HealthpointCapital Interviews Dr. J. Kevin McGraw: A Look into Spine Interventional Radiology
BY ARIELLA P. GOLOMB, MD, SEPTEMBER 17, 2007
J. Kevin McGraw, MD, FSIR is the Co-Director of Vascular and Interventional Radiology Riverside Methodist Hospital in Columbus, Ohio and a Clinical Assistant Professor of Radiology at the Medical College of Ohio in Toledo, Ohio. He currently serves on the Physician advisory board of Cardinal Spine and Arthrocare Spine.
HealthpointCapital took the opportunity to interview Dr. McGraw to learn more about interventional radiology and IR treatment of the spine.
HC:
How did you become involved in spine IR procedures?
JKM: I trained at the University of Virginia from 1992-1997. During that time, the first percutaneous Vertebroplasty was performed in the US at UVA. I incorporated the procedure into my practice. The success of Vertebroplasty led to other interventional spine procedures.
HC:
What spine-related clinical studies and technology developments have you been involved in?
JKM:
I have published numerous papers on Vertebral Augmentation. I also edited a book titled “Interventional Radiology of the Spine, Image-Guided Pain Therapy” published by Humana Press. I am currently working with Arthrocare Spine and Cardinal Health to develop new products for vertebral augmentation. I also have a patent pending spinal fixation device called VPIN (Vertebral Percutaneous Interbody Nail). We just completed a finite element analysis and technical feasibility study. The results were presented at the most recent Society of Interventional Radiology Meeting in Seattle.
HC:
How are patients typically referred to your practice? How is the decision made to be treated by an interventional radiologist rather than a neurosurgeon or orthopedist?
JKM:
Many of my patients are referred by neurosurgery and orthopedic surgery. I have developed a strong working relationship with many of the surgeons in my hospital. They realize that we are the leaders in minimally invasive image-guided spinal procedures. Likewise, I send many patients to a surgeon who are not a candidates for some of the procedures that I offer. Also, many patients come directly to me, particularly the patients with back pain from vertebral body compression fractures.
HC:
Approximately how many interventional radiologists are there in the U.S.? Do they all perform spine procedures? How fast is the specialty growing, and what drives that growth?
JKM:
There are about 3500 IRs across the country. The majority perform spinal procedures with the most common spinal procedure being vertebral augmentation. There currently is a shortage of IRs across the country because the demand for minimally invasive procedures continues to grow.
HC:
What are the most common IR spine procedures?
JKM:
Vertebral augmentation procedures and epidural steroid injections.
HC:
Which procedures require branded devices?
JKM:
Several procedures require branded devices. Kyphon has branded Kyphoplasty, Arthrocare has nucleoplasty, Smith and Nephew had branded Intradiscal Electrothermal Annuloplasty (IDET).
HC:
What are the benefits and risks of vetebroplasty vs. kyphoplasty to treat VCFs?
JKM:
This is a topic of great controversy. If pain relief from a compression fracture is the objective, both procedures have similar results. Likewise, both procedures have similar results with regard to height restoration. Patients are at a greater risk with the Kyphoplasty procedure as pointed out in
a recent article in JVIR by Dr. Murphy of Johns Hopkins. Kyphoplasty also is about 10-15 times more expensive than Vertebroplasty.
HC:
Besides Kyphon, what other companies are targeting spine interventional radiologists?
JKM:
Arthrocare Spine, Cardinal Health, Medtronic, Cook Inc., Stryker to name a few.
HC:
What are the big spine interventional radiology meetings and societies?
JKM:
The annual Society of Interventional Radiology Meeting, The ASSR (American Society of Spinal Radiology) meeting, the ASITN (American Society of Interventional and Therapeutic Neuroradiology) meeting.
HC:
What new technologies are on the horizon and who is driving them?
JKM:
Arthrocare is making advances in vertebral augmentation with void creation and cement delivery. Cardinal Health has developed targeted cement placement and automated cement mixing. Many other companies are looking at minimally invasive spinal procedures.
Thank you for your time, Dr. McGraw. We look forward to seeing you at NASS and other industry events!
