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GLG News by Orthopedic Surgeons (US)

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December 1, 2008
Sales of Infuse product will likely decline with closer scrutiny of off-label use
Analysis of: Medtronic Says Device for Spine Faces Probe | online.wsj.com
Author: Wayel Kaakaji, Chief Executive Officer and Medical Director, Spinal and Neurosurgical Institute
Medtronic might see a significant drop in its sales as a result of closer scrutiny of off-label use of its products.  Infuse has been a cash cow for Medtronic, and if sales drop, it will reflect deeply in the sales numbers.
December 1, 2008
Accuray Cyberknife Sales About to Go Through The Roof
Analysis of: Experts Debate CyberKnife for Prostate Cancer | www.washingtonpost.com
Author: Wayel Kaakaji, Chief Executive Officer and Medical Director, Spinal and Neurosurgical Institute
Prostate cancer can be treated by Cyberknife, and the numbers of patients treated and the number of units sold by Accuray (ARAY:NASDAQ) will very likely increase dramatically over the next 5-10 years. 
October 13, 2008
Joint replacement surgery is a trade not a visit to the fountain of youth
Analysis of: Unclear how much pounding new hips, knees can take | news.yahoo.com
Author: GLG Expert Contributor
Patients, especially so called "boomers" can have unrealistic expectations of appropriate activity levels after joint replacement surgery. Like an mecahnical sytem they are subject to fatigue which could lead to early failure. It is up to surgeons to set realistic expectaions for patients, al;though...
October 10, 2008
Mixed Blessings for Medtronic in Professional Spinal Surgery Organizations
Analysis of: Letter to CMS from a Coalition of Spine Care Professional Societies | www.spine.org
Author: Wayel Kaakaji, Chief Executive Officer and Medical Director, Spinal and Neurosurgical Institute
The data presented by multiple professional societies does not lend clinical support of many Medtronic products in the Medicare population.  The data does not support the use of disc arthroplasty in the Medicare population, and does not find any clinical advantage of kyphoplasty over vertebroplasty. ...
October 9, 2008
New electrode may expand the capabilities of the Advance System from Neurometrix
Analysis of: NeuroMetrix Receives FDA 510(k) Clearance For UNIVERSAL(TM) Electrodes Used In The Performance Of Nerve Conduction Studies | www.medicalnewstoday.com
Author: Wayel Kaakaji, Chief Executive Officer and Medical Director, Spinal and Neurosurgical Institute
New electrode will increase the capabilities of the Advance device from Neurometrix, potentially leading to more sales of the disposable electrodes The increased capabilities may also increase the number of practicioners interested in the Advance system, generating more sales for the company
September 25, 2008
Proton beam therapy has no proven advantage
Analysis of: Proton Radiotherapy: A Review | www.nytimes.com
Author: Wayel Kaakaji, Chief Executive Officer and Medical Director, Spinal and Neurosurgical Institute
The cost of proton beam installations is massive, and is not justified in light of available litterature regarding the superiority of this therapy. There are only a handful of tumors, such as chordoma, where the proton beam therapy is recommended over other types of radiation.  The higher compensation...
Giles ScuderiAugust 6, 2008
There is a need for a total joint registry in the United States
Analysis of: New York Times July 29, 2008 A call for warning system on artificial joints | www.nytimes.com
Author: Giles Scuderi, Director, Orthopedic Surgeon, Insall Scott Kelly Institute
The AAOS has established the need for a total joint registry however there are financial and legal hurdles that must be overcome. The value of total joint registries have been realized in Europe and Australia with a significant reduction in the revision rate of implants. A joint registry can provide...
July 2, 2008
Anesthetic factors that modulate postoperative pain
Analysis of: Why anaesthetics can make the pain worse | www.newscientist.com
Author: GLG Expert Contributor
1/ Genetic factors. Data indicate that genetic factors modulate the anesthetic requirement to control pain duirng and after surgery 2/ Gender sensitivity to anesthetics 3/ Anesthesia or lack of it  may lead to increase postoperative pain 4/ lack of proper perioperative monitoring of pain 5/ lack...
June 30, 2008
Overmedication, and underdiagnosis, are commonplace in the dementia patient
Analysis of: Doctors Say Medication Is Overused in Dementia | www.nytimes.com
Author: Wayel Kaakaji, Chief Executive Officer and Medical Director, Spinal and Neurosurgical Institute
Aricept, Namenda, Risperdal are grossly overused in the treatment of patients with suspected dementia Many patients with dementia have not received proper diagnosis, and do not receive proper treatment Better public and medical education will hopefully reverse this glaring deficit in our medical sy...
May 27, 2008
Squeaking hips show risk of early adopting
Analysis of: That Must Be Bob. I Hear His New Hip Squeaking | www.nytimes.com
Author: GLG Expert Contributor
The implant market is very competitive with surgeons being aggresive as early adopters to try to get a competitive edge and market themselves as using state of the art implants. This is pushed by the implant makers and often offer cooperative advertising....

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