home by a surgeon they know and trust. Follow up is easier and more efficacious."<br />
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Dr. Pettine's background is in spinal surgery, research and rehabilitation. His spine fellowship was at the Institute for Low Back Care in Minneapolis, and he complete residency and a master's degree in orthopedic surgery at the Mayo Clinic in Rochester, Minn. He earned a medical degree from the University of Colorado School of Medicine.<br />
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Dr. Pettine holds 14 awards from medical school and residency, has been published 22 times and presented at 45 events and conferences around the world. He recently founded the Society for Ambulatory Spine Surgery, which he launched last November with Access MediQuip. He is a member of the American Academy of Orthopaedic Surgeons, North American Spine Society and Arthroscopy Association of North America.</div>The Spine Institutehttp://www.blogger.com/profile/14772060988122848565noreply@blogger.com1tag:blogger.com,1999:blog-7139766133686742515.post-59059590469237149972012-03-30T07:45:00.000-07:002012-03-30T07:46:08.536-07:00ASC Industry Leader to Know: Dr. Kenneth Pettine of Loveland Surgery CenterWritten by Taryn Tawoda | March 29, 2012 | <a href="http://www.beckersasc.com/asc-leaders/asc-industry-leader-to-know-dr-kenneth-pettine-of-loveland-surgery-center.html">Becker's ASC Review</a><br />
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Kenneth Pettine, MD, is a spine surgeon and the founder of the Spine Institute and Loveland (Colo.) Surgery Center and Rocky Mountain Associates in Orthopedic Medicine. <br />
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When considering surgery center trends for 2012, Dr. Pettine told Becker’s ASC Review, "I think there's going to be a very renewed interest in ASCs. It is profitable to do spine surgery at an ASC for both the spine surgeon and other owners, and implant costs can be a source of additional passive income. Include 12-minute turnaround times and overall efficiency, patient satisfaction and this situation is too good for a spine surgeon not to desire. I have no intention of changing my ownership structure. In fact, I just want to own more."<br />
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Dr. Pettine is board certified and a member of the American Academy of Orthopedic Surgeons, the North American Spine Society and the Arthroscopy Association of North America. He received his fellowship training at the Institute for Low Back Care in Minneapolis, completed his residency and his master's degree in orthopedic surgery at the Mayo Clinic in Rochester, Minn., and was awarded his MD from the University of Colorado School of Medicine. <br />
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Dr. Pettine previously served as a staff orthopedic surgeon and chief of the sports medicine clinic at Eisenhower Army Medical Center in Fort Gordon, Ga.; associate clinical professor at the Medical College of Georgia; and visiting consultant at the Veteran's Administration Hospital in Augusta, Ga.The Spine Institutehttp://www.blogger.com/profile/14772060988122848565noreply@blogger.com1tag:blogger.com,1999:blog-7139766133686742515.post-44026932945173437122012-03-28T11:16:00.000-07:002012-03-28T11:16:48.891-07:00Positive Signs for Gene Therapy in Slowing the Course of Disc DegenerationSpinal News International - Issue 22, March 2012 -- <a href="http://spinerevolution.com/wp-content/uploads/2012/03/22-Spinal-News_lowres.pdf" target="_blank">view as PDF</a><br />
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<i>A new study, which was presented at the annual meeting of the North American Spine Society (NASS; 2–</i><i>5 November 2011, Chicago, USA) and subsequently published online in The Spine Journal, has found </i><i>that gene therapy has the potential to delay disc degeneration.</i><br />
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Lead author Steven Leckie, Department of Orthopedic Surgery, University of Pittsburgh Medical Center, Pennsylvania, USA, and co-investigators reviewed the use of the adeno-associated virus sero-type 2 (AAV2) vector carrying genes for either bone morphogenetic protein 2 (BMP2) or tissue inhibitor of metalloproteinase 1 (TIMP1) to manage degenerative disc disease in New Zealand white rabbits. Explaining the purpose of the study, Leckie, who presented the data at NASS, said: “BMP2 is known to induce proteoglycan production in the intervertebral disc and TIMP1 is anti-anabolic in that it prevents the breakdown of proteoglycan. The problem with growth factors is that they are transient, so the philosophy of gene therapy is that we might be able to induce a sustained response from the host.” He added that, in their study, which won the 2011 outstanding Paper: Basic Science award at NASS, they used AAV2 because it has been shown to be safer than other vectors used in previous studies.<br />
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The 34 skeletally mature rabbits used in the study were divided into five groups: non-surgical (negative controls; six), sham procedure (negative controls; four), puncture surgery (underwent puncture surgery but did not receive any subsequent therapy, positive controls; eight), puncture surgery followed by treatment with AAV2-BMP2 (eight), and puncture surgery followed by treatment with AAV2- TIMP1 (eight). Puncture surgery was performed with a 16-gauge needle, which has been reliably shown to induce degeneration, in L2-L3, L3-L4, and L4-L5 discs. Leckie said: “The outcomes that we measured included MRI, histology, biomechanics, and biochemistry.”<br />
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After 12 weeks, rabbits in the non-surgical and the sham procedure groups did not show any evidence of disc degeneration on MRI but all rabbits in the puncture surgery group did have evidence of disc degeneration (on MRI, images of nucleus pulpous in the affected area darkened and decreased over the 12 weeks of the study). About the treatment groups, Leckie said: “Although they did have some degree of<br />
disc degeneration, they appeared to have less degeneration than the puncture group.” In The Spine Journal paper, Leckie et al reported that the nucleus pulpous of the treated groups “retained their size and did not darken as much as the punctured discs.”<br />
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Leckie said that he and his fellow investigators also collected serum biomarkers for C-telopeptide II, which he explained is the breakdown product of C-terminus of collagen II and could be measured in the serum. He added: “At 12 weeks, the control rabbits had a slight increase [the rabbits in the non-surgical group], the<br />
puncture rabbits had significantly higher serum values, and the treatment groups had values that fell well below those of the puncture group.”<br />
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As well as the MRI data and the biomarker data, there was also histological data. Leckie said: “The discs of the control and sham rabbits appeared to be normal. The punctured discs appeared relatively acellular and more fibrotic, and the discs that were treated with AAV2-BMP2 or AAV2-TIMP1 gene therapy had a relative maintenance of cellularity and relative preservation of their architecture.”<br />
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Leckie concluded by saying: “We have MRI evidence, serum biomarker evidence, biomechanics evidence, and histology evidence that gene therapy treatment with AAV2-BMP2 or AAV2-TIMP1 might help slow the course of disc degeneration in a rabbit model.”<br />
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<br />The Spine Institutehttp://www.blogger.com/profile/14772060988122848565noreply@blogger.com0tag:blogger.com,1999:blog-7139766133686742515.post-28793214827223991142012-03-28T07:24:00.001-07:002012-03-28T11:19:46.073-07:00For Back, Neck Pain, Artificial Disc Replacement Has Cost, Outcome Advantages Over Fusion Surgery<div style="text-align: left;"><span style="color: #666666; font-family: Arial, Helvetica, sans-serif;"><span style="line-height: 19px;"></span></span></div><span style="color: #666666; font-family: Arial, Helvetica, sans-serif;"><a href="http://www.sciencedaily.com/releases/2011/03/110322151258.htm#.T3Hu0WOi5Ko.twitter" target="_blank">ScienceDaily</a> (Mar. 22, 2011) —</span><br />
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<span style="color: #666666; font-family: Arial, Helvetica, sans-serif;">When physical therapy and drugs fail to relieve back or neck pain, patients often turn to spinal fusion surgery as a last resort, but two new studies show that in certain situations, especially when several discs are involved, artificial disc replacement may give better long-term results at lower cost.</span><br />
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<span style="color: #666666; font-family: Arial, Helvetica, sans-serif;">Hospital costs for artificial disc replacement were 49 percent lower, and four years out from surgery, artificial disc patients were four times less likely to need additional surgery than those who had fusion operations, according to two recently published studies.</span><br />
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<span style="color: #666666; font-family: Arial, Helvetica, sans-serif;">"Back pain is the fifth leading cause of hospital admission and the third most common reason for surgery," said orthopaedic surgeon Rick B. Delamarter, M.D., co-director of the Cedars-Sinai Spine Center. "Estimates vary and are probably understated, but health care expenditures for back pain top $91 billion a year, not including indirect and societal costs such as time lost from work and worker's compensation.It is crucial that we develop surgical procedures that are cost effective without sacrificing high-quality results."</span><br />
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<span style="color: #666666; font-family: Arial, Helvetica, sans-serif;">Delamarter is a lead author of the two studies, which were published recently in the SAS Journal of the International Society for the Advancement of Spine Surgery and the Society for Minimally Invasive Spine Surgery.</span><br />
