Latest / Becker’s Healthcare Podcast / Advancing Cervical Spine Care and Neuroprosthetics with Rory KJ Murphy, MD

Transcript

Advancing Cervical Spine Care and Neuroprosthetics with Rory KJ Murphy, MD · Becker’s Healthcare Podcast

• 0:02
  This is where health care leadership comes together.
• 0:04
  Becker's sixteenth annual meeting brings more than 3,500
• 0:07
  hospital and health system executives and nearly 800
• 0:10
  speakers to Chicago, April.
• 0:14
  This series event includes keynote conversations with Dallas
• 0:17
  Cowboys legend Troy Aikman and former president George
• 0:20
  w Bush. For the agenda and event details,
• 0:23
  visit beckershospitalreview.com
• 0:25
  and click on the events tab in the
• 0:26
  upper right. We're looking forward to hosting you
• 0:29
  in Chicago.
• 0:31
  This is Carly Beam with the Becker Spine
• 0:34
  and Orthopedics podcast, and I'm thrilled to be
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  joined today by doctor Rory Murphy, a spine
• 0:38
  surgeon with Barrow Neurological Institute.
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  Doctor Murphy, thank you for being here today.
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  Thank you very much for the invite today,
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  and thank you for setting this podcast up.
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  Absolutely. So before we dive into our questions,
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  could you just introduce yourself and share a
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  bit more about your background?
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  Yes.
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  My name is Rory Murphy. I'm a neurosurgeon,
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  and I'm a neurosurgeon with the Barrow Brain
• 1:00
  and Spine Group, and I practice here in
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  Phoenix, Arizona.
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  Been here for over eight years.
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  And, did my
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  Irish, did my medical school in Ireland, came
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  over here, did my training and my residency
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  in WashU in Saint Louis, fellowship in San
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  Francisco, and then moved here. And,
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  here,
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  I do
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  have a a busy neurosurgical practice, and I
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  really one of my main areas I'm really
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  interested in is helping people move, especially after,
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  cervical injuries, so cervical spinal cord injuries or
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  helping people with cervical degenerative cervical myelopathy.
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  And so,
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  really
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  working on different ways to help
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  diagnose,
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  treat,
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  better surgical options for those conditions
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  and also
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  better research opportunities and
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  working with companies and setting up companies to
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  try and commercialize
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  and get solutions out into the the real
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  world to help people.
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  Absolutely. That's all very fascinating. And, doctor Murphy,
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  I wanted to touch on something that you
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  had mentioned in the conversation that,
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  we had earlier, last year. I know there's
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  been some interesting conversations about cervical disc replacement
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  infusions around, especially at, like, three levels. And
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  I want to hear your perspective on this
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  debate and what you've been hearing from the
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  spine community.
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  Yeah. And and it's it's very topical. I
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  had, two or three people in clinic today.
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  We discussed,
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  they had
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  three
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  symptomatic
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  areas with radiculopathy
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  or myelopathy,
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  attributable to three levels.
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  And we had a long discussion with people.
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  And some of the people today would have
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  been, one patient who's a neurologist and, one
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  patient who's an athlete. So we're going through
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  the ins and outs and nuances, and there's
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  no exact right answer. I always
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  discuss with people,
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  try and match
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  you'll find out what they hope to achieve
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  and improve,
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  then try and give them the options and
• 2:59
  potentially match their goals the best.
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  Ultimately,
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  disc replacement arthroplasty versus fusion,
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  currently, the data
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  says that they are about the same.
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  Mhmm. We have perspective information and in data
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  from Norway and Sweden
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  saying that there's no
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  difference between them and the disrobeisement is not
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  better nor worse than the fusion. And similarly,
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  a fusion is not better nor worse than
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  the disreplacement.
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  Other data from The US and especially industry
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  sponsored studies,
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  suggests that
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  disc replacements may have some benefits over fusions.
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  You know, ultimately, it's down to what a
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  patient's goals are and probably what a person's
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  what challenges a person's willing to deal with
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  in the future.
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  Yeah. Because I can imagine,
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  your patient who's,
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  neurologist versus an athlete, they might have very
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  different goals on what they want in their
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  healing.
