Spine innovation in the 21st century — Cost, quality & knowing what surgeons want

Written by Laura Dyrda | May 10, 2016 | Print  |

TranS1 continues to build around its core product, AxiaLIF, acquired from Baxano. The technology is designed for surgeons to perform L5-S1 spinal fusions without removing the facet joints and destabilizing the spine.

AxiaLIF technology approaches the spine through the pre-sacral space. Unlike the lateral approach, surgeons do not need to dissect the psoas muscle. It is also different from the transforaminal approach, as surgeons do not need to remove the facet joint during the approach and thereby risk lingering instability. Lastly, it also differs from the anterior approach (ALIF),as the surgeon does not need to filet open the abdomen.


"These other approaches to the spine cause serious damage to the tissues that surgeons are required to traverse to access the spine," says Jeffrey Schell, CEO of TranS1. "Our mission is to minimize the collateral damage that the approach causes. The AxiaLIF procedure minimizes the need to dissect through muscles with an incision approximately 2 cm long. The procedure can be performed on an outpatient basis and can avoid the major complications often associated with spine surgery, including nerve damage."


The most successful new technologies today provide better quality care than older devices, while also providing economic value to the healthcare system. TranS1 has conducted studies showing AxiaLIF's economic value; an article published in The Journal of Managed Care Medicine shows AxiaLIF could save $3,500 to $4,000 per case. There are thousands of L5-S1 spinal fusions performed every year, representing a dramatic cost savings opportunity.


The procedure cuts costs by shortening hospital stays and rehabilitation time, compared with other fusion procedures, so patients can return to their regular activities and spend less on postoperative care.


TranS1 is now working on technologies that would bring similar advantages to those offered by AxiaLIF at the L5-S1 to higher levels of the spine.


The company recently re-hired Brandon Arthurs, an engineer who was one of the key product developers on AxiaLIF, as well as other lateral and interbody approaches. In his new role, Mr. Arthurs will lead research and development for TranS1 to leverage his talent for innovation.


TranS1 also works closely with Rocky Mountain Patent, Mr. Schell's patent company, to protect innovations.


"Rocky Mountain Patent is one of the go-to law firms for start-ups," says Mr. Schell. "We aggressively file patent applications and cultivate intellectual property in a way that is cost-prohibitive to other companies."


And despite being a smaller company, TranS1 focuses on research and development to accomplish their mission around innovation. The company expects to launch its first new product this year, followed by multiple products over the next few years that will focus on new and innovative ways to access the spine.


"We believe in our capacity to develop new solutions to help patients thrive," says Mr. Schell. "You will start to see our new products coming out over the next few years, and we hope to have a robust portfolio to disrupt the spinal fusion industry."


The engineers partner with surgeons to develop new technologies and then train other surgeons in the new approach. The company arranges cadaver workshops to train surgeons on AxiaLIF around the country. Those surgeons also have input in advancing the system.


"Given that surgeons have the most experience with medical technologies and patients, surgeons are the best positioned individuals to actually lead innovation," says Mr. Schell. "We can sit in the board room with executives and engineers and come up with technologies, but without surgeon leadership in our research and development, we are just going to take a small step. I'm not interested in small steps; I'm interested in drastic improvement and disruption in the current market."


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