Spine Products in Use Both Outside and Inside the United States

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Handbook of Spine Technology

Abstract

The spine product market in the United States and that of the rest of the world shares many similarities but also has significant differences. The FDA approval process of medical devices in the United States has a more stringent, often inconsistent, and prolonged pathway to final approval than when compared to the CE marking process in Europe. In fact, a large number of spinal implants have not yet been either approved or used as widely in the United States as compared to the rest of the world. There are three main spine product categories, namely lumbar artificial discs, interspinous spacers, and dynamic stabilization systems that can be identified as “new” and not as widely used in US markets. After analyzing why some of the products in these categories failed the FDA approval process, we present other unique spine products widely used in European and other international markets but not so commonly seen in US markets.

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References

  • Ament JD, Mollan S, Greenan K, Binyamin T, Kim KD (2017) Understanding United States investigational device exemption studies-clinical relevance and importance for healthcare economics. Neurosurgery 80(6):840–846

    Article  Google Scholar 

  • Bisschop A, Van Tulder MW (2016) Market approval processes for new types of spinal devices: challenges and recommendations for improvement. Eur Spine J 25(9):2993–3003

    Article  Google Scholar 

  • Crawford RJ et al (2013) A prospective study of patient-reported outcomes for two years after lumbar surgery augmented with DIAM® Interspinous Implant. J Musculoskelet Res 15(3):2-222 to 29-235

    Google Scholar 

  • DIAM™ Spinal Stabilization System Surgical Technique (2019) [ebook]. Medtronic, Memphis, p 12. http://www.arcos.com.uy/pdf/productos/194/437_953_diamst.pdf. Accessed 25 Mar 2019

  • Dynesys Dynamic Stabilization System (2015) [ebook]. Zimmer Biomet, Minneapolis, p 22. https://www.zimmerbiomet.com/content/dam/zimmer-biomet/medical-professionals/000-surgical-techniques/spine/dynesys-lis-less-invasive-surgery-surgical-technique.pdf. Accessed 25 Mar 2019

  • Food and Drug Administration (2012a) SUPERION® INTERSPINOUS SPACER. [cited June 12, 2018]. https://www.accessdata.fda.gov/cdrh_docs/pdf14/P140004D.pdf

  • Food and Drug Administration (2012b) Instructions for use: coflex® Interlaminar Technology. [cited June 12, 2018]. https://www.accessdata.fda.gov/cdrh_docs/pdf11/P110008C.pdf

  • Food and Drug Administration (2012c) Premarket approval application: coflex® Interlaminar Technology (P110008). [cited June 10, 2018]. https://www.accessdata.fda.gov/cdrh_docs/pdf11/P110008a.pdf

  • Formica M, Divano S, Cavagnaro L et al (2017) Lumbar total disc arthroplasty: outdated surgery or here to stay procedure? A systematic review of current literature. J Orthop Traumatol 18(3):197–215

    Article  Google Scholar 

  • French-Mowat E, Burnett J (2012) How are medical devices regulated in the European Union? J R Soc Med 105(Suppl 1):S22–S28

    Article  Google Scholar 

  • Gazzeri R, Galarza M, Alfieri A (2014) Controversies about interspinous process devices in the treatment of degenerative lumbar spine diseases: past, present, and future. Biomed Res Int 2014:975052

    Article  Google Scholar 

  • Gomleksiz C, Sasani M, Oktenoglu T, Ozer AF (2012) A short history of posterior dynamic stabilization. Adv Orthop 2012:629698

    Article  Google Scholar 

  • Hahn BS, Ji GY, Moon B et al (2014) Use of annular closure device (Barricaid®) for preventing lumbar disc reherniation: one-year results of three cases. Korean J Neurotrauma 10(2):119–122

    Article  Google Scholar 

  • Heneghan C, Thompson M (2012) Rethinking medical device regulation. J R Soc Med 105(5):186–188

    Article  Google Scholar 

  • Hrabálek L, Machác J, Vaverka M (2009) The DIAM spinal stabilisation system to treat degenerative disease of the lumbosacral spine. Acta Chir Orthop Traumatol Cech 76(5):417–423

    PubMed  Google Scholar 

  • Klassen PD, Bernstein DT, Köhler HP et al (2017) Bone-anchored annular closure following lumbar discectomy reduces risk of complications and reoperations within 90 days of discharge. J Pain Res 10:2047–2055

    Article  Google Scholar 

  • Ko CC, Tsai HW, Huang WC et al (2010) Screw loosening in the Dynesys stabilization system: radiographic evidence and effect on outcomes. Neurosurg Focus 28:E10

    Article  Google Scholar 

  • Kramer DB, Xu S, Kesselheim AS (2012) How does medical device regulation perform in the United States and the European union? A systematic review. PLoS Med 9(7):e1001276

    Article  Google Scholar 

  • Lampert FM, Schwarz M, Grabin S, Stark GB (2012) The “PIP scandal” – complications in breast implants of inferior quality: state of knowledge, official recommendations and case report. Geburtshilfe Frauenheilkd 72(3):243–246

    Article  CAS  Google Scholar 

  • Landi A (2014) Interspinous posterior devices: what is the real surgical indication? World J Clin Cases 2(9):402–408

    Article  Google Scholar 

  • Lauer M, Barker JP, Solano M, Dubin J (2017) FDA device regulation. Mo Med 114(4):283–288

    PubMed  PubMed Central  Google Scholar 

  • Ledic D, Vukas D, Grahovac G, Barth M, Bouma GJ, Vilendecic M (2015) Effect of anular closure on disk height maintenance and reoperated recurrent herniation following lumbar discectomy: two-year data. J Neurol Surg A 76(3):211–218. https://doi.org/10.1055/s-0034-1393930

    Article  Google Scholar 

  • Lee SH, Seol A, Cho TY, Kim SY, Kim DJ, Lim HM (2015) A systematic review of interspinous dynamic stabilization. Clin Orthop Surg 7(3):323–329

    Article  Google Scholar 

  • Mishra S (2017) FDA, CE mark or something else?-Thinking fast and slow. Indian Heart J 69(1):1–5

    Article  Google Scholar 

  • Parker SL, Grahovac G, Vukas D et al (2016) Effect of an annular closure device (Barricaid) on same-level recurrent disk herniation and disk height loss after primary lumbar discectomy: two-year results of a multicenter prospective cohort study. Clin Spine Surg 29(10):454–460

    Article  Google Scholar 

  • Phillips FM, Voronov LI, Gaitanis IN, Carandang G, Havey RM, Patwardhan AG (2006) Biomechanics of posterior dynamic stabilizing device (DIAM) after facetectomy and discectomy. Spine J 6(6):714–722

    Article  Google Scholar 

  • Pintauro M, Duffy A, Vahedi P, Rymarczuk G, Heller J (2017) Interspinous implants: are the new implants better than the last generation? A review. Curr Rev Musculoskelet Med 10(2):189–198

    Article  Google Scholar 

  • Raciborski F, Gasik R, Kłak A (2016) Disorders of the spine. A major health and social problem. Reumatologia 54(4):196–200

    Article  Google Scholar 

  • Rome BN, Kramer DB, Kesselheim AS (2014) Approval of high-risk medical devices in the US: implications for clinical cardiology. Curr Cardiol Rep 16(6):489

    Article  Google Scholar 

  • Sastry A (2014) Overview of the US FDA medical device approval process. Curr Cardiol Rep 16(6):494

    Article  Google Scholar 

  • Sorenson C, Drummond M (2014) Improving medical device regulation: the United States and Europe in perspective. Milbank Q 92(1):114–150

    Article  Google Scholar 

  • Tyagi V, Strom R, Tanweer O, Frempong-boadu AK (2018) Posterior dynamic stabilization of the lumbar spine review of biomechanical and clinical studies. Bull Hosp Jt Dis (2013) 76(2):100–104

    Google Scholar 

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Correspondence to Tejas Karnati .

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Karnati, T., Kim, K.D., Ebinu, J.O. (2020). Spine Products in Use Both Outside and Inside the United States. In: Cheng, B. (eds) Handbook of Spine Technology. Springer, Cham. https://doi.org/10.1007/978-3-319-33037-2_54-1

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  • DOI: https://doi.org/10.1007/978-3-319-33037-2_54-1

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  • Print ISBN: 978-3-319-33037-2

  • Online ISBN: 978-3-319-33037-2

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