What's your favorite BVNA system?
Started by drusso
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I haven’t done mdt yet but I have used kyphoflex which is the same osteotome. It is pretty great. I think MDT will win the tech race. Stryker is fine but comparatively flimsy compared to Boston. They are going to have to compete on price. Boston will remain the market leader for a long time as they have continued to improve the tools and their PA portal is the best.
Used them all a bit. Boston has the best data/support, Stryker is the fastest overall procedure time IMO and a system that's easy for folks that use them for kypho, MDT has the fastest burn time and most flexible for complex cases
Costs and comfort/support will likely drive market share
Costs and comfort/support will likely drive market share
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MDT is pushing hard for us to use their system since we have a rebate on all MDT stuff at our facility. Not that it helps me. Not really looking to switch from Boston after so many cases without an issue
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I just played with the MDT system yesterday. I liked it. Very straightforward. That said, I'm really only doing these as a loss leader since I don't have any ASC ownership and you can't do them in office and Medicare reimbursement pro fees are less than 400 bucks a case so it's a massive money loser for me.
Yep. I do >90% procedures in office. I cap at 2/mo for bvna for this exact reason.
I have used the mdt osteotome extensively on kypho and like it a lot (fyi it’s same exact piece as merit powercurve). Very robust tool that reliably turns medial. My only concerns are with very hard bone. It can sometimes be difficult to remove osteotome and steer up/down in very hard bone. Similar with Stryker, it was “fine” on average bone, not strong enough for very hard bone. I also have concerns re lack of straight stylet to extend channel with both systems on S1 and some wide L5 vert bodies.
Minus asc overhead?
I am not sure how much longer I will offer Intracept. They take forever to do, and TBH I just really don't like the procedure. It is boring and that time is far better for me stacking NPV/RFA/ESI. An hour in the clinic with say 5 patients that need procedures looks like two epidurals, two sets of MBB (4 total, likely 2 RFA) and an US guided GTB CSI. Maybe two to three of those patients needs medications. One or both RFA patients will need a repeat or two in the next year. Maybe 3 of those 5 are NPV. Come on man...
The referral line keeps moving and the wait time to get in stays short. Referral sources stay happy...
The referral line keeps moving and the wait time to get in stays short. Referral sources stay happy...
That does not include staffing costs etc, just reimbursement minus kit
Right, pretty terrible for the time it takes
send them to me. n=3. I am still in the honeymoon phase.
Yes, go for it. That is enough to make a difference. I think our reps are all conspiring to hold $6000. I tell them all the first to go to $4000 wins. They act like they don’t hear me. 😂
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Time will tell if Medtronic's system has the strength to easily navigate through hard bone. I have gotten into BLACK vertebral bodies with Intracept.
I have used the instruments from all 3 essentially.
I have used Intracept for BVNA and it basically does what I need it to do and I really don’t have major complaints.
I have used the Medtronic articulating osteotome for kyphoplasty and it is a quite robust system that I feel will be capable of use in hard bone.
I have used the Stryker curved kyphoplasty system and I found it somewhat flimsy and I did not like it. From what I understand, their BVNA system uses the same instrument for access. I can’t imagine it would be as capable as the other two systems.
I have used Intracept for BVNA and it basically does what I need it to do and I really don’t have major complaints.
I have used the Medtronic articulating osteotome for kyphoplasty and it is a quite robust system that I feel will be capable of use in hard bone.
I have used the Stryker curved kyphoplasty system and I found it somewhat flimsy and I did not like it. From what I understand, their BVNA system uses the same instrument for access. I can’t imagine it would be as capable as the other two systems.
Reviewing the pathophysiology of Modic type disc degeneration, it’s not hard to believe this could work. That looks like a lot of procedural work though. Not something most of us are going to have anywhere near enough regen volume to do it efficiently enough to pencil out.
It’s like PRP for facet OA. Fine for young people. Old patients on Medicare will want free RFA.
Plus frankly I doubt all the bmac approach will ever work better than intracept.
Completely understand that perspective.
physicians can’t be completely selfless but when treating patients, my creed is to always try to do what I want someone to do for my mom.
If not financially feasible for me, I refer patients who are good intracept patients either to a hospital employed doc paid via RVU, or to the closest pain fellowship training facility.
Keep at it Steve. For a salaried doc, intracept is a wonderful clinical tool.
I’ve gotten more hugs after intracept than any other procedure besides kypho.
