fail, the space between the vertebrae narrows, compressing nerves and causing pain that often radiates from the spine to the extremities. In ACDF, surgeons remove the diseased disc, restorethespacebetweenthevertebraeandfuse the bones. That alleviates nerve pain but limits the patient’s neck mobility and transfers stress to the adjacent vertebrae, which may lead to subse- quent surgeries, said Zimmer Biomet Director of Strategic Communications Mark Richards. RichardscalledACDFan“establishedtechnology” that satisfies most surgeons, but patients deliv- ered a different message. “Patients want to reduce their pain, but not at the cost of mobility,” he said. “They also don’t want to be back for another surgery.” Those problems spurred the Mobi-C®’s devel- opment. As in ACDF, surgeons decompress the nerves, but instead of fusing the vertebrae, they insert an artificial disc with a mobile bearing that allows natural motion in the neck and reduces stress between the implant and the bone. “Alleviating [patients’] pain is the number-one goal, but a secondary goal, which I think has been overlooked in ACDF, is to respect the nat- ural physiology and restore quality of life and the activities of daily living,” Richards noted. SilvergatePharmaceuticals,Inc.,basedinGreenwood Village, Colorado, customizes products to fill a smaller market niche – literally. The company markets three FDA-approved drugs for pediatric patients(twoforhighbloodpressureandanother that treats both acute lymphoblastic leukemia and polyarticular idiopathic juvenile arthritis). The medications, which repurpose molecules already used in adult medications, don’t require compounding by pharmacists, which involves, for example, crushing tablets and combining the powder with a liquid. “The compounded drugs can taste terrible or require injection,” said Silvergate Pharmaceuticals CEO Frank Segrave. In addition, the compounding process may differ from pharmacy to pharmacy, a concern for care- givers administering the medications. Silvergate Pharmaceuticals developed kid- friendly, sweet-tasting liquid medications that caregivers can dose reliably by body weight. Most importantly,theymeettheneedsofpatientswith limited ability to speak for themselves. “Kids aren’t just different-size patients, they’re really different individuals in the way their bodies have evolved and developed,” Segrave said. “It’s ridiculous to think that a patient who is two months old will get the same amount of medication as one three years old. Our medica- tions are designed to help physicians, nurses and pharmacistsproperlytitrateandtailorthedoseof the product to each specific patient.” Successfulcompanies,itseems,listentoandlearn from their end users. The Mobi-C Cervical Disk from Zimmer Biomet improves neck mobility after a discectomy, a key patient concern. Silvergate Pharmaceutical, Inc. develops pediatric versions of adult medications that make it easier for caregivers to administer and kids to take. 16 BIOSCIENCECOLORADO / / 2019-2020