A round of applause echoed through the Bahamas when 3Spine, Inc., a spinal device company based in Chattanooga, Tennessee, announced the appointment of Pierce Nunley, M.D. to 3Spine’s Medical Advisory Board. The announcement was made at the International Society for the Advancement of Spine Surgery Annual Conference.
Pierce Nunley, M.D. Joins 3Spine’s Medical Advisory Board
Dr. Nunley is a spine surgeon who is board certified by both the American Board of Orthopaedic Surgeons and by the American Board of Spine Surgery. He is published in numerous books and journals and per the press release, has “served as the designated principal investigator (PI) on over 30 clinical research studies.”
3Spine isn’t the only organization benefiting from Dr. Nunley’s expertise. Dr. Nunley is currently the director of Shreveport, Louisiana-based Spine Institute of Louisiana, the chairman of the American Board of Spine Surgery, and an Associate Professor at Louisiana State University.
3Spine Co-Founder and Medical Director Scott Hodges, D.O. is close to Dr. Nunley. In the press release, Dr. Hodges commented, “Pierce [Dr. Nunley] is a friend and a real technology leader.”
Dr. Hodges continued, “He [Dr. Nunley] is one of the few surgeons I know who can look into the future and see change, who also has the scientific, business, and teambuilding experience to make it happen. There is a reason you see Pierce on so many projects, and I am thrilled that he is part of ours.”
3Spine’s technology includes MOTUS and the BalancedBack procedure. Per its website, the BalancedBack procedure is the “first ‘total’ joint replacement for the lumbar spine.” MOTUS is the implant used in the BalancedBack procedure.
OTW spoke with Dr. Nunley about his appointment. Dr. Nunley told OTW, “I have been involved with design, development and research in spinal motion for 20 years. In the cervical space, we are there with disc replacements clearly demonstrating improved outcomes for many pathologies.”
Dr. Nunley continued, “Lumbar has been more challenging. In my opinion, the 3Spine MOTUS technology has the potential of being highly disruptive, if we can repeat the pilot outcomes in our IDE [investigational device exemption]. It is exciting to play a role in this research and provide a better option for patients with disabling back and leg pain.”

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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