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<span style="color: #666666; font-family: Arial, Helvetica, sans-serif;">Both studies compared disc replacement surgery with the more common fusion operation to treat degenerative disc disease -- deterioration caused by aging and wear and tear. One study looked at 209 patients with damaged neck discs who received either minimally invasive disc replacement or the more complex spinal fusion surgery. These patients were followed at regular intervals for four years. A separate group of 136 who received an artificial disc two years after the first group also were part of the study. All patients were assessed on their satisfaction with the results of the procedure. The other study focused on 53 patients suffering from three-level, lower back disc disease and looked at cost comparisons for length of hospital stay, resources used and other factors</span><br />
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<span style="color: #666666; font-family: Arial, Helvetica, sans-serif;">Discs act as cushions between the bones (vertebrae) of the spine. When healthy, the discs have enough "give" to allow the back to be flexible but are firm enough to provide stability. With age or injury, they lose their pliability and density. Nerves may become pinched between the bones, causing pain not just in the spine but in other parts of the body.</span><br />
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<span style="color: #666666; font-family: Arial, Helvetica, sans-serif;">Fusion surgery seeks to relieve symptoms of the degenerative disease by removing the damaged disc and replacing it with bone. Studies show this procedure often can be effective but there can be drawbacks: in some cases, fused spinal sections can lose flexibility, impeding normal movement and stressing adjacent discs, often leading later to more fusion surgery. Artificial disc replacement, which has been performed in the United States since 2000, tends to cause less tissue injury than fusion surgery, and the discs are designed to maintain natural spine movement and reduce need for follow-up surgery.</span><br />
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<span style="color: #666666; font-family: Arial, Helvetica, sans-serif;">In their study of patients suffering neck (cervical) disc disease, Delamarter and his colleagues found both disc replacement and fusion surgery acceptable options providing good long-term outcomes. But four years out from surgery, fusion patients were four times more likely to need more surgery. Half of these secondary operations were needed to treat new disc problems occurring adjacent to fused sections.</span><br />
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<span style="color: #666666; font-family: Arial, Helvetica, sans-serif;">Patients in the study had imaging scans to measure before-and-after flexibility and range of motion; were evaluated for physical and neurological improvement; and completed self-assessment questionnaires on neck disability, neck and arm pain intensity. Improvements were seen in all categories, regardless of the surgical procedure, but results tended to be at least slightly better in patients with disc replacements.</span><br />
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<span style="color: #666666; font-family: Arial, Helvetica, sans-serif;">An important area, according to Delamarter, was patient satisfaction with the procedure. Four years after surgery, nearly 88 percent of disc replacement patients reported that they were very to completely satisfied, compared with 76 percent of fusion patients. When asked if they would undergo the same surgery again, 89 percent of disc replacement patients and 81 percent of fusion patients said yes.</span><br />
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<span style="color: #666666; font-family: Arial, Helvetica, sans-serif;">"While the results of this 13-center study are preliminary, it appears that artificial disc replacement surgery compares favorably as an effective procedure, is preferred by patients and slows the rate of adjacent-level disease," Delamarter said.</span><br />
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<span style="color: #666666; font-family: Arial, Helvetica, sans-serif;">Spinal fusion has been recognized as one of the more expensive surgical procedures. The second study looked at costs and is believed to be the first to compare those of three-level disc replacement with three-level fusion. It evaluated itemized billing records of 53 patients undergoing surgery for three consecutive discs of the low back (lumbar spine) at St. John's Health Center in Santa Monica, Calif., where Delamarter practiced before joining Cedars-Sinai.</span><br />
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<span style="color: #666666; font-family: Arial, Helvetica, sans-serif;">Total hospital costs for patients undergoing disc replacement surgery averaged 49 percent lower than those for fusion patients.</span><br />
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<span style="color: #666666; font-family: Arial, Helvetica, sans-serif;">The number of fusions for low back pain is rising rapidly, but Delamarter urges hospitals, insurers and surgeons to consider alternatives, including total disc replacement.</span><br />
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<span style="color: #666666; font-family: Arial, Helvetica, sans-serif;">"After safety and effectiveness of a procedure have been documented, cost is an important consideration," he said. "Artificial disc replacement technology appears to offer a promising, cost-saving alternative to fusion, especially for patients with disease at three levels."</span><br />
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<span style="color: #666666; font-family: Arial, Helvetica, sans-serif;">The artificial discs implanted in these studies -- the ProDisc-C and ProDisc-L -- were manufactured by Synthes USA Products. Delamarter and his colleagues have evaluated outcomes and written about the devices since the FDA approved them for research and limited use in the United States. Delamarter is a consultant for Synthes and receives royalties on the ProDisc devices. However, he does not receive royalties on devices used for his patients or any other patients at Cedars-Sinai Medical Center.</span><br />
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<span style="color: #666666; font-family: Arial, Helvetica, sans-serif;"><i><a href="http://www.sciencedaily.com/releases/2011/03/110322151258.htm#.T3Hu0WOi5Ko.twitter" target="_blank">read this story online</a></i></span><br />
<br />The Spine Institutehttp://www.blogger.com/profile/14772060988122848565noreply@blogger.com4tag:blogger.com,1999:blog-7139766133686742515.post-81675325085549253432012-03-26T11:53:00.001-07:002012-03-26T11:53:34.947-07:00Becker's ASC Review June Meeting to Gather 700 Industry Leaders to Discuss Orthopedics, Spine, ASC Profitability<br />
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Becker's ASC Review will host more than 700 surgery center industry leaders at its annual meeting June 14-16, 2012, at the Westin on Michigan Avenue in Chicago.</h3>
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<span style="background-color: white; font-family: Arial, Helvetica, sans-serif; font-size: 14px; line-height: 15px;">Chicago, Illinois (PRWEB) March 25, 2012</span> </div>
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Becker's ASC Review will host more than 700 surgery center industry leaders at its annual meeting June 14-16, 2012, at the Westin on Michigan Avenue in Chicago.</div>
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The orthopedic, spine and pain-focused ASC conference brings together surgeons, physician leaders, administrators and ASC business and clinical leaders to discuss how to improve your ASC and its bottom line and how to manage challenging clinical, business and financial issues.</div>
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The conference will feature 30 presentations from physician leaders, including: </div>
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<li style="background-attachment: initial; background-clip: initial; background-color: initial; background-image: url(http://www.prweb.com/images/bullet.gif); background-origin: initial; background-position: 0px 0.5em; background-repeat: no-repeat no-repeat; border-bottom-width: 0px; border-color: initial; border-image: initial; border-left-width: 0px; border-right-width: 0px; border-style: initial; border-top-width: 0px; list-style-type: none; margin-bottom: 0.5em; margin-left: 0px; margin-right: 0px; margin-top: 0.5em; padding-bottom: 0px; padding-left: 1em; padding-right: 0px; padding-top: 0px;">Evolving Clinical Developments in Interventional Pain Management – Mark Coleman, MD, CEO, National Spine and Pain Centers, LLC</li>
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Attendees will also have the chance to see a variety of presentations on improving profitability, featuring speakers such as Nancy Boyd of Crane Creek Surgery Center; Luke Lambert, of Ambulatory Surgical Centers of America; Jeff Leland of Blue Chip Surgical Center Partners; Tom Mallon of Regent Surgical Health; Kenny Hancock of Meridian Surgical Partners; Andrew Hayek of Surgical Care Affiliates; Robert Zasa of ASD Management; Charles Peck of Health Inventures; Steve Arnold, MD, of Access MediQuip; and Larry Taylor of Practice Partners.</div>
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Keynote speakers for the conference include Lou Holtz, legendary football coach and analyst for ESPN; Tucker Carlson, contributor to FOX News and editor-in-chief of The Daily Caller; and Sam Donaldson, ABC News veteran.</div>
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To register, visit: 10th Annual Orthopedic, Spine and Pain Management-Driven ASC Conference<a href="http://www.beckersasc.com/news-analysis/10th-annual-orthopedic-spine-and-pain-management-driven-asc-conference-improving-profitability-and-business-and-legal-issues.html?utm_source=prweb&utm_medium=pr" target="_blank">10th Annual Orthopedic, Spine and Pain Management-Driven ASC Conference</a></div>
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For information on sponsorship opportunities, contact Jessica Cole at Jessica(at)beckershealthcare(dot)com or call (312) 929-3621.</div>
