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How BYU-born research went from (almost) disrupting the cellphone business to advancing spinal repairs

From flip-phones to helping fix spines, these BYU researchers found themselves changing the landscape of modern spinal surgery.

Angie Taylor poses for a portrait at her home in American Fork, Utah.
Angie Taylor, who had her neck fused between C5, C6 and C7 with a cervical interbody device in March, poses for a portrait at her home in American Fork on Monday, Nov. 1, 2021. She is able to workout again without pain.
Kristin Murphy, Deseret News

Just moments away from closing the deal on a multimillion dollar research grant in 2007, a group of BYU mechanical engineers watched the opportunity slip through their fingers thanks to an entirely unexpected technology event.

Apple released its first iPhone.

The work being done by a team led by BYU researcher and professor Larry Howell was aiming to innovate the hinge mechanisms on the — at the time — ubiquitous flip-phone cell design. However, the debut of Apple’s slab-style, touchscreen smartphone would not only fundamentally redefine the world of cellphones, but send all its competitors scrambling for a response that included mostly abandoning plans for future iterations of phones featuring the flip.

Peter Halverson was a member of Howell’s BYU team and working toward his master’s degree at the time. Halverson said it was a huge letdown to be so close to seeing the work they’d done earn massive financial backing, particularly in the light of the 11th hour deflation.

Brigham Young University professor Larry Howell holds the prototype of a new medical device in Provo on Thursday, March 18, 2021. The device, designed by Howell and university students, aims to vastly improve a patient’s range of motion after a spinal fusion surgery.
Brigham Young University professor Larry Howell holds the prototype of a new medical device in Provo on Thursday, March 18, 2021. The device, designed by Howell and university students, aims to vastly improve a patient’s range of motion after a spinal fusion surgery.
Laura Seitz, Deseret News

“Our rep was scheduled for a meeting with the company we were working with to finalize paperwork on a very large grant, but he got sick and had to postpone the meeting,” Halverson recalled. “It happened to coincide with the release of Apple’s first iPhone. Before the meeting could be rescheduled, we heard they were shutting down all research on flip-phone development.”

Halverson and his teammates’ work focused on an area of mechanical engineering known as compliant mechanisms, a term that applies to rigid materials designed in such a way that they can move or flex and then return to their original shapes. Some very simplified examples include things like a backpack latch or paperclip.

In spite of losing the lucrative grant, thanks to the vision of Steve Jobs and one of the biggest technological innovations of the last century, the BYU researchers were not dissuaded and launched an effort to identify what other product areas could benefit from their innovative work.

Halverson said orthopedic medical devices arose as an arena where their compliant design advancements might be put to use in a way no one had previously conceived.

“Looking at what was required for spinal movement and disc replacement seemed to make sense,” Halverson said. “As we started investigating, we found a lot in common with what is required of that type of device and what we had developed for the phone hinge.”

Halverson said one of the first big steps was switching materials. While the cellphone hinge was developed using polymers, a device intended to be installed in spinal procedures would need to be constructed from titanium, an extremely resilient metal that is flexible and friendly to bone growth necessary for patient recovery.

Howell, who literally wrote the book when it comes to compliant mechanisms, said designing a replacement that emulates the unique function of a spinal disc was a huge challenge.

“We needed this device to behave like a natural disc, which does some very complex things,” Howell said. “It had to have motion in two directions, bending backwards and forwards and bending side to side in a very constrained space.”

Howell said his team used sophisticated mathematical modeling and simulations to work out details of the design, a complex titanium matrix that emulates the movement of natural discs and also provides fertile ground for post-surgical bone growth.

Brigham Young University professor Larry Howell is pictured in Provo on Thursday, March 18, 2021. Howell and BYU students have designed a new medical device that aims to vastly improve a patient’s range of motion after the spinal fusion surgery.
Brigham Young University professor Larry Howell is pictured in Provo on Thursday, March 18, 2021. Howell and BYU students have designed a new medical device that aims to vastly improve a patient’s range of motion after the spinal fusion surgery.
Laura Seitz, Deseret News

The innovations developed by Howell and his team caught the eye of Utah biotech pioneer Gary Crocker and entrepreneur David Hawkes, who saw a great potential for the advanced technology the BYU researchers had developed in a market that generates billions of dollars each year.