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  Yeah. Age, stage in life, their other medical
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  challenges.
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  These are very important things to take into
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  account.
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  So
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  this is a very topical conversation. We're gonna
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  be debating this of the spine somewhat,
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  in a month's time here in Phoenix in
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  Desert Ridge.
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  So myself and doctor Alvesh Patel from Northwestern
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  will be, as part of the CSRS
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  and WNS
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  special courses.
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  We'll be debating
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  the pros and cons of three level arthroplasty
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  versus fusion.
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  And, I've been nominated to be the proponent
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  of three level arthroplasty.
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  So I'm gonna go through,
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  the data, the most up to date data,
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  gather information from the registries,
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  and data from, industry
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  sources on two versus three levels.
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  And doctor Patel would do the same for
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  three level fusions. So we'll go through the
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  different,
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  pros and cons of both. So it's I
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  think everyone agrees that there is a rule
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  for three level art capacity in some people.
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  Mhmm. There's, three level fusions better than other
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  people.
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  And we just have to try and
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  match the best solution to the person.
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  Absolutely. And that sounds like a really,
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  exciting opportunity you have ahead. And doctor Murphy,
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  I was wondering if you could dive into
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  some of the research that you'll be,
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  doing this year at Beryl, whether it is,
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  you know, into fusion or arthroplasty
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  or is any other interesting areas of spine
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  and neurosurgery?
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  Yeah. So another,
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  you know, I spent a long time with
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  the insurance company this morning. I have a,
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  you know, 50 year old athletic,
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  dancer,
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  and,
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  she has a two level arthroplasty
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  at four or five and five and six.
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  And, she is developing symptoms, severe symptoms in
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  radiculopathy,
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  c seven radiculopathy,
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  changes c six, c seven. Mhmm. So,
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  her preference after extensive discussion
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  is to have another arthroplasty because she did
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  so well after the other two,
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  but her insurance will not approve,
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  or cover
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  a third
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  disc replacement or third arthroplasty.
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  So I think there's a lot of information
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  we need to get out there. We need
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  to they
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  their reasonable or their, logical,
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  reason to deny it is they have to
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  has already approved it for two levels.
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  So I think there's a couple of things
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  we need to do. We need to probably
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  show that in in certain people, three level
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  arthroplasty is
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  safe and effective
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  and have the FDA
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  acknowledge that.
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  And the the other thing we need to
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  look into more is hybrid. So when you
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  have somebody who has
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  primarily disc degeneration that you can do an
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  arthroplasty on very well, but maybe another level
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  where they would do better with the fusion,
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  what's the long term data from a hybrid,
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  approach?
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  And I know High Ridge and, are looking
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  at, doing a study where they're doing
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  assessing long term outcomes after a hybrid approach,
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  I. E, doing a disc replacement
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  and
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  a the continuous level infusion. So that's one
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  study we're looking forward to being part of
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  this year.
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  That's awesome.
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  And then I was wondering, you know, what
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  are some of the top trends that you're
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  following in health care today?
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  Well,
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  couple of things. I am a trustee for
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  an excellent charity called myelopathy.org,
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  which is set up by people with ser
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  degenerative cervical myelopathy to help advocate for them,
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  help with diagnosis,
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  and help educate people with degenerative cervical myel
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  myelopathy. So I that,
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  group has primarily came out of The United
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  Kingdom.
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  And
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  now, interestingly,
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  the website is growing in popularity in The
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  US. So more and more people in, The
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  US and North America
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  are logging on to the website because they
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  they recognize the value. So I think the
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  patient education
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  and giving people options,
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  is really improving. And,
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  if you have people with myelopathy
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  in your clinic, I definitely recommend that you
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  direct them to the myelopathy.org
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  website where you can get very
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  balanced,
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  informative
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  information for your patients. And
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  it's a great resource for anyone who tries
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  to help people with degenerative cervical myelopathy or
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  who has their family member with degenerative cervical
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  myelopathy.
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  Mhmm. So the myelopathy.org,
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  charity is really growing in The US this
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  year. I think there's gonna be a lot
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  of work helping with people with spinal cord
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  injuries, using
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  different techniques.
