MagnetOs for predictable fusions

My name is Alpesh Patal. I’m the head of orthopedic spine surgery at Northwestern, and I’m fellowship-trained in both orthopedic spine surgery and neurosurgical spine surgery. My practice specializes in cervical spine surgery as well as minimally invasive spine surgery.

The most appealing part of MagnetOs is that it addresses a fundamental problem we face as spine surgeons, which is achieving a reliable and predictable fusion. It starts with solving that problem and delivers results. As spine surgeons, we are familiar with the relationship between the immune system and bone healing—this field is called osteoimmunology. MagnetOs takes the immune system and harnesses its power to promote bone healing. It does this through its unique submicron needle-like structure, which polarizes macrophages from the M1 phenotype to the M2 phenotype. It is the M2 macrophages that create an environment that promotes bone healing, reduces inflammation, and helps us achieve a more successful spinal fusion.

This unique aspect of MagnetOs is what sets it apart from other bone graft products. The catalyst for me adopting it in my practice was the results I saw in my patients. The great clinical outcomes and successful fusions, especially in complex and challenging fusion environments, convinced me that MagnetOs can deliver on its promise to promote bone healing and enhance spinal fusion.

I’d like to share a case with you. It involved a 60-year-old female who presented to our hospital after an injury with severe neck pain. She had an unstable C2 fracture involving the lateral masses and pedicles of C2, along with a fracture at C4. The pre-surgical imaging initially suggested an odontoid fracture but turned out to be a much more complex unstable C2 fracture, which was the primary cause of her severe neck pain.

The surgical plan for the patient was a posterior C1 to C4 instrumented fusion, reduction of her fracture, and posterior lateral bone grafting using local autograft bone and MagnetOs as a bone graft extender. Post-surgery, the x-rays showed excellent restoration of alignment, and I was very pleased with the positioning of the implants. More impressively, about eight months after the surgery, the CT scan revealed a robust amount of fusion in the posterior lateral space from C1 to C4. Despite being a challenging fusion environment, the fusion was strong and consistent across the entire area.

What’s most impressive is that the fusion we achieved with MagnetOs was not a spot fusion—it was robust and confluently formed along the entire posterior space from C1 to C4. This is a prime example of the benefits of using evidence and science to guide decisions about bone graft products.

Outside of my practice, we’re seeing the use of MagnetOs grow and spread. More and more surgeons are adopting the science that Kuros brings to the table, and the solution that MagnetOs offers is gaining traction in the spine community. I’m convinced that we’ll see better results for patients in terms of both clinical outcomes and more successful spinal fusions.

When I speak to fellow spine surgeons about MagnetOs, I emphasize its strong foundation in science. It accomplishes the goal of promoting bone healing and enhancing spinal fusion. Simply put, it works the way you want it to work. It works better than any other bone graft extenders that have come to market over the 15 years of my career. I’m very pleased with the results.

My name is Cornelis Polstra, and I work at the Nevada Spine Clinic and within the Nevada Spine Clinic, at the Robotic Spine Institute of Las Vegas. I am an orthopedic and neurological spine surgeon.

I was introduced to Curos probably around 2015, and the reason I was very interested in it is because it provided a well-tested and safe material that underwent advanced surface modification, giving it a needle grip texture. This modification allows the material to attract monocytes from the bloodstream and decorticated bone near the fusion site, which eventually become bone-making cells. The ability to mix this material with my local autograft and amplify its bone-forming ability seemed like a no-brainer, so I was very impressed with it.

Since then, the development of Curos has only gone further. All these white powders often look the same when they come into the operating room—just a white granular material—but you can’t see what happens at the microscopic level on the surface. What Curos has done is create a surface modification that forms this needle grip structure, which attracts the right kind of cells to the bone-making area. These cells are then turned into pro-healing M2 macrophages, and this process eventually initiates substantial bone formation from the osteoprogenitor cells in the area. This ultimately stabilizes the patient and results in clinically high fusion rates, delivering greater success for my patients.

We conducted a prospective data collection that we later retrospectively analyzed, focusing on both the cervical and lumbar spine. I treated a wide variety of patients in my practice, including those with challenging comorbidities, such as obese patients, multi-level revision surgeries, those who had not healed before and had pseudoarthroses, and long-term smokers. Together with my colleagues, we now have the ability to perform clinical studies to demonstrate where the rubber meets the road, showing that this product is far superior to what we used to use.

I believe that Curos has a tremendous opportunity to expand its presence in the U.S. with the future development of this product, as it is strong and well-backed by science. Based on that, I have great hope for their growth, and I look forward to seeing where they go and what new products will be developed for my patients.

I like to practice evidence-based medicine, so every step of the way, I make sure there is strong evidence for what we are doing and what we’re applying to my patients. I now feel confident that I no longer see the inflammatory side effects we used to associate with BMPs, while still benefiting from the tremendous efficacy of this product.

