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