Bisschop Arno, van Tulder Maurits W
Department of Orthopedic Surgery, VU University Medical Center, Amsterdam, The Netherlands.
Department of Health Sciences, Faculty of Earth and Life Sciences, VU University, De Boelelaan 1085, 1081 HV, Amsterdam, The Netherlands.
Eur Spine J. 2016 Sep;25(9):2993-3003. doi: 10.1007/s00586-016-4606-1. Epub 2016 May 27.
Spinal pathology and related symptoms are among the most common health problems and are associated with high health care costs and productivity losses. Due to the aging population, these costs are further increasing every year. Another important reason for the increasing costs is the market approval of new technologies, such as spinal devices that are usually more expensive than the existing technologies. Previous cases of medical device failure led to concern about possible deficiencies in the market approval process.
The objective is to provide an overview of U.S. Food and Drug Administration (FDA) regulation regarding spinal implants to delineate the challenges and opportunities that spine surgery currently faces.
In this paper, two cases of market entries of spinal devices are presented and evaluated to illustrate these deficiencies.
Spinal implant regulation is facing several challenges. New spinal devices should increase patient outcomes and safety at reasonable societal costs. The main challenge is to have a rigorous evaluation before dissemination, while still leaving room for innovative behavior that thrusts the healthcare practice forward.
We have provided recommendations to enhance spinal implant regulation and improve and ensure the patient's safety and the future of spine surgery.
脊柱疾病及相关症状是最常见的健康问题之一,与高昂的医疗费用和生产力损失相关。由于人口老龄化,这些费用每年都在进一步增加。成本上升的另一个重要原因是新技术的市场获批,例如通常比现有技术更昂贵的脊柱器械。先前的医疗器械故障案例引发了对市场审批过程中可能存在缺陷的担忧。
目的是概述美国食品药品监督管理局(FDA)对脊柱植入物的监管,以阐明脊柱外科目前面临的挑战和机遇。
本文介绍并评估了两例脊柱器械进入市场的案例,以说明这些缺陷。
脊柱植入物监管面临若干挑战。新型脊柱器械应以合理的社会成本提高患者疗效和安全性。主要挑战在于在推广之前进行严格评估,同时仍要为推动医疗实践进步的创新行为留出空间。
我们提出了加强脊柱植入物监管、改善并确保患者安全以及脊柱外科未来发展的建议。