Meet the Innovators behind XLIF® Crestline

Every month we will be showcasing both Development and Marketing leaders for a particular product or procedure to give you an inside look into what it’s like innovating at NuVasive®. With October’s announcement of Lateral Single-Position Surgery, the first innovation we dived into was XLIF® Crestline.

XLIF Crestline is a supplemental solution to XLIF, enabling lateral access when a high iliac crest or anterior psoas would preclude or discourage a surgeon from using a traditional lateral trajectory at L4-L5.


Meet Byron Riemhofer, XLIF Crestline Sr. Development Engineer and Mike Jensen, XLIF Crestline Product Manager. Byron joined NuVasive in 2013 as an engineering intern and worked his way to Sr. Dev. Engineer. Mike has been with NUVA for two and a half years, starting as an Associate Product Manager on the XLIF team.

What sparked the need for XLIF Crestline? 

  • Mike: The need was driven by the market more than anything. Lateral surgery has proven benefits and as surgeons continue to adopt it into their surgical practice we wanted to expand the capabilities of our system as much as possible. Ultimately we wanted to enable surgeons to perform lateral single-position surgery, even in the face of challenging anatomy.

Can you name one of the challenges in creating Crestline? 

  • Byron: This is a new system for NuVasive, meaning there was no predicate to base the designs off of, so learning the anatomy and the technique from scratch was a challenge that I enjoyed overcoming over the course of the project.

What were the resources needed to start this project? 

  • Byron: A strong surgeon design team, project budget, and the engineering and marketing leads to bring the project to life.
  • Mike: After that it was all about having a clear goal and clinical requirements from our surgeon design team.

Usually the first idea might not be the greatest idea. Is the original idea for XLIF Crestline what it is today? If it has changed, what necessitated the change? 

  • Byron: There has definitely been some evolution of the project from the initial concept at the first kickoff meeting, to the commercially launched product on the market today. From an engineering standpoint, the system was designed to be very simple to use, yet highly effective. Our feedback from the field so far seems to reflect that, which is very positive.
  • Mike: I completely agree with Byron here. The project has evolved naturally over time as we followed the design process based on clinical requirements and made sure we met the market needs. The original idea hasn’t changed but the tools to execute the procedure have adapted over time and I’m sure they will continue to as we strive to provide the most relevant procedural solutions.

What was your favorite part about the design process and marketing process for Crestline? 

  • Byron: The challenge of designing for utility within the approach made the project really fun and exciting.  It was awesome to get into the lab with our surgeon design team to try out different prototypes and watch the surgeons point out various anatomical landmarks and how they were using the instrumentation to better aide in the technique.
  • Mike: As for me in Marketing, I really enjoyed working with our surgeon partners and finding the right way to launch this strategically. Developing a solution that is so closely tied to another but with some key differentiators made it engaging to find the right fit in our portfolio. Having the opportunity to develop educational platforms for surgeons and our sales staff was fun.

If you’re interested in becoming part of the innovation here at NUVA, search our open roles here.

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