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About Becker’s ASC Review<br />Becker's ASC Review features general business, legal and clinical guidance for surgery center administrators, physicians and industry leaders. Each of the magazine’s nine annual print issues reaches a qualified audience of more than 25,000 key business leaders and focuses on topics such as joint ventures, development and expansion, regulatory and compliance issues and methods to increase surgery center profitability. Every surgery center in the nation receives Becker’s ASC Review.</div>
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<a href="http://www.prweb.com/releases/prweb2012/3/prweb9325126.htm" target="_blank">read original press release online</a></div>
</div>The Spine Institutehttp://www.blogger.com/profile/14772060988122848565noreply@blogger.com0tag:blogger.com,1999:blog-7139766133686742515.post-32961654370989697812012-03-23T12:45:00.000-07:002012-03-23T12:45:25.629-07:00The Most Interesting 2.5 Days in the ASC & Spine Business Are Coming — The 10th Annual Orthopedic, Spine and Pain Management-Driven ASC Conferenceby the Staff at <a href="http://www.beckersasc.com/orthopedic-spine-driven-ascs/the-most-interesting-25-days-in-the-asc-a-spine-business-are-coming-the-10th-annual-orthopedic-spine-and-pain-management-drive-asc-conference.html?Spine_Business_Are_Coming_%E2%80%94_The_10th_Annua" target="_blank">Becker's ASC Review</a><br />
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<span style="background-color: white; color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">This conference includes great spine, orthopedic and pain management physician leaders as speakers. These include speakers such as Charles Gordon, MD, of Texas Spine and Joint Hospital; David Rothbart, MD, of Spine Team Texas; Richard Wohns, MD, of South Sound Neurosurgery; Scott Glaser, MD, of Pain Specialists of Greater Chicago; <b>Kenneth Pettine, MD, of The Spine Institute and Loveland Surgery Center</b>; Brian Cole, MD, of Rush University Medical Center; Laxmaiah Manchikanti, MD, of the American Society for Interventional Pain Management Physicians; John Caruso, MD, of Parkway Surgery Center; John Peloza, MD, of the Center for Spine Care; and James T. Caillouette, MD, of Hoag Orthopaedic Institute will all lead informative sessions about the biggest ideas, challenges and trends in spine, orthopedics and pain management. </span><br style="background-color: white; color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><br style="background-color: white; color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><span style="background-color: white; color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">The conference also includes incredible speakers on improving profitability in ASCs such as Nancy Boyd of Crane Creek Surgery Center; Luke Lambert, of Ambulatory Surgical Centers of America; Jeff Leland of Blue Chip Surgical Center Partners; Tom Mallon of Regent Surgical Health; Kenny Hancock of Meridian Surgical Partners; Andrew Hayek of Surgical Care Affiliates; Robert Zasa of ASD Management; Charles Peck of Health Inventures; Steve Arnold, MD, of Access MediQuip; Larry Taylor of Practice Partners in Healthcare; Larry Teuber, MD, of Medical Facilities Crop.; Michael J. Lipomi of Surgical Management Professionals; Gregory DiConciliis of Boston Out-Patient Surgical Suites; John Seitz of Ambulatory Surgical Group; and Edward Hetrick of Facility Development & Management. </span><br style="background-color: white; color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><br style="background-color: white; color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><span style="background-color: white; color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">The conference will be held in Chicago, June 14 through June 16, at the Westin Hotel on Michigan Avenue. Key note speakers are legendary football coach Lou Holtz, editor-in-chief of The Daily Caller and Fox News contributor Tucker Carlson and ABC News veteran Sam Donaldson.</span><br style="background-color: white; color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><br style="background-color: white; color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;" /><span style="background-color: white; color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">To learn more and register, </span><a href="http://www.blogger.com/"><span style="color: #1965c3; font-family: Helvetica, Arial, Geneva, sans-serif;"><span style="background-color: white; font-size: 12px; line-height: 18px;"><span id="goog_649786788"></span>click here</span></span><span style="background-color: white; color: #292929; font-family: Helvetica, Arial, Geneva, sans-serif; font-size: 12px; line-height: 18px;">.<span id="goog_649786789"></span></span></a><br />
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view the <a href="http://www.beckersasc.com/orthopedic-spine-driven-ascs/the-most-interesting-25-days-in-the-asc-a-spine-business-are-coming-the-10th-annual-orthopedic-spine-and-pain-management-drive-asc-conference.html?Spine_Business_Are_Coming_%E2%80%94_The_10th_Annua" target="_blank">article online here</a>The Spine Institutehttp://www.blogger.com/profile/14772060988122848565noreply@blogger.com0tag:blogger.com,1999:blog-7139766133686742515.post-23617158066136119812012-02-09T12:36:00.000-08:002012-02-09T12:36:16.424-08:00Dr. Kenneth Pettine Named to Becker's list of Spine and Neurosurgeon Inventors to Know<b>20 Spine and Neurosurgeon Inventors to Know</b><br />
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<span style="font-size: x-small;">Written by <a href="http://beckersorthopedicandspine.com/spine/itemlist/user/75-lauramiller" target="_blank">Laura Miller</a> | February 08, 2012 | <a href="http://beckersorthopedicandspine.com/spine/item/10712-20-spine-and-neurosurgeon-inventors-to-know" target="_blank">Becker's Orthopedic, Spine, and Pain Management Review</a></span><br />
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Here are 20 spine and neurosurgeons currently in practice who invented spinal devices, techniques and systems.<br />
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<b>Edward Benzel, MD (Cleveland Clinic, Cleveland). </b>Dr. Benzel holds at least nine patents for devices, including a cervical spine stabilization method and system and a spinal column retaining apparatus. He is chairman of the Cleveland Clinic's department of neurosurgery. His clinical interests focus on spinal disorders, complex spine instrumentation and spine tumors. He is one of the founding members of the Lumbar Spine Research Society, which formed in 2007. He is chairman of the review board for the Journal of Neurosurgery: Spine and has reviewed for Spine, The Spine Journal and other publications. Dr. Benzel is medical co-director of the Cleveland Clinic Foundation Spine Research Laboratory. Dr. Benzel earned his medical degree from the Medical College of Wisconsin in Milwaukee, where he also completed his residency in neurosurgery. He received fellowship training in spine surgery and spinal cord injury at VA Medical Center in Albuquerque.<br />
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<b>Scott Boden, MD (Emory Healthcare, Atlanta). </b>Dr. Boden holds at least six different patents for medical devices and his research focuses on spine fusion, spinal disorders and bone regeneration. He is the director of Emory Healthcare's orthopedics and spine center as well as chairman and founder of the National Spine Network. More than 150 of Dr. Boden's journal articles have been published, and he has authored or edited more than 42 book chapters and nine books on spine topics. His research on the fundamental mechanisms of bone growth and regeneration has been awarded by the American Academy of Orthopaedic Surgeons, North American Spine Society, International Society for Study of the Lumbar Spine and other professional organizations. He earned his medical degree at University of Pennsylvania School of Medicine in Philadelphia, completed an internship at George Washington University Medical Center in Washington, DC, and received fellowship training at Case Western Reserve University Hospital in Cleveland.<br />
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<b>Robert S. Bray, Jr., MD (Diagnostic and Interventional Spinal Care, Marina del Rey, Calif.).</b> Dr. Bray has contributed to more than 20 patents, including a cervical dynamic stabilization system, SmartPlate spinal implant and a slidable bone plate system. He is the founding director and CEO of his practice, Diagnostic and Interventional Spine Care. He was chief of neurosurgery for the U.S. Air Force at David Grant Medical Center in 1989 and the founding director of the Institute for Spinal Disorders at Cedars-Sinai Medical Center in Los Angeles. Dr. Bray has served as spine consultant for the U.S. Men's volleyball team and the Oakland Raiders, among other professional athletic organizations. After he received his medical degree from Baylor College of Medicine in Houston, Dr. Bray completed his residency at Baylor Affiliated Hospitals, also in Houston.<br />
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<b>James Lloyd Chappuis, MD (Spine Center Atlanta). </b>Dr. Chappuis is in private practice at Atlanta Spine Center and holds patents for several spine devices, including an internal pedicle screw insulator apparatus and facet fusion system. Additional patents are pending for devices such as the Doppler retractor and a modular lumbar interbody fixation system. Dr. Chappuis is a member of several professional societies, including North American Spine Society and American Academy of Orthopaedic Surgeons. In addition to his clinical work, Dr. Chappuis has authored several papers on spinal surgery and served as a clinical instructor at The Medical College of Georgia in Augusta. Dr. Chappuis earned his medical degree at The Medical College of Ohio in Toledo and completed his residency in orthopedic surgery at Campbell Clinic/University of Tennessee. His additional training includes the AO Spine Fellowship where he studied in Karlsbad, Germany.<br />
