Has spine become a fashion industry?

Fact: The spine industry moves so fast that there is no time for clinical studies. Since there is no time for clinicals, there is no feedback loop for solid clinical outcomes. The way to sell more devices is to create new features or approaches.

This is understandable. Suppose a spine company performed a 5-year RCT (randomized control trial) for a specific IB fusion implant. Once the study was finally published maybe 7 years late, that specific implant is no longer commercially available. The market has moved on. Seven years later, surgeons are now interested in newer “shinny objects”.

In the fast-moving consumer fashion industry, this is a well-known cycle. The cycle lasts for a few months. There are four parts of the fashion cycle:

  • the Rise,
  • the Peak,
  • the Decline,
  • and the Abandonment.

In the spine device industry, there is also a known cycle. The cycle lasts for a few years. There are four parts of the spine feature cycle:

  • the Interest,
  • the Max Adoption,
  • the Loss of Interest,
  • and the Abandonment (moving on to something newer).

The new spine fashion could be a new material combo (eg: PEEK/Ti), a new coating (eg: nano Ti), a new surgical approach (eg: OLIF), a new MIS expandable cage, a new patient-specific 3D-printed cage, a new robot, and so on.

The reality is that there are over 300 spine device companies competing for a spine surgeon’s attention with new fashion features without any clinical data.

Take Home Message: The spine fashion cycle is just too fast to figure out which products have the better outcomes.

Do you agree ?