Advancing Cervical Spine Care and Neuroprosthetics with Rory KJ Murphy, MD

Summary

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Podcast Summary

Becker’s Healthcare Podcast

Episode: Advancing Cervical Spine Care and Neuroprosthetics with Rory KJ Murphy, MD

Date: February 7, 2026
Host: Carly Beam (Becker's Healthcare)
Guest: Dr. Rory Murphy, Neurosurgeon, Barrow Neurological Institute

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Episode Overview

This episode features a focused discussion with Dr. Rory Murphy, a prominent neurosurgeon at Barrow Neurological Institute, on recent developments in cervical spine care, ongoing research into spinal surgery approaches, and the evolving field of neuroprosthetics. Dr. Murphy shares clinical insights, discusses hot topics in the spine community, and offers predictions for technological advances and challenges in the field. The tone is collaborative, informative, and accessible, blending Dr. Murphy’s expertise with practical patient considerations.

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Key Discussion Points and Insights

Introduction to Dr. Rory Murphy (00:48 – 01:57)

• Dr. Murphy shares his background, having trained in Ireland, St. Louis, and San Francisco, now practicing in Phoenix.
• Core interests: diagnosing/treating cervical spinal cord injuries and degenerative cervical myelopathy, advancing surgical methods, and translating research into real-world solutions.
• Active in collaborating with companies to bring innovations to market.

Cervical Disc Replacement vs. Fusion: The 3-Level Debate (01:57 – 05:01)

• Dr. Murphy discusses real-world cases involving multi-level cervical spine disease and the nuanced debate regarding disc replacement (arthroplasty) vs. fusion, especially at three levels.
• He emphasizes tailoring treatment to patient goals (e.g., neurologist vs. athlete).
• Current evidence:
  • Registry data from Scandinavia: no significant difference between disc replacement and fusion outcomes.
  • Some US industry-sponsored studies suggest disc replacement may offer benefits.
  • Key consideration: patient preferences and willingness to face different future challenges.
• Dr. Murphy will soon participate in a high-profile debate at the Spine Summit, advocating for three-level arthroplasty with Dr. Alpesh Patel representing the fusion side.
• “I think everyone agrees that there is a role for three level arthroplasty. In some people, three level fusions [are] better than [for] other people, and we just have to try and match the best solution to the person.” (Dr. Murphy, 04:56)

Research Directions: Expanding Indications and Hybrid Procedures (05:01 – 07:11)

• Discusses challenges with insurance limitations, as FDA currently only approves two-level disc replacements.
• Case example: a patient with prior two-level arthroplasty seeks a third, but insurance denial—need for more data and regulatory change.
• Growing research interest in “hybrid” approaches: mixing disc replacement and fusion at different affected levels. Ongoing and planned studies will provide outcome data for this approach.

Advocacy and Patient Education (07:11 – 08:54)

• Dr. Murphy is a trustee for myelopathy.org, which offers education and support for degenerative cervical myelopathy patients and families.
  • Originally from the UK; now expanding influence in North America.
• Strong emphasis on the importance of accessible, balanced patient education resources.

Innovations in Acute Spinal Cord Injury Treatment (08:54 – 09:46)

• Participation in a major multicenter trial (led by Dr. Alan Levi, University of Miami), randomizing patients with acute cervical spinal cord injury to hypothermia or standard care.
• Results expected in the next 12–18 months—seen as crucial for guiding future acute spinal cord injury care.

The Promise of Neuroprosthetics and Brain-Computer Interfaces (09:46 – 10:47)

• Significant growth anticipated in neural prosthetics (e.g., brain-computer interfaces) to restore movement/function post-spinal cord injury or stroke.
  • Leading companies: Neuralink, Paradromics, Phantom Neuro.
• Dr. Murphy predicts rapid development and novel applications for these technologies in the next 5–10 years.
• “I think the neuroprosthetics will be quite different in five, ten years, and we’ll be using them in ways that we didn’t quite expect.” (Dr. Murphy, 10:40)

Healthcare System Headwinds (10:47 – 11:53)