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<b>Kingsley R. Chin, MD (Institute for Modern & Innovative Spine Surgery, Ft. Lauderdale, Fla.). </b>Dr. Kingsley is the founding spine surgeon at the Institute for Modern & Innovative Spine Surgery and inventor of the FacetFuse Minimally Invasive Screw System and MANTIS minimally invasive pedicle screw system for spinal fusion. During his career, Dr. Chin served as the chief of spine surgery at the University of Pennsylvania in Philadelphia and has published several articles in professional journals. He is a diplomat of the National Board of Medical Examiners and American Board of Orthopaedic Surgeons. He earned his medical degree at Harvard University in Boston and completed the Harvard Combined Orthopaedic Residency with Massachusetts General Hospital in Boston. His additional training includes a fellowship in adult reconstructive surgery at Harvard and a fellowship in spine surgery at Case Western Reserve University in Cleveland.<br />
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<b>Charles R. Gordon, MD (Texas Spine and Joint Hospital, Tyler). </b>Dr. Gordon has contributed to the development of several patented devices, including an artificial functional spinal unit system and an expandable articulating intervertebral implant. He founded the device company Flexuspine along with his practice, Gordon Spine Associates, based in Tyler, Texas. He is a co-founder of Texas Spine and Joint Hospital and a member of the North American Spine Society and American Association of Neurological Surgeons, among other professional organizations. He received his medical degree from Baylor College of Medicine in Houston and completed his residency and fellowship at The Medical College of Virginia.<br />
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<b>Regis W. Haid, Jr., MD (Atlanta Brain and Spine Care, Atlanta). </b>Dr. Haid holds multiple patents for implants used during cervical lateral mass plating, anterior cervical plating, posterior and transforaminal lumbar interbody fusion and cervical arthroplasty. He is a founding partner of Atlanta Brain and Spine Care and medical director of the Piedmont Spine Center and neuroscience service line at Piedmont Hospital in Atlanta. Dr. Haid has traveled internationally to present at spine conferences, including visits to Italy, Russia and Switzerland. He was previously the staff neurosurgeon for the U.S. Air Force at Wilford Hall Medical Center in San Antonio. Dr. Haid earned his medical degree from West Virginia University in Morgantown, where he also completed his neurosurgical residency. He received fellowship training in spinal disorders at the University of Florida College of Medicine.<br />
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<b>Ken Y. Hsu, MD (St. Mary's Spine Center, San Francisco). </b>Dr. Hsu is co-inventor – with James F. Zucherman, MD, also at St. Mary's — of the X Stop Interspinous Process Decompression System, which alleviates the symptoms of lumbar spinal stenosis. The process, FDA-approved in 2005, was first in the category of interspinous process devices. Dr. Hsu, who holds 43 patents, has been the director of spine surgery at St. Mary's Medical Center since 1988 and is a member of the clinical faculty at Stanford University. He received his medical degree from State University of New York, completed a residency in general surgery at Mt. Zion Hospital in San Francisco and an orthopedic surgery residency at St. Mary's. He completed a fellowship in spine and pediatric orthopedic surgery at the University of Hong Kong.<br />
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<b>A. Jay Khanna, MD (Johns Hopkins Medical Center, Baltimore). </b>Dr. Khanna is an associate professor of orthopaedic surgery and biomedical engineering at the Johns Hopkins University and holds patents for an orthopedic screw system and universally deployable and expandable bone and screw anchor assembly. He currently serves on the clinical teams of BOSS Medical and Cortical Concepts, two companies that he co-founded with his colleagues and biomedical engineering students from Johns Hopkins to foster the development of new orthopedic technologies. Dr. Khanna previously served as the Clinical Director of the Johns Hopkins Center for Bioengineering, Innovation and Design (CBID) which prepares graduate and undergraduate biomedical engineering students to become leaders in the medical device industry and creates collaborations between clinicians and engineers at Hopkins to develop new technologies and companies. Dr. Khanna has a special interest in treating patients with cervical spinal disorders and the use of minimally invasive techniques for the treatment of lumbar spinal disorders. He is a member of North American Spine Society and American Academy of Orthopaedic Surgeons. In addition to his clinical practice, Dr. Khanna has research interests in minimally invasive spine surgery and spinal biomechanics. He earned his medical degree at the Georgetown University in Washington, D.C., and completed his residency at Johns Hopkins. His additional training includes a fellowship spine surgery in the departments of in orthopedic and neurosurgery at the Cleveland Clinic.<br />
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<b>Jeffrey A. Kozak, MD (Foundren Orthopedic Group, Houston). </b>Dr. Kozak is a spine surgeon with Foundren Orthopedic Group and has a special interest in performing anterior procedures. He helped design several spinal implants and holds a patent for a spinal fixation device he invented. During his career, Dr. Kozak served on the Texas Workers' Compensation Task Force and authored several professional articles on spine surgery. He is a founding member and past president of the Texas Spine Society and member of the North American Spine Society. Dr. Kozak earned his medical degree from Baylor College of Medicine in Houston, where he also completed his residency in orthopedic surgery. His additional training includes spinal fellowships in England, France and Germany.<br />
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<b>Casey K. Lee, MD (Spine Care and Rehabilitation, Roseland, N.J.). </b>Dr. Lee is a spine surgeon with Spine Care and Rehabilitation and founder of Nexgen Spine, which developed the Physio-L Artificial Disc. He serves as chairman and chief medical officer of Nexgen Spine and continues his interest in the development of artificial disc prostheses. During his career, Dr. Lee has served as president of the North American Spine Society and New Jersey Orthopaedic Society as well as co-founder of the Korean American Spine Society. He has authored several papers published in spine text books and peer-reviewed journals. Dr. Lee earned his medical degree from Kyungpook National University Medical School in Korea and completed his orthopedic surgery residency at Carney Hospital/Boston City Hospital in Boston. In addition to his clinical work, Dr. Lee spent time as a professor of surgery at the University of Medicine and Dentistry of New Jersey-New Jersey Medical School in Newark.<br />
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<b>Isador Lieberman, MD (Texas Back Institute, Plano). </b>Dr. Lieberman holds multiple patents for his technological innovations, including SpineAssist, a robotic tool he recently co-developed for use during minimally invasive spine surgery. He has held appointments with Cleveland Clinic as staff surgeon and professor of surgery at Cleveland Clinic Lerner College of Medicine. His developments have been recognized with awards from Cleveland Clinic and the Spine Society of Europe. He recently co-founded the Uganda Charitable Spine Surgeon Mission, with which he accompanies a team of surgeons to visit Uganda each year to treat the underprivileged with spine conditions. He earned his medical degree from the University of Toronto in Ontario, Canada, and completed his residency at Mount Sinai Hospital in Toronto. He also completed residency programs in orthopedic surgery at two Toronto hospitals along with a clinical fellowship in spine and trauma surgery at The Toronto Hospital.<br />
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<b>David W. Lowry, MD (The Brain+Spine Center, Holland, Mich.). </b>Dr. Lowry is a neurological spine surgeon with The Brain+Spine Center and co-founder of TransCorp Spine. He continues to serve as a board member of the company. During his career, Dr. Lowry invented a new spine surgery technique, the TransCorporal Micro Discectomy, for patients suffering from spinal stenosis. He holds two patents for his work and continues his efforts in research and development in areas such as the cervical spine. Dr. Lowry is a member of North American Spine Society and Congress of Neurological Surgeons. He also serves on the board of trustees for Hope College, his alma mater. Dr. Lowry earned his medical degree at Johns Hopkins Medical School in Baltimore and completed additional training at the University of Pittsburgh.<br />
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<b>Robert Masson, MD (NeuroSpine Institute, Orlando).</b> Dr. Masson is the founder and president of NeuroSpine Institute and a retired Lieutenant Commander of the United States Naval Reserve. He has a professional interest in minimally invasive spine surgery and developer of the iMAS surgical principles, techniques and products for Synthes Spine. The iMAS is an interpedicular minimal access surgery of the lumbar spine. During his career, Dr. Masson has treated several professional athletes, including football and basketball players. In addition to his clinical practice, Dr. Masson is a member of the Society for Minimally Invasive Spine Surgery. He was also featured on a Discovery Health documentary as a neurological surgery expert. Dr. Masson earned his medical degree at the University of Florida and completed his neurological surgery residency in Gainesville, Fla. His additional training includes a fellowship in skull base surgery and neurotology at the House Ear Clinic in Los Angeles.<br />