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  I'm looking forward to hopefully more data. We're
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  part of the
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  doctor Alan Levi from University of Miami is,
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  hypothermia trial where people with acute cervical spinal
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  cord injuries
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  will be randomized to cooling or standard of
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  care treatment.
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  And, that has been running now for a
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  number of years. We're one of the sites
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  along with, three or four four or five
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  other sites. So, hopefully, the data from that
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  will come out in the next twelve to
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  eighteen months. So we're really looking forward to
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  that data,
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  because we really need better ways to help
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  people with severe
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  cervical spinal cord injuries. And then for people
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  who you know, once we've decompressed the spinal
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  cord straight away,
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  maybe done cooling, maybe used different medications.
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  If they don't improve after twelve to eighteen
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  months, what options do we have? And there's
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  a huge growth in,
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  neuroprosthetics.
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  So brain computer interfaces, basically trying to bridge
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  the gap between the brain and the extremities.
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  And you can see a number of excellent
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  companies really pushing to move this forward,
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  including,
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  Neuralink,
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  Paradromix,
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  Phantom Neuro.
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  It's really
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  an exciting time for neuroprosthetics
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  and helping people respond with injuries or strokes
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  or other neurological injuries.
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  Yeah. And I'm curious, you know, with that
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  technology, particularly the brain computer in interfaces, your
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  neurolink chips,
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  What's your outlook for this technology, let's say,
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  as soon as even in the next five
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  years?
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  Well, I think every time
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  you know, we always see
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  kind of a cycle.
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  So
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  there usually, it takes five to ten years
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  for the new technology comes along. The first
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  few years, we're learning about it. We're gaining
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  familiarity with it. And it takes, you know,
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  five to ten years before we really,
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  get comfortable with it and we really see
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  the benefits.
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  Examples being the stereotype and navigation for spine,
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  robotic use,
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  arthroplasty.
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  All these things, we
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  we gain knowledge over time. So, endoscopy as
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  well. You know, we
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  so I think the neuroprosthetics
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  will be quite different in five to ten
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  years, and,
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  we'll be using them in ways that we
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  didn't quite expect.
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  So I'm looking forward to that. Great. And
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  then couple other questions.
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  What do you think will be the biggest
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  headwind that you'll be facing in 2026?
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  It's really hard for people to navigate the
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  health care system. You're unwell. You have a
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  a severe brain or spine problem. You're in
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  pain.
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  Navigating the system is very trippy.
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  It's hard to get to your primary care
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  doctor.
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  It's hard to get the preventative care.
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  And
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  when you do
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  get seen and assessed,
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  it's hard to get the imaging. And then
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  subsequently, if you do need a procedure to
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  help you, the insurance company to approve it.
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  So
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  that's my main concern for my patients.
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  How do they get to the
• 11:35
  get assessed, diagnosed, and treated correctly
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  in
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  a pragmatic, holistic way?
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  So, you know,
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  that's my concern.
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  A
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  reduction in care because of,
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  insurance
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  and rationing of care.
• 11:53
  Got it. And then just the last question
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  I had for you is, how are you
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  thinking about growth over the next twelve to
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  twenty four months?
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  Well, there's different areas to grow. You know,
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  I'm always trying to, make sure that my
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  patients are better educated because the better educated
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  they are, the better they do. The more
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  they understand their condition, the more they understand
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  the options, the better they do.
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  Practice wise, we're always trying to refine our
• 12:16
  practice and make it better.
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  Growth research wise, hoping to add more new
• 12:22
  help options to help people with cervical menopause
• 12:24
  and spinal cord injuries.
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  And,
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  you know,
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  on the entrepreneurial side, we're looking forward to
• 12:32
  hopefully first in human trials for smart implants
• 12:35
  and connected implants in the next, you know,
• 12:37
  twelve to eighteen months. So I think that'll
• 12:39
  be a big growth area.
• 12:42
  Great. Well, doctor Murphy, thank you so much
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  for joining us today. Look forward to connecting
• 12:47
  down the line.
• 12:48
  Excellent. Thank you very much.