When we begin using a new bone graft material, we need substantial data. In my case, when I was introduced to it, I first looked at the basic science data—specifically, what was happening at the surface with the needle grip surface modification and whether it was really having an effect on a cellular level. Once that data showed clear benefits, we moved to animal data, then large animal data, and eventually human data. But to gather human data, we also need to contribute to it, which is why I was excited to perform my own prospective data collection on my patients and report the great outcomes we saw with MagnetOs.

While I can’t quote the exact number of patients I’ve treated with MagnetOs, it’s well over a thousand at this point. It has become a well-proven bone graft extender, and I think there is tremendous history already behind it, with ongoing success. It’s my number one bone graft extender for everything I do, with great clinical outcomes, positive patient-reported data, and excellent post-operative imaging studies.

My name is Andrew Sama, and I practice at the Hospital for Special Surgery in New York City. I’m a spine surgeon and the co-chief of the spine service at the hospital.

When I met the team at Curos, I was impressed by their scientific knowledge and the application of that science to the technology they create. When I met with them, it felt more like a scientific discussion or an academic conversation rather than a sales pitch. I was impressed by their ability to be a science-based company rather than a sales-based company. They have created products like Magnetos that are fundamentally sound and can be applied by any surgeon for any patient with good outcomes.

I’m looking for a bone graft that’s commercially available, with good handling properties and characteristics that work to achieve fusion. The great features of Magnetos are that it maintains the shape that you mold it to. When you place it into the fusion gutter, it prevents soft tissue from falling into that gutter and allows good, hard trabecular bone to form as part of your fusion mass. That’s a predictable event.

One of the cases where I used Magnetos was for a 62-year-old male patient with a history of Parkinson’s disease. He had severe back pain and neurogenic claudication, which is difficulty walking due to pressure on the nerves in the back. He had failed to improve despite physical therapy, modifications to his activities, and some injections into his back that provided temporary relief. He was still debilitated by his condition, so I felt he would benefit from surgery to decompress the nerves, realign his spine, and stabilize it. This is where Magnetos is of paramount importance. We mixed the Magnetos with his own bone that we removed during the decompression, placed it as a substrate, and his body produced bone that grew, matured, and stabilized the segment forever.

We have anterior, posterior, and lateral projections of the patient’s lumbar x-ray. It shows a grade 1 degenerative spondylolisthesis of L4 and L5. On bending films in flexion and extension, there is minimal reduction when the patient extends his spine, demonstrating some segmental instability. The CT scan confirms this instability as the patient’s spondylolisthesis reduces somewhat in the supine position. The degenerative nature of his facet joints is also visible on the axial cuts. His MRI scan reveals the spondylolisthesis and, as a consequence of facet hypertrophy and ligamentum hypertrophy, he has subarticular lateral recess stenosis.

During the operation, I focused on decompressing his nerves, accessing the disc space to restore the lost height, and reducing the spondylolisthesis. We placed pedicle screws with rods and mixed the bone graft created during his laminectomy with Magnetos. This was packed into the inner transverse process gutters and in space, allowing for the fusion mass to occur. The post-operative x-rays, taken one year later, show an excellent fusion mass in the inner transverse process gutters bilaterally. He has maintained his reduction of the spondylolisthesis and preserved the disk space height with no significant subsidence.

Fibrin PTH is one of the most exciting aspects of Curos that drew me to the company. I was fascinated by the concept of using parathyroid hormone, which we’ve used at our institution for patients with osteoporosis for over 20 years, to locally fortify bone by mixing it with fibrin and placing that in the fusion bed.

I would tell my colleagues that Curos is a company founded on strong scientific principles, with a team of scientists and leaders who genuinely have the patient’s best interest at heart. I believe their products, such as Magnetos, are reproducibly successful in achieving bone fusions in spine surgery.

I’m Faheem Sandhu, a professor of neurosurgery and the director of neurosurgery at MedStar Georgetown University Hospital. My practice focuses on adult degenerative conditions of the spine, and I specialize in minimally invasive procedures to treat these disorders of the spine.

I’m looking for a material that doesn’t have a lot of side effects, provides maximal fusion, and is reliable and reproducible every time I use it. I’m someone who really needs to see the basic science before I switch to a new product. When I saw the preclinical data and animal studies on Curos, it was very compelling. The Magnetos fusion was identical to the autograft bone fusion site. There was solid bone formation and robust bone formation on both sides, and they were almost indistinguishable. Seeing is believing when it comes to fusion, and the project fusion is a comprehensive look at all the evidence supporting Magnetos’ use in clinical settings. There are a number of prospective level 1 studies being conducted, comparing Magnetos to autograft bone, which is the gold standard.