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<b>Seth Neubardt, MD (Seth Neubardt, M.D. & Jack Stern, M.D., Ph.D., White Plains, N.Y.). </b>Dr. Neubardt is the sole inventor of several medical patents, including one for a spinal procedure to safely insert screws which is now used at more than 25 hospitals in 15-plus countries. He has a professional interest in developing technology for minimally invasive spine surgery, such as an electrically insulated surgical probing tool and an apparatus and method for locating defects in bone tissue. He is a fellow with the American Academy of Orthopaedic Surgeons and member of the North American Spine Society. Dr. Neubardt earned his medical degree from the University of Texas Medical School at Houston and completed his residency in orthopedic surgery at Montefiore medical Center and Albert Einstein College of Medicine in New York City. His additional training includes an orthopedic and neurological spine fellowship at New York University Medical Center in New York City.<br />
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<b>Kenneth A. Pettine, MD (Rocky Mountain Associates, Loveland, Colo.). </b>Dr. Pettine is co-inventor and co-designer of the Maverick Artificial Disc, a disc replacement device for the neck and back. He is a co-founder of Rocky Mountain Associates and a surgeon at Loveland (Colo.) Surgery Center. During his career, Dr. Pettine has been chief investigator for eight FDA studies involving non-fusion spine technology. He is a distinguished speaker at national and international symposiums and the author of nearly 20 research publications. He received his medical degree from the University of Colorado School of Medicine in Denver. He completed his residency and his master's degree in orthopedic surgery at the Mayo Clinic in Rochester, Minn., and completed a fellowship at the Institute for Low Back Care in Minneapolis.<br />
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<b>David G. Schwartz, MD (OrthoIndy Northwest, Indianapolis). </b>Dr. Schwartz is the inventor of the Anteres Spinal Instrumentation System, which is used for the treatment of spinal fractures, scoliosis and tumors. During his career, Dr. Schwartz's clinical interests include spinal deformities, kyphosis, scoliosis and low back pain. He is the director of OrthoIndy's Spine Fellowship and an assistant clinical professor in the department of orthopedic surgery at Indiana University in Bloomington. He earned his medical degree from Loyola University in Chicago, completed a residency in orthopedic surgery at Northwestern University in Chicago and received fellowship training in spine surgery at the Leatherman Spine Center, Kosair Childrens Hospital and the University of Louisville, all located in Louisville, Ky.<br />
<br />
<b>Jeffrey Wang, MD (UCLA Comprehensive Spine Center, Los Angeles). </b>Dr. Wang practices with the UCLA Comprehensive Spine Center and is the director of the UCLA Spine Surgery Fellowship. He is the inventor of an artificial disc, which he used in a spine surgery for Governor Benigno R. Fitial, who was suffering from spinal stenosis. During his career, Dr. Wang has served on the editorial boards for several professional journals, including editor-in-chief for Global Spine Journal and deputy editor for The Spine Journal. He has served on the board of directors for the Cervical Spine Research Society and North American Spine Society as well as held leadership positions with the American Academy of Orthopaedic Surgeons. In addition to his clinical work, Dr. Wang runs a basic science laboratory. His research interests include gene therapy for spinal disorders, minimally invasive spine surgery and bone growth biological proteins. He earned his medical degree at the University of Pittsburgh School of Medicine and completed his residency in orthopedic surgery at UCLA School of Medicine. Dr. Wang's additional training includes a spine and spinal cord injury fellowship at University Hospitals of Cleveland.<br />
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<b>Anthony T. Yeung, MD (Desert Institute for Spine Care, Phoenix). </b>Dr. Yeung developed the FDA-approved Yeung Endoscopic Spine System, and was one of the first spine surgeons to utilize endoscopically-guided laser for degenerative conditions of the lumbar spine. During his career, Dr. Yeung has authored more than 70 scientific publications on his technique. He is currently the president of the World Congress of Minimally Invasive Spine Surgeons and has held leadership positions within numerous other national and international spine organizations. Dr. Yeung received his medical degree from University of New Mexico School of Medicine in Albuquerque, completed his residency at Maricopa County General Hospital in Phoenix and served in the U.S. Navy Medical Corp in Subic Bay, Philippines.<br />
<br />
<b>Jim Zucherman, MD (San Francisco Orthopaedic Surgeons). </b>Dr. Zucherman is a senior spine partner at San Francisco Orthopaedic Surgeons Medical Group and inventor and co-developer of the X-Stop, an interspinous process device for treating lumbar spinal stenosis. He is also in the process of developing the Starflex motion preservation minimally invasive spine stabilization device through Spartek. During his career, Dr. Zucherman has pioneered several surgical techniques and developed one of the first laparoscopic lumbar spinal fusions and percutaneous cervical discectomy procedures in the United States. He has been a principle investigator for the Prodisc and Flexicore FDA lumbar disc replacement trials as well as the Prestige and Cervicore cervical disc replacement trials. Dr. Zucherman earned his medical degree at Baylor College of Medicine in Houston and completed his residency in orthopedic surgery through the San Francisco Orthopaedic Residency Program. His additional training includes a pediatric and orthopedic spine surgery fellowship at the Duchess of Kent Children's Orthopaedic Hospital of the University of Hong Kong.<br />
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<br />The Spine Institutehttp://www.blogger.com/profile/14772060988122848565noreply@blogger.com4tag:blogger.com,1999:blog-7139766133686742515.post-47604166624181908232012-02-03T06:44:00.000-08:002012-02-03T06:44:08.317-08:00Spinal fusion surgery: The science behind Manning's life changing operationBy <a href="http://news.medill.northwestern.edu/authorprofile.aspx?id=193533" target="_blank">Christi Sodano</a> | Feb 02, 2012 | <a href="http://news.medill.northwestern.edu/chicago/news.aspx?id=199809" target="_blank">Medill Reports Chicago</a><br />
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With his home turf the epicenter of the Super Bowl buzz this season, his younger brother in contention for the NFL championship and a potentially life-changing contract decision only one month away, it is little wonder why Peyton Manning’s recovery is at the forefront of Indianapolis conversation.<br />
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Last September, Manning underwent his third neck surgery in two years. The controversial spinal-fusion surgery aimed to correct a cervical disc herniation in his neck has been associated with declines in his on-field performance.<br />
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Cervical disc herniation occurs when the cushioned discs, which act as shock absorbers between the vertebrae, bulge and pinch the spinal cord or nerve root that are encased in the spine.<br />
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This is generally caused by repeated neck motion or trauma and can result in loss of motor function and numbness or sharp pain, said Dr. Selene Parekh, associate professor of orthopedic surgery at Duke University.<br />
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Typically surgery is considered only after the patient has endured prolonged pain of up to six weeks, said Dr. Wellington Hsu, assistant professor of orthopedic surgery at the Feinberg School of Medicine at Northwestern University.<br />
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In Manning’s case, disc fragments pinching the nerve root in his cervical spine likely caused acute pain and decreased arm strength.<br />
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During the September operation, doctors removed a single disc through a small incision in the front of the neck, alleviating pressure on the nerve root and replacing the disc with bone grafts or a plastic implant. Once the new disc is set into place, the surrounding vertebrae are fused using a titanium plate and screws in the upper and lower vertebrae.<br />
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Prior to Manning’s spinal-fusion surgery, he underwent two microdiscectomies in an attempt to correct the problem. After a series of diagnostic tests in September showed his recovery was not on track, spinal-fusion surgery became the next step.<br />
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Although the surgery is touted by many industry professionals as more than 95 percent successful, Dr. Kenneth Pettine, an American Academy of Orthopedic Surgeons member, said in a 2010 report, “The perception is that this is a great operation. I’m not saying it’s an awful operation. We’re just presenting the data that it’s certainly not 95 percent.”<br />
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“When you get one level fused, the next level up and down has to take all the motion. This very often accelerates into adjacent level dysfunction. That can happen two years later, that can happen 10 years later,” said Shaeffer Bannigan, development engineer at NuVasive, Inc., a spinal surgery technology company.<br />
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Hsu, who published a study in 2010 about the likelihood of athletes to return to the NFL after spinal- fusion surgery said, “For a player like Manning, the time frame to play football is closing in and when his arm strength was not improving fast enough, he elected to have the fusion.”<br />
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In his study, Hsu analyzed 99 players, some of whom are still on the field, and found on average players treated surgically had a higher return-to-play rate and longer career than players who are treated nonsurgically and position was a key factor in success after surgery.<br />
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Performance after surgery largely depends on the player's position and is particularly relevant for quarterbacks, Parekh said.<br />
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“Loss of function, even if only by a few degrees, is significant because if neck rotation is inhibited, that can affect your ability to assess what is happening on the field,” he said.<br />
