Three spine surgeons from across the U.S. discuss where they see the biggest opportunities in spinal biologics and disc generation.
Question: Where are stem cells and biologics headed in the spine field?
D. Greg Anderson, MD. Rothman Institute (Philadelphia): Selective use of bone morphogenetic protein-2 continues to be seen in the market, although the amount of off-label usage has fallen. Cell-based products seem to enjoy pockets of popularity. A wide array of less-expensive, lower efficacy products continue to be used with limited clinical data to support their usage. Companies will likely have to provide stronger supportive data to support biologic products in the future in order to gain reimbursement acceptance.
Scott Blumenthal, MD. Texas Back Institute (Plano): Mesoblast just completed enrollment for its study, which was truly blinded; the physicians administering the injections didn't know who got the Mesoblast and who didn't. That will be really interesting to see. We are six months away from that data. There is another company in San Diego, Vivex, which has started a clinical trial with allograft material. They are another company to keep an eye on; we've met with dozens of these companies and Vivex is the first one that said they would put money into a study of their products.
William Tally, MD. Athens (Ga.) Orthopedic Clinic: More companies are starting to include some form of a cellular component with their products. We started three years ago with a bone graft material that had a cellular component and were one of two in the market. Now there are more, and I think there will be more studies on the regenerative use of stem cells. Clinically, they aren't really viable yet, but there will be more studies on disc regeneration.