Uri Arnin is a serial entrepreneur in the spine space. In addition to possessing dozens of issued patents, he’s the former CTO of multiple Israeli spine companies that have been acquired for their novel technology, including Impliant, which developed the world’s first facet replacement device; Spine 21, known for the first-ever remote-controlled spinal implant; and ApiFix and its procedure for treatment of adolescent idiopathic scoliosis.
Arnin is currently Co-founder and CTO of ZygoFix. The company’s zLOCK technology facilitates a percutaneous approach to lumbar fusion. By fusing the facet joint with a small but rigid titanium implant – rather than fusing vertebrae using an artificial bridge – surgeons can stabilize the back and bring on pain relief in a less invasive way.
We spoke to Arnin about what he’s learned from his decades in medical device R&D and why he’s able to bring a unique perspective to the field.
What drove you to medical device R&D?
Arnin: I spent many years in many different fields and accidentally got into medical devices when I was 45 years old, 20 years ago. I started with a total hip replacement project. But it took me some time to understand that the solutions that exist in the hip and knee are quite good. When I looked around and tried to understand, “Where is the need in orthopedics?” I realized that spine is tens of years behind the other parts of the body in terms of solutions. And because the spine is more complex, because people are more conservative, there is need in spine for better solutions.
You noted your career before medical devices. How did your prior work inform and complement what you’ve accomplished in orthopedic R&D?
Arnin: Before getting into medical devices, I was involved in many different fields of engineering — metal machining, special coatings and metal injection molding, plastic injection molding, the use of different polymers. These are many different fields that typically engineer that work in spine or general orthopedics never see, because the industry is very conservative and gets used to using very, very specific materials and production methods.
When you bring to the table additional tools from your experience in the past, then it makes it easier for you to think differently and come up with different solutions. Other people who are tied to just one or two processes are not able to do that.
How have the lessons you learned early in your career shaped you as a leader, and the way that you approach your work today?
Arnin: You can design something that is technically perfect, but you have no way to predict the interface with the human body. Whenever you start your clinical trials, you discover things that surprise you, because the interaction with the human body is always different than what you think when you are doing something completely new. You have to adjust quickly, listen carefully to the surgeons and the patients and try to find the limitations of your design and the problems and mistakes, and fix them as quickly as possible.
However, if you talk with 10 or 20 surgeons, you will hear very, very different opinions about your design and your technology, the way it should be used, the indications and the patients to use it with. You have to consider everything carefully and get to your decision. Where do you want to take this technology? Where do you believe it fits best?
Otherwise, if you run from one corner to the other, change direction and change indications, you will get nowhere. There are two opposite things that you have to balance.
What one piece of advice do you have for product development leaders in orthopedics?
Arnin: I’m not more clever than the thousands and thousands of engineers who work all over the world, and in other companies — many of them much bigger and stronger, and many of them much more experienced.
When I come to solve a specific problem, I must bring something new to the table. It can be a new material, a new production method, a new coating, a new treatment. Something that changed the equation and was not there two years ago, or just came out, or is being used in another field but was never used in orthopedics. Only when you have such a new tool can you do something of value.
The other thing is a need to balance between the evolution and the revolution. Most developments are evolutions. People are doing a little bit more of this and a little bit less of this, and that is how we’re seeing advances. When you come with a revolution, with something that was never done before, you must use as many things as possible that were done before and were proven before, and focus your revolution in a very, very narrow area. Otherwise, it’s going to be too much for the market to accept.
What technology gaps remain in orthopedics?
Arnin: This relates to another venture that I have, where I’m trying to take all the components and technologies that are being used in pacemakers and bring them to orthopedics.
Think about an orthopedic implant that can be adjusted, or fine-tuned post-surgery in a non-invasive way, based on specific feedback from the patient. For example, think of a spinal implant that you can place between two vertebrae, and adjust the gap between the two vertebrae, up to the point where the patient is telling you, “This is the best. Now leave it like that, because this feels the best.”
In order to be able to accomplish this, we need a group of technologies that have been used for tens of years in pacemakers—implantable batteries, an implantable microprocessor, two-way communication between the implant and the surgeons, and so on. Add a mechanical component to the technology, and then it’s possible to do it.
In orthopedics today, I would say everything that we do is fixed. You cannot change it; you cannot adjust it. When the surgery is done, it’s done. In order to twist an implant just a little bit more, you must have a second surgery. I believe that mentality belongs to the past, and it is possible to do it in a much better way. But again, this is a revolution that is difficult to do. I’m sure that in the coming 10 years, we’ll see more and more of that technology.
Annie Zaleski is an ORTHOWORLD contributing author.