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Recovery plans after surgery vary depending on the patient.<br />
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According to Parekh’s medical-information blog, the bone usually takes 12 weeks to fuse and after fusion, “a prolonged course of therapy will be needed to regain some of the loss of function, mobility and strength.”<br />
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Despite a lengthy recovery process, Hsu speculated that, “Manning will be able to come back to the NFL next year. What his level of play will be after he returns is still yet to be determined.”<br />
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However, Hsu’s opinion is not shared by all.<br />
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“My personal opinion was that there wasn’t an entirely honest view of what was happening him, there is a real chance that he may never return to play in the NFL,” Parekh said.<br />
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<a href="http://news.medill.northwestern.edu/chicago/news.aspx?id=199809" target="_blank">View this article in its original publication.</a>The Spine Institutehttp://www.blogger.com/profile/14772060988122848565noreply@blogger.com2tag:blogger.com,1999:blog-7139766133686742515.post-45947178078890878002012-01-17T13:48:00.000-08:002012-01-23T12:09:09.519-08:00Now Enrolling: ACADIA Facet Replacement System Study for Lumbar Spinal Stenosis<br />
<a href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtM6ZFNrVzaBl3eSkaqHfok9rSsAVWPLbGG8maMwvi2B9LYzWV8t-hZHFUFJVE6L7z-XW0mqAxkZGRt05JD9GDRJG7zxABzrH0nwmx5ugnyMrhAmtleUoCRxnktHGtFW66mJ6lBy26Ky8/s1600/ACADIA_final_constr%2523219D92B.jpg" imageanchor="1" style="clear: right; float: right; margin-bottom: 1em; margin-left: 1em;"><img border="0" height="196" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgtM6ZFNrVzaBl3eSkaqHfok9rSsAVWPLbGG8maMwvi2B9LYzWV8t-hZHFUFJVE6L7z-XW0mqAxkZGRt05JD9GDRJG7zxABzrH0nwmx5ugnyMrhAmtleUoCRxnktHGtFW66mJ6lBy26Ky8/s200/ACADIA_final_constr%2523219D92B.jpg" width="200" /></a>The ACADIA™ Facet Replacement System (AFRS) study is designed to compare two treatment options for lumbar spinal stenosis and is one of many clinical trials in which The Spine Institute is participating. This page is designed to provide more information as to what the study involves and who is eligible to participate. After learning about the study here, if you are interested in participating or would like to receive more information, please contact our research coordinator, Nic Rittenhouse, at 970.669.8881, ext. 229 or complete our <a href="http://spinerevolution.com/contact/" target="_blank">contact form</a>.<br />
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<b>Pre-Procedure Evaluation</b><br />
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To be eligible for the ACADIA™ study, you must meet specific study criteria that are designed to find the best possible candidates for the study. During your pre-procedure evaluation, your doctor will review your medical history, perform a neurological exam, and take images of your lower spine called radiographs to determine the extent of your stenosis. You will also be asked to complete several questionnaires to help us determine the level of pain or discomfort your stenosis is causing you and how it’s affecting your quality of life.<br />
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<b>The Procedure</b><br />
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If you qualify for the study and choose to participate, your doctor will treat your stenosis with one of two procedures: surgical decompression with facet replacement using the ACADIA™ Facet Replacement System or surgical decompression with spinal fusion, which is a current standard of care for treating lumbar spinal stenosis. The decision as to which treatment you will receive is decided at random. As part of the study, two out of every three patients will receive the ACADIA™ Facet Replacement System and one out of every three patients will receive spinal fusion.<br />
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<b>Post-Procedure Follow-Up</b><br />
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After your procedure, you will need to attend follow-up visits at six weeks, three months, six months, twelve months, and twenty-four months so your doctor can document your progress.<br />
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<b>Frequently Asked Questions</b><br />
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<i>What is the purpose of a clinical study?</i><br />
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A clinical study (also called a clinical trial or a research trial) is to examine treatment options for specific health conditions. Although there are many types of clinical trials, all must follow the strict rules set by the U.S. Food and Drug Administration (FDA). These rules help protect the rights and safety of those who volunteer to take part in clinical research studies.<br />
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<i>Can I receive the ACADIA™ Facet Replacement System without joining the study?</i><br />
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No, the ACADIA™ Facet Replacement System is currently only available to patients through a clinical study.<br />
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<i>Are there any costs involved with taking part in the ACADIA™ Clinical Study?</i><br />
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Any study-related tests, procedures, physician fees, or services that are not covered by your insurance will be provided to you at no cost. However, you will be responsible for your insurance co-pays.<br />
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<i>How do I know if I’m right for the ACADIA™ study?</i><br />
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In addition to the medical information that your doctor will collect at your pre-procedure evaluation, there are criteria that will make you right for the study (inclusion criteria), and criteria that will automatically exclude you (exclusion criteria). Here is a brief list – the complete list may be found on the ACADIA™ study protocol summary on The Spine Institute website.<br />
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Inclusion criteria include:<br />
<ul>
<li>21-85 years of age and skeletally mature</li>
<li>Undergone at least six cumulative months of conservative treatment prior to surgery including any of the following:</li>
</ul>
<blockquote>
- Medications<br />
- NSAIDs<br />
- Physical therapy<br />
- Bracing<br />
- Chiropractic manipulation<br />
- Modified activities of daily living<br />
- Epidural injections<br />
- Facet block injections </blockquote>
<ul>
<li>Persistent leg, thigh, and/or buttock symptoms, including pain, numbness, burning or tingling</li>
<li>Willing and able to comply with post-operative and routinely scheduled clinical and radiographic evaluations</li>
<li>Live in the immediate area of The Spine Institute (Loveland, Colorado) and have no plans to relocate to another geographic area before the completion of the study, or live outside the immediate area and are willing to comply with scheduled postoperative visits with a Spine Institute physician.</li>
</ul>
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Exclusion criteria include:<br />
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<ul>
<li>Previous surgical procedure at the operative or adjacent level, except for micro-discectomy, laminectomy, lamino/foraminotomy, rhizotomy, IDET, and/or interspinous spacer</li>
<li>Previous lumbar fusion or disc replacement procedure</li>
<li>Osteoporosis</li>
<li>Certain levels of spondylolisthesis or retrolithesis</li>
<li>Scoliosis of the lumbar spine</li>
<li>Discogenic back pain because of torn, herniated, inflamed or irritated disc or other cause that give you axial back pain from degenerative disc disease</li>
<li>Spinal stenosis at more than three lumbar segments</li>
<li>Acute trauma to the lumbar spine has occurred within the last 24 months</li>
<li>Type I Diabetes</li>
<li>Known allergy to cobalt chromium or titanium</li>
<li>Pending litigation related to back pain or injury, or are currently receive Worker’s Compensation</li>
</ul>
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These criteria will not automatically include you in or exclude you from in the ACADIA™ Clinical Study, they are merely to give you an idea of what’s involved. The complete list is available on the <a href="http://clinicaltrials.gov/ct2/show/NCT00401518?term=ACADIA&rank=1">clinicaltrials.gov</a> website.<br />
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For further questions on the study or to schedule a pre-procedure evaluation, please contact The Spine Institute Research Coordinator, Nic Rittenhouse, at 970.669.8881 ext. 229 or complete our <a href="http://spinerevolution.com/contact/" target="_blank">contact form</a>.<br />
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<a href="http://spinerevolution.com/">Spine Institute Home</a>The Spine Institutehttp://www.blogger.com/profile/14772060988122848565noreply@blogger.com5tag:blogger.com,1999:blog-7139766133686742515.post-5351708164420442202012-01-03T15:04:00.000-08:002012-01-23T12:09:46.185-08:00Are You a Candidate for Lumbar Artificial Disc Replacement?At the Spine Institute, we advocate for artificial disc replacement over fusion for a number of reasons. While everyone's condition is unique and you must always discuss your options for artificial disc replacement with your physician, here are the criteria for a candidate for a ProDisc-L implant made by <a href="http://sites.synthes.com/na/prodisc/Patients/AreYouACandidate/Pages/LowBack.aspx" target="_blank">Synthes</a>:<br />
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<ul>
<li>You must be suffering from Degenerative Disc Disease (DDD) at only one level between L3 and S1. DDD is defined as a disc that is worn out or has become injured and is causing pain. This determination is made based on history, physical examination and x-rays</li>
<li>You should have at least six months of conservative treatment (e.g., medications, physical therapy, etc.) without relief of symptoms</li>
<li>Your vertebrae must be dimensionally large enough to support the device</li>