• Describes the complex challenges patients face navigating the current US healthcare system for spine and brain conditions.
  • Barriers include referrals, imaging access, insurance approval for procedures.
• Expresses concern over increasing rationing of care and reduced access due to insurance constraints.
• “How do they get assessed, diagnosed, and treated correctly in a pragmatic, holistic way... That’s my concern—a reduction in care because of insurance and rationing of care.” (Dr. Murphy, 11:26)

Approaching Growth and Innovation (12:01 – 12:42)

• Dr. Murphy’s vision for growth:
  • Advance patient education to improve outcomes.
  • Practice refinement for better patient care.
  • Continued research—especially novel treatments for cervical myelopathy and spinal cord injuries.
  • Entrepreneurial initiatives: first-in-human trials for smart and connected implants expected in the next 12–18 months.

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Memorable Quotes & Timestamps

• On Individualized Treatment:
  “Try and match, you know, find out what [patients] hope to achieve and improve and then try and give them the options that potentially match their goals the best.”
  – Dr. Murphy, 02:28

• On Treatment Evidence:
  “Registry data from Norway and Sweden [say] there’s no difference...the disc replacement is not better nor worse than a fusion.”
  – Dr. Murphy, 02:52

• On the 3-Level Arthroplasty Debate:
  “I’ve been nominated to be the proponent of three level arthroplasty... I think everyone agrees that there is a role for three level arthroplasty.”
  – Dr. Murphy, 04:39 & 04:56

• On Patient Advocacy:
  “If you have people with myelopathy in your clinic, I definitely recommend that you direct them to the myelopathy.org website... very balanced, informative information for your patients.”
  – Dr. Murphy, 07:40

• On Neuroprosthetics:
  “It’s really an exciting time for neuroprosthetics and helping people with spinal cord injuries or strokes or other neurological injuries.”
  – Dr. Murphy, 09:34

• On Systemic Healthcare Barriers:
  “It’s really hard for people to navigate the healthcare system... when you do get seen and assessed, it’s hard to get the imaging. And then...the insurance company [needs] to approve it.”
  – Dr. Murphy, 11:05

• On Practice Growth:
  “The better educated [patients] are, the better they do. The more they understand their condition, the more they understand the options, the better they do.”
  – Dr. Murphy, 12:03

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Notable Segment Timestamps

• Dr. Murphy’s Background and Philosophy – 00:55 – 01:57
• Disc Replacement vs. Fusion: Data and Trends – 02:19 – 03:43
• Debate at Upcoming Spine Summit: Three-Level Arthroplasty – 03:53 – 05:01
• Hybrid Surgical Approaches: Research Focus – 05:22 – 07:02
• Patient Advocacy: myelopathy.org – 07:11 – 08:29
• Acute Spinal Cord Injury Research and Neuroprosthetics – 08:54 – 10:47
• Healthcare System Challenges – 10:56 – 11:53
• Future Growth, Smart and Connected Implants – 12:01 – 12:42

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Conclusion

This episode is a concise yet in-depth discussion of some of the most pressing and promising issues in cervical spine surgery and neuroprosthetics, seen through the lens of clinical practice, research, patient advocacy, and innovation. Dr. Murphy offers balanced insights into the disc replacement vs. fusion debate, highlights the regulatory and insurance-driven limitations to surgical options, and expresses optimism about technological advances that could soon transform care for people with spinal cord injuries. The episode is especially valuable for spine care professionals, patient advocates, and anyone interested in where neurotechnology is headed over the next decade.

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Transcript

[A]

This is where healthcare leadership comes together. Becker's 16th annual meeting brings more than 3,500 hospital and health system executives and nearly 800 speakers to Chicago, April 13th through the 16th. This year's event includes keynote conversations with Dallas Cowboys legend Troy Aikman and former President George W. Bush. For the agenda and event details, visit Beckershospitalreview.com and click on the Events tab in the upper right. We're looking forward to hosting you in Chicago.

[B]

This is Carly Beam with the Becker Spine and Orthopedics podcast. And I'm thrilled to be joined today by Dr. Rory Murphy, a spine surgeon with Barrow Neurological Institute. Dr. Murphy, thank you for being here today.

[C]

Thank you very much for the invite today, and thank you for setting this podcast up.

[B]

Absolutely. So before we dