The future of spinal surgery is biologics. Fusions, screws will soon be considered dark ages techniques. Dr Gary Michelson

As I have back issues I do a lot of research about new treatments. Within the next few years fusion surgery, screws, plates, cages will be a thing of the past. We already have implantable discs which mimic an actual disc's cushion and ability to move. Enter Dr Kevin Pauza.

http://www.pennstatehershey.org/web/alumni/pauza

Dr. Kevin Pauza has patented a bio gel which can be injected into the herniated, ruptured disc. No need to add plates, screws in long expensive surgeries any more. This can be done with outpatients in about five minutes and costs 95% less. Soon screws, cages, plates and bolts will be considered Frankenstein medicine.

Spinal fusion causes the person to lose mobility in the fused area. This ends up putting more pressure on the local non-fused vertebrae which can cause more damage that would necessitate more fusion surgery. The bio gel is made up of human material. It's injected into the disc to restore it to its original size. They can basically plump the discs back up to the size when you were a teenager. Currently this product and technique is going through FDA appraisal.

I predict companies like Medtronic will either fight against this product or buy the patents. Medtronic would buy the patents to either use them or not allow others to use them. There is money to be made in titanium screws but not so much in injectable bio gels.

From the article above, ""I never use an alarm clock, and I work seven days a week," says Kevin Pauza, M.D., '90, an Interventional Spine specialist and researcher who focuses on the diagnosis and non-surgical treatment of back and neck pain. "It doesn't feel like work when you love what you do."

An ardent advocate of minimally-invasive techniques, Pauza has developed a series of eight patents for a device and biologic that instigates healing and regrowth of degenerated tissue.

"I say do your own thing as long as you're happy and helping others," he says simply."

Imagine a doctor who wants to not just make spine surgery better but also cheaper. Dr Gary Michelson has had the opposite goal. His goal is to make spine surgery more expensive so he can make money.

Here are his patents.

	PAT. NO.		Title
1	8,419,722		Apparatus and method for injection of fibrin sealant in spinal applications
2	8,403,923		Injection of fibrin sealant in the absence of corticosteroids in spinal applications
3	8,403,895		Injection of fibrin sealant including an anesthetic in spinal applications
4	8,394,072		Injection of fibrin sealant including an anesthetic in spinal applications
5	8,206,448		Injection of fibrin sealant using reconstituted components in spinal applications
6	7,597,687		Injection of fibrin sealant including an anesthetic in spinal applications

Seems the series III trials of the fibrin sealant were not more effective than injecting saline solutions. What's interesting is that injecting saline solution into the disc actually helped quite a bit. I would think over time the saline solution would leave the disc area.

There have also been some advances in artificial discs which allow movement.

http://eastbayspine.com/disc-replacement-lumbar-procedures-spine-surgery-east-bay-area.html

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