<li>You must not have an active infection, either throughout your body or localized to your spine</li>
<li>You must have good bone quality (no osteoporosis or osteopenia)</li>
<li>You must not be allergic to cobalt chromium, molybdenum, polyethelene, titanium, or tantalum</li>
<li>You must be old enough that the bones in your body are mature and no longer growing</li>
<li>You must not have spinal anatomy that would prevent implantation of the device or cause the device to be unstable in your body, as determined by your doctor</li>
</ul>
<div>
Learn more about other devices we use for <a href="http://spinerevolution.com/disc-replacement" target="_blank">lumbar artificial disc replacement</a> on our website.</div>
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<div>
Remember, these are just criteria for the artificial disc replacement device. Only you and your doctor can decide the best treatment for you and your condition.<br />
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<a href="http://spinerevolution.com/">Spine Institute Home</a></div>
<br />The Spine Institutehttp://www.blogger.com/profile/14772060988122848565noreply@blogger.com2tag:blogger.com,1999:blog-7139766133686742515.post-48071016554411670872011-12-28T08:22:00.000-08:002012-01-23T12:10:17.680-08:0010 Tips for a Healthy BackHere are 10 tips for keeping your back healthy from <a href="http://www.knowyourback.org/Pages/BackPainPrevention/LifestyleChoices/TenTips.aspx" target="_blank">knowyourback.org</a>:<br />
<br />
<ol>
<li>Standing: Keeping one foot forward of the other, with knees slightly bent, takes the pressure off your low back. </li>
<li>Sitting: Sitting with your knees slightly higher than your hips provides good low back support. </li>
<li>Reaching: Stand on a stool to reach things that are above your shoulder level. </li>
<li>Moving Heavy Items: Pushing is easier on your back than pulling. Use your arms and legs to start the push. If you must lift a heavy item, get someone to help you. </li>
<li>Lifting: Kneel down on one knee with the other foot flat on the floor as near as possible to the item you are lifting. Lift with your legs, not your back, keeping the object close to your body at all times. </li>
<li>Carrying: Two small objects (one in either hand) may be easier to handle than one large one. If you must carry one large object, keep it close to your body. </li>
<li>Sleeping: Sleeping on your back puts 55 lbs. of pressure on your spine. Putting a couple of pillows under your knees cuts the pressure in half. Lying on your side with a pillow between your knees also reduces the pressure. </li>
<li>Control Your Weight: Additional weight puts a strain on your back. Keep within 10 lbs. of your ideal weight for a healthier back.</li>
<li>Quit Smoking: Smokers are more prone to back pain than nonsmokers because nicotine restricts the flow of blood to the discs that cushion your vertebrae. </li>
<li>Minor Back Pain: Treat minor back pain with anti-inflammatories and gentle stretching, followed by an ice pack.</li>
</ol>
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<a href="http://spinerevolution.com/">Spine Institute Home</a></div>
<br />The Spine Institutehttp://www.blogger.com/profile/14772060988122848565noreply@blogger.com0tag:blogger.com,1999:blog-7139766133686742515.post-80471886723593781082011-12-13T14:37:00.000-08:002012-01-23T12:10:59.552-08:00Definitive Back-Pain Study?<span class="Apple-style-span" style="font-size: xx-small;">written by Biloine W. Young | <a href="http://ryortho.com/spine.php?news=1604_Definitive-BackPain-Study" target="_blank">Orthopedics This Week</a> | Dec. 6, 2011</span><br />
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<br />
Can a single injection of stem cells repair and regenerate diseased lumbar discs? That question may soon be answered by the first of its kind nationwide study that will test the safety and efficacy of the use of mesenchymal precursor cells (MPCs) to replace bone, cartilage and muscle.<br />
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Headquartered at the University of California, Davis, the study will be directed by Dr. Kee Kim, associate professor and chief of spinal neurosurgery at UC Davis Health System. He will collaborate with Scott Fishman, professor and chief of pain medicine and co-principal investigator, to monitor the patients' progress.<br />
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An estimated 30 million people in the United States suffer from back pain. Degenerative disc disease is the most common cause of low-back pain, which develops with the gradual loss of a material called proteoglycan, which cushions the bones of the spine and enables normal motion.<br />
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"Many scientists and clinicians have injected all different kinds of material into the degenerated disc, hoping that something good will happen. Thus far, we have not been very successful, but we hope that a stem cell-based therapy will be the answer that we have been seeking for decades," Kim said. In pre-clinical studies on sheep with discs that were damaged or degenerated, a single injection of the stem cells was found to make the discs indistinguishable from healthy ones.<br />
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"If safety and efficacy are shown in the study, this would be revolutionary,” Kim noted. “It would imply that we can possibly turn back the clock on aging by not only stopping the progression of degenerative changes in the disc, but also reversing the degenerative process," he said. The researchers plan one single injection of adult stem cells directly into the diseased lumbar discs.<br />
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Researchers will enroll approximately 100 study participants, 10 at UC Davis and the rest at 11 other medical centers throughout the country. The participants will be individuals who have suffered from moderate low-back pain for a minimum of six months and whose condition has not responded to other, conventional treatments.<br />
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The patients will be divided into four groups. One group will receive a high dose of MPCs plus hyaluronic acid, a substance that facilitates the localization and retention of the stem cells. A second group will receive a lower dose of MPCs, plus the hyaluronic acid. A third group will receive the hyaluronic acid alone and a fourth group will receive only the saline solution.<br />
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"As an investigator, the design of this study is one of its most attractive features. This type of randomized study where the patients are blinded to the treatment is as good as it's going to get to eliminate any possible bias," Kim said.<br />
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The current study is sponsored by Mesoblast Ltd., of Melbourne, Australia, which is investigating stem cell technology to regenerate and repair bone and cartilage. The MPCs are derived from a single adult donor's bone marrow to ensure homogeneity, thus minimizing the risk of rejection by the recipient. Kim will not receive compensation from Mesoblast for his participation in the study.<br />
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<a href="http://spinerevolution.com/">Spine Institute Home</a><br />
<br />The Spine Institutehttp://www.blogger.com/profile/14772060988122848565noreply@blogger.com0tag:blogger.com,1999:blog-7139766133686742515.post-41600398945912101202011-11-28T10:52:00.001-08:002012-01-23T12:11:33.968-08:00Stem Cell Shots into the Heart Could Stave Off Chest PainThis story from ABC World News Tonight includes a video that helps demonstrate the healing power of adult stem cells. Instead of injecting a patient's own adult stem cells into the spine to enable healing as we are doing at The Spine Institute, in this story, the adult stem cells are being injected into the patient's heart to treat chest pain.<br />
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The video that immediately follows the story of treating a heart with adult stem cells tracks the progress of a young man with a spinal cord injury who was treated with embryonic stem cell therapy. This therapy is different from the work we are doing with adult stem cells, but it's a remarkable testament to the healing power of stem cells.<br />
<br />
<a href="http://abcnews.go.com/Health/HeartHealth/injecting-heart-stem-cells-helps-chest-pain/story?id=14018901#.TtPXamOa9tk" target="_blank">Go to the story and video</a><br />
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<a href="http://spinerevolution.com/">Spine Institute Home</a>The Spine Institutehttp://www.blogger.com/profile/14772060988122848565noreply@blogger.com0tag:blogger.com,1999:blog-7139766133686742515.post-64082832361491795982011-11-22T11:53:00.001-08:002012-01-23T12:12:10.273-08:005 Comments on Spine Surgeries in ASCs From Surgeons Who Perform Them<br />
<span class="Apple-style-span" style="font-size: x-small;">written by Laura Miller | </span><span class="Apple-style-span" style="font-size: x-small;"><a href="http://beckersorthopedicandspine.com/orthopedic-spine-practices-improving-profits/item/9940-5-points-on-spine-surgeries-in-ascs-from-surgeons-who-perform-them" target="_blank">Becker's Orthopedic, Spine, and Pain Management Review</a> | </span><span class="Apple-style-span" style="font-size: x-small;">November 21, 2011</span><br />
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Here are five spine surgeons performing cases in ambulatory surgery centers and why they urge other surgeons to transition into the outpatient setting.<br />
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<b>1. Richard Hynes, MD, The Back Center (Melbourne, Fla.).</b> Dr. Hynes says the advantages of performing cases in the ASC include the same or quicker recovery time, reduced length of stay in a medical facility and same-day recovery. He performs several procedures, including laminectomies, anterior cervical discectomies and fusions and other minimally invasive, percutaneous spine procedures in an outpatient ambulatory surgery center.<br />