I started using Magnetos about three years ago, and I’ve been very pleased with the results. The results have matched what I saw in the preclinical studies. I’ve seen excellent fusion results, and I have a number of patients who are now more than a year out from long fusion constructs. Their CT scans show excellent fusion throughout the construct.

I had one particular case that was very challenging. It was a lady with a hemi-vertebrae who had a tethered cord-type presentation due to the deformity in her spine. I performed a thoracolumbar fusion on her, and her bony anatomy was a little altered due to this congenital defect. Having a reliable fusion was something I was concerned about. The surgery went fine, but about six weeks later, she developed a seroma at the site of the surgery, which is a fluid collection. We saw it on the CT scan, but there were no signs of infection. She was experiencing a lot of discomfort due to muscle stretching, so I took her back to the operating room to wash out the seroma, which turned out to be sterile. At the time, I was able to inspect the fusion mass, and I was expecting to reinforce it, but even at six weeks, the Magnetos material had solidified. It was literally rock hard, and I couldn’t chip away at it. It was reassuring to see that so early after surgery.

I recommend Magnetos to my colleagues because I’ve found it to be extremely reliable and reproducible. I’ve shown them pictures and discussed cases that demonstrate the fusion in various settings. The response I’ve received from my colleagues has been very positive, and most of them are very intrigued. I usually get a response like, “Wow, that’s pretty impressive fusion, especially based on the time frame and the setting of the fusion.”

My name is Richard Todd Allen, and I’m a board-certified orthopedic surgeon working at UC San Diego Health. I’ve been in practice for about 13 and a half years, following my fellowship. My expertise or specialization is in reconstructive procedures for adult deformities, scoliosis, tumors, and I also do a lot of upper cervical spine and cervical thoracic deformity procedures, both open and minimally invasive.

One feature that stood out to me when looking at the ovine study and then seeing the transition in my practice with the use of Magnetos is its surface architecture. The needle grip surface and the biologically active implants with altered surface features create a bone response that improves fusion outcomes compared to prior implants. These implants are placed under compression, and I found that the ovine model gave me more confidence, even in a very challenging biological environment like the inter-transverse space, where I could use Magnetos in my most difficult patients.

The hope is that the higher-level studies, like Project Fusion, which Magnetos is currently conducting, will show predictable, reliable fusion outcomes when compared to current bone grafts, which have limited data, particularly in the academic patient. These patients often have very limited soft tissue envelopes, prior infections in their spine, and challenging environments. Having that predictability is what I’m hoping to see more of in the future with Magnetos.

I’ve actually seen this clinically with my patients, especially those undergoing revisions or with proximal junctional kyphosis. I’ve noticed a level of durability and reliable predictability in my fusion environment. When I correlate what I see intraoperatively with the CT scans, I’ve been very impressed by the bone formation. In fact, in one recent case, I used Magnetos in a space at about eight months post-op. The CT scan revealed a robust fusion in a proximal junctional failure case. I could clearly see where I placed the Magnetos, and the granules had evolved into a solid fusion. The strength and durability of the fusion were impressive.

The fusion bed, the vascularity, the soft tissue envelope, and the limited bone available for fusion all make these environments difficult to work with. Having a graft that generates a reliable biological response and gives me predictability is essential. I appreciate Magnetos’ history with surface architecture modifications, which help generate that biological response. The ability to produce a strong tissue response is exactly what I look for in a graft.

Those features make Magnetos a viable alternative to consider in practices where you need that type of graft.

My name is Stuart Tucker, and I’m a consultant spinal surgeon. I work principally at Greater Street Children’s Hospital in London, where I’ve been working for just over 12 years and have been a consultant for 21 years.

The principal challenge at Great Ormond Street Hospital is dealing with children who have significant comorbidities. These are often children with quite serious illnesses who face a host of medical problems. In pediatric surgery, the primary goal is to achieve a fusion, but this must be done over multiple levels, which is why we require a bone graft substitute. While adherence to a particular surgical technique is essential for a good outcome, the impact of different bone grafts cannot be underestimated. It’s vital for a surgeon to critically analyze the graft they are using to ensure the best surgical results.

In pediatric skeletal patients, I use a combination of bone dust generated with a high-speed burr mixed with Magnetos. I see no indication to take additional bone from areas like the spinous processes because this tends to result in an ugly, widened scar and doesn’t provide a good bed for muscle attachment. One theoretical advantage of using a highly porous graft, like Magnetos, is the absorption of the hematoma that forms as part of the fusion bed. This reduces the risk of having a wet wound and, subsequently, lowers the risk of infection.

In scoliosis surgery, we need to achieve multi-level fusion, and we want to do that using a product that is safe with respect to human disease transmission. As a team, we decided to switch to Magnetos, and this decision was based on clinical research and the belief that it would yield the best possible results for our patients.

I would strongly recommend Magnetos to surgeons elsewhere, based on its effectiveness and safety.