Spinal News International recently met with DePuy Synthes Spine’s Dan Wildman and Bill Horton to discuss the company’s aims, strategies, and upcoming product releases. Aiming to improve patient outcomes across the field of spinal surgery, the company has a number of exciting developments in the pipeline, from updates to existing tech to new, innovative technologies.
Wildman, Spine Platform leader, began working with Johnson & Johnson—DePuy Synthes’ parent company—in 1981. He covered ground in sales, marketing and product development with a number of large medical device companies, before progressing to global leadership roles. Wildman described DePuy Synthes’ strategy as moving beyond purely mechanical solutions by employing scientific expertise, and bringing improved rigour to understanding diseases; diagnosing them earlier, treating them more efficiently and delivering better and more effective treatment to spinal patients. In the field of spinal surgery—which is challenging all the way from diagnosis to postoperative care—immense variability in diagnostic tools, surgical techniques and access to learning and technology contribute to unpredictable patient outcomes, and often unreproducible technical success. “The key focus of DePuy Synthes Spine is to narrow in on some of those variables,” said Wildman. “To try and bring better standardisation to the field in terms of equipment, training and technique, and to make these procedures less invasive and less burdensome on patients.”
Horton is DePuy Synthes Spine’s vice president for Research and Development. An orthopaedic spinal surgeon himself, he has focused on complex deformity surgery research. Acting as a consultant for a number of medical device companies, he joined DePuy Synthes full-time in 2012. Horton emphasised the importance of Johnson & Johnson’s company breadth and structure, and in particular the capability to converge expertise from the pharmaceutical, consumer health, and medical device sectors, as well as Johnson & Johnson Innovation Centers on specific initiatives for spinal patients. He noted that the multinational’s enormous size places DePuy Synthes in prime position to offer an interdisciplinary approach to research and development, The unique breadth of expertise within Johnson & Johnson allows DePuy Synthes, he asserted, to comprehensively shape technologies that require a blend of specialised skills from inception to market. “We are leveraging the power of the Johnson & Johnson ecosystem, bringing the right scientific capabilities from across the company to deliver better and more effective treatment to spine patients,” Horton said. The company’s many offerings span from medtech innovations to biologics.
One of the biggest product launches of 2016 for DePuy Synthes Spine was that of the Kick navigation system. To make visualisation more widely accessible, the company has partnered with BrainLab to develop the Kick system. It is designed to enhance visualisation during open and minimally invasive spinal procedures for surgeons who typically rely on conventional X-ray, and works with the existing operating room C-arm. The Kick system consists of an infrared camera, computer and monitor, which displays up to four different views at one time to provide a clear picture of the operating field. This is intended to allow surgeons to work with the C-arm based images they are used to, while reducing operative time and radiation exposure for the operating room staff, since there should be need for multiple image captures and X-ray equipment repositioning to get different views.
The Kick system has a number of potential benefits for improving surgical outcomes for patients, in line with the strategy detailed above. Wildman emphasised the importance of improving access to new and effective technologies across the globe. Many navigation systems are very large and very expensive, installed at only the leading, best-funded institutions. The Kick system, however, comes at a much lower price point and size. Not only should it offer more flexibility in terms of practical use—small enough to fit into a suitcase—but the lower cost associated with the initial purchase and upkeep of the device means that smaller centres in lower-income territories should be able to invest. This could bring the benefits of navigation—reduced need for revision surgery, higher screw placement accuracy and reduced radiation exposure—to a far greater number of patients. By increasing access to navigation technology, DePuy Synthes Spine should be able to help minimise variability in spinal surgery, even in developing countries—where low back pain is a growing problem. The company is, Wildman asserted, in prime position to penetrate both developed and developing markets, with the aim of helping to bring patient care worldwide up to the higher levels offered by specialist centres.
Also launched this autumn was the Synfix Evolution secured spacer system, a stand-alone ALIF system that treats lumbar degenerative disc disease with a PEEK spacer, coupled with a titanium zero-profile plate and four divergent locking screws. Synfix Evolution is designed to deliver superior biomechanical stability, eliminating the need for additional posterior instrumentation, while offering a set of instrumentation that allows ease of use and implant options that accommodate a variety of patient anatomies.
These two launches follow the global launch of the Expedium Verse spinal system earlier this year. This all-in-one pedicle screw system is designed to enable surgeons to perform complex multiple spinal correction manoeuvres during spinal fusion surgery with a single implant type and fewer instruments, compared to traditional pedicle screw systems. The system—which may potentially reduce the risk of screw pullout or migration when compared to traditional screws—is also intended to reduce sterilisation burden for hospital and staff, and may reduce the number of screws needed in a procedure.