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Improved technology for less invasive procedures has made it possible to bring spine cases into the outpatient setting, according to Dr. Hynes. Interbody fixation, bone morphogenic protein and percutaneous procedures are the way of the future, he says, and the methodology will continue to evolve for better outcomes.<br />
<br />
<b>2. James Lynch, MD, SpineNavada, Surgery Center of Reno.</b> Dr. Lynch performs spine surgery in an ASC and says it's good business in today's cost- and quality-conscious healthcare environment to do so. Positive data for spine surgery and spine surgeons in the ASC setting will play a large role in the future, as comparative profiling of physicians using data points allows patients to "shop" for physicians and hospitals to benchmark providers against one another, he says.<br />
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He expects to see spine technology revolve around minimally invasive spine surgery, robotics, nuclear disc replacement and imaging in the future. An additional shift toward generic spinal implants could help administrators manage costs at ASCs and specialty spine facilities.<br />
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<b>3. Robert Nucci, MD, Citrus Park Surgery Center (Tampa, Fla.).</b> Dr. Nucci performs several cases in outpatient ASCs, including far lateral interbody fusions. To perform single or multi-level FLIFs, Dr. Nucci removes the disc through a small incision, inserts a mesh cage and inflates it with allograft bone. The average OR time for the procedure is 129 minutes, surgeon time is 118 minutes and recovery time is 180 minutes. The average blood loss is 141 cc and there is minimal muscle tissue disruption.<br />
<br />
Dr. Nucci also performs cervical disc replacement in ASCs using an artificial disc. The average OR time is 92.4 minutes, surgeon time is 77.5 minutes and recovery is 140.8 minutes. Patients are under anesthesia for approximately two hours and experience average blood loss of 95 cc. He hasn't experienced any complications with that procedure. The reasons he cites for performing these cases in an ASC include:<br />
<br />
• The infection rate is lower than in hospitals<br />
• There is less overhead cost and increased efficiency in the OR<br />
• Shorter anesthesia time<br />
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<b>4. Joan O'Shea, MD, The Spine Institute of Southern New Jersey. </b>Dr. O'Shea predicts at least 80 of practicing spine and neurosurgeons are capable of performing their cases in the ASC, whether they are currently doing so or not. However, not every surgeon is suited for the switch; she notes that ASC surgeons must perform quick surgeries, be confident in their surgical ability and have a good support team.<br />
<br />
For her cases in the ASC, Dr. O'Shea increases patient comfort and decreases the risk of complications by:<br />
• Taking patients off of medications during the preoperative<br />
• Using cottonoids to stop epidural bleeding<br />
• Using Decadron to relieve patients of post-operative nausea and vomiting<br />
• Using cervical traction five to 15 pounds<br />
• Encouraging early ambulation to avoid urinary issues<br />
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<b>5. Ken Pettine, MD, The Spine Institute, Loveland (Colo.) Surgery Center.</b> Spine surgeries performed at the hospital are a significant expense and surgeons stand to leave money on the table if they perform procedures there instead of an ASC, Dr. Pettine says. His experience shows outpatient spine surgery can be performed safely and effectively in ASCs; in the 284 outpatient spine cases Dr. Pettine has performed, he reports no complications (although his ASC has a 23-hour convalescence center). He recommends ASCs start slow with less complicated cases, such as decompressions, and then moving to the more complicated procedures.<br />
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To recruit spine surgeons, ASC administrators can present data about the safety and efficacy of spine in other ASCs and entice them through shared income. Insurance contracts for spine can be attractive to payors because implant carve-outs bill 10 percent over retail price while hospitals bill significantly higher. Surgery centers can gain an even higher return if they negotiate discounts with device companies.<br />
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Read the original article on <a href="http://beckersorthopedicandspine.com/orthopedic-spine-practices-improving-profits/item/9940-5-points-on-spine-surgeries-in-ascs-from-surgeons-who-perform-them" target="_blank">Becker's Orthopedic, Spine, and Pain Management Review</a>.<br />
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<a href="http://spinerevolution.com/">Spine Institute Home</a>The Spine Institutehttp://www.blogger.com/profile/14772060988122848565noreply@blogger.com0tag:blogger.com,1999:blog-7139766133686742515.post-12076503999950277382011-10-27T08:56:00.000-07:002012-01-23T12:12:43.704-08:00Orthopedic Stem Cells: Using Adult Stem Cells to Treat Back Pain<br />
When it comes to stem cells, there is often a lot of mystique surrounding them. We hear from the media that we can create a human being out of a bundle of cells, which is not necessarily true. We also tend to look at embryonic stem cells as being the only type of stem cell. With these types of embryonic stem cells, one idea is to be able to create a liver or kidney in a Petri dish, which is not controllable or feasible at this point, and the work being done by the Orthopedic Stem Cell Institute isn’t about that.<br />
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When we look at stem cell types, we have embryonic stem cells on one hand and adult stem cells on the other. The characteristics of each of these are not like other cells. For instance, a liver cell can divide but it will only ever be a liver cell. These stem cells, both embryonic and adult, can turn into different types of cells. The embryonic stem cells can really turn into any cell type, but adult stem cells are limited as far as the cells they can turn into. This depends upon environment or niche and what they are already programmed to become. A lot of people think there is a lot of promise with embryonic stem cells and there is, although we are not quite there yet.<br />
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We are still at the forefront of stem cell technology and embryonic stem cells in particular. With those cells, we do not have the ability to control what types of tissue they turn into. For example, we could be trying to manipulate these cells to turn into kidneys, but they might start to develop as pancreatic cells, which is troublesome. Another key with all stem cells is that they can proliferate quite a bit, usually at a higher rate than just a regular somatic cell. Although this sounds good at first glance, the issue with this, particularly with embryonic stem cells, is we cannot control that division. Hence, these cells can keep going and going without dying. In the normal bodily process, cells are programmed to die after a certain time, but these embryonic stem cells can evade that action and continue dividing, which takes on the characteristic of cancer cells. In some animal studies, an issue that keeps arising is development of tumors in some of these animals. It is difficult to predict if tumors are going to form when using some sort of embryonic stem cell treatment. This is still a scary area through which we are still trying to navigate.<br />
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However, the focus of the Orthopedic Stem Cell Institute is on adult mesenchymal stem cells. On the whole, the media does not give a lot of attention to these kinds of stem cells, as using them avoids any kind of ethical or controversial issues. There is a great amount of research being done on adult mesenchymal stem cells, however, because they are very powerful.<br />
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First off, we can control what cell type they turn into much more easily. For example, the treatment used by the Orthopedic Stem Cell Institute focuses on Mesenchymal precursor cells (MPC). Mesenchymal means these cells are not going to turn into any kind of blood product such as a red blood cell or white blood cell, although they are derived from bone marrow. The fact that they are precursor cells means these MPCs are only going to differentiate into one of a few cell types. They are either going to become bone cells, i.e., osteoblasts, or chondrocytes, i.e., cartilaginous tissue such that we see in intervertebral discs and joints, etc. All of that really depends on the environment in which we place these adult stem cells where it is well suited to do this. For example, we can inject these MPCs into a bone fracture, and because the cells are surrounded by bone tissue, these cells will receive signals from the surrounding cells that tell them to turn into bone. However, the cells we use will be injected into a disc or joint, and the cells composing the disc and joint tissue will signal the stem cells to develop into similar tissue. Again, there is no chance of any sort of pancreatic cell or nerve cell type spontaneously forming because we are using certain adult stem cell types, which are limited and cannot turn into anything like that. In addition, as the tissue surrounding the disc and joint is relatively avascular, there is not really any worry of these cells migrating through the blood stream to somewhere else in the body and causing any sort of problem. As far as the proliferation issue with embryonic stem cells, we have not seen this issue with adult stem cells in terms of dividing exponentially without ceasing. There is almost a preset limit to how many times these adult stem cells will divide. <br />
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Through the Orthopedic Stem Cell Institute, the Spine Institute treats lumber and cervical spine conditions using Adult Stem Cells using an FDA-approved stem cell therapy and is also involved with an FDA clinical trial. Visit the <a href="http://spinerevolution.com/adult-stem-cell/">stem cell page</a> on our website for more information on both.<br />
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<a href="http://spinerevolution.com/">Spine Institute Home</a>The Spine Institutehttp://www.blogger.com/profile/14772060988122848565noreply@blogger.com1