“I immediately recognized that this would be a very, very useful technology to be applied in the whole arena of spine and neck repair,” Crocker said. “Particularly in an arena of devices where the needle hadn’t really moved significantly for decades.”

With Crocker’s backing, Hawkes moved forward on figuring out how to manufacture the devices, a process with its own unique challenges owing to the complicated design and titanium material requirements. But Hawkes and his team, which now includes Halverson, were able to overcome the engineering challenges of turning a great idea into a practical solution and the Nexus brand now includes a growing line of devices that leverage the novel technology.

That technology has become a go-to for neurosurgeon Dr. John Edwards, a Lehi-based specialist in minimally invasive procedures and who has been using the Nexus devices for the past several years.

He said the design addresses the three most critical aspects of disc fusion surgery including matching and maintaining the height of the original disc with appropriate shock absorption, replicating the curve of the patient’s spine and allowing for post-surgical bone growth that ensures the fused vertebrae stay that way.

“The Nexus implant is unique because it addresses all three areas effectively by its design,” Edwards said. “The implant has been a fantastic device.”

For years, most types of spinal repair procedures required surgeons to make gaping incisions down the spinal column, a technique that both increases recovery time and elevates risk of infection. Edwards favors a technique that uses small incisions on either side of the spine, one that dramatically compresses hospital and recovery time.

Angie Taylor shows an X-ray of where she had her neck fused between C5, C6 and C7 with a cervical interbody device back in March, while at her home in American Fork on Monday, Nov. 1, 2021.
Angie Taylor shows an X-ray of where she had her neck fused between C5, C6 and C7 with a cervical interbody device back in March, while at her home in American Fork on Monday, Nov. 1, 2021.
Kristin Murphy, Deseret News

And that was a huge plus for Angie Taylor, a patient that was suffering chronic pain and other issues after a pair of car accidents led to two herniated discs in her upper spine.

“I was in major pain that just didn’t go away,” Taylor said. “I had shoulder pain and numbness that ran down my arms and into my fingers.

“I really had no mobility in my neck and couldn’t even turn my chin to see my shoulders.”

Taylor said she became aware of the problem three years ago following assessments by chiropractors and, eventually, an MRI scan that pinpointed her cervical disc issues. But, she was nervous about spine surgery and potentially coming out of it in worse shape than she was already in. But, the constant pain and limited movement eventually became too much.

Taylor had a fusion procedure performed by Edwards, who installed two Nexus implants along with a rod-and-screw apparatus that helped lock everything together. The biggest surprise, Taylor said, was how fast the surgery changed her life and put her back on the path to engaging in the activities she’d missed since the injury.

“After the procedure, I was out of bed in an hour-and-a-half,” Taylor said. “It was a really fast recovery. I ended up going to a baseball game just a couple days after the surgery.”

After the March operation, Taylor said she feels she’s probably at about 90% recovery and has already reengaged her workout routines, cycling and driving golf balls. And, she’s looking forward to the upcoming snow sports season.

When asked if she’d be warming up on green- and blue-rated runs when she’s back on her skis, Taylor had a quick answer, reflecting how well she’s feeling about her freshly fused spine.

“We’re just going to hit it,” Taylor said.

Angie Taylor, who had her neck fused between C5, C6 and C7 with a cervical interbody device in March, laughs while feeling for the surgical scar, which is so small she can’t feel it, to point it out for a photo at her home in American Fork on Monday, Nov. 1, 2021.
Angie Taylor, who had her neck fused between C5, C6 and C7 with a cervical interbody device in March, laughs while feeling for the surgical scar, which is so small she can’t feel it, to point it out for a photo at her home in American Fork on Monday, Nov. 1, 2021.
Kristin Murphy, Deseret News