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GLG News by Surgeons who Perform Spinal Fusions

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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 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...
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...
February 11, 2008
This acqusition, and others, represent a significant upgrade of Alphatec's portfolio
Analysis of: Alphatec Holdings, Inc. Acquires An Exclusive Worldwide License for Innovative Dynamic Anterior Cervical Plate Technology | www.healthpointcapital.com
Author: Wayel Kaakaji, Chief Executive Officer and Medical Director, Spinal and Neurosurgical Institute
Alphatec product line will expand and increase their market share The cervical plate from Progressive is much more promising than the Trestle plate developed by Alphatec, and should increase sales and improve the cervical implant portfolio
December 26, 2007
Medtronic loses litigation to DePuy over polyaxial Vertex screws, what is the significance?
Analysis of: U.S. Federal Court Issues Permanent Injunction Against Medtronic's Vertex And Vertex Max Screws | www.medicalnewstoday.com
Author: Wayel Kaakaji, Chief Executive Officer and Medical Director, Spinal and Neurosurgical Institute
the use of Vertex polyaxial screws is only a minor part of the spinal implant protfolio at Medtronic (MDT:NYSE).  This should not affect the bottom line to any significant extent.
October 19, 2007
New medicare regulations might result in better care, but at what cost?
Analysis of: Nonpayment for Performance? Medicare's New Reimbursement Rule | content.nejm.org
Author: Wayel Kaakaji, Chief Executive Officer and Medical Director, Spinal and Neurosurgical Institute
-The new regulations will probably result in quality improvement in the selected targeted areas -It is unclear whether the cost of implementation and monitoring will offset the savings to the medicare system -Medicare will likely introduce further quality measures to fall under similar payment cuts. ...
October 15, 2007
For persistent back pain treatment, call a specialist
Analysis of: Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society | www.annals.org
Author: Wayel Kaakaji, Chief Executive Officer and Medical Director, Spinal and Neurosurgical Institute
If back pain persists, the patient should be referred to a specialist so further diagnosis and workup can be undertaken.  Patients with back pain are treated with a variety of interventions and medications in the hope that they will return to their normal activities.  Too often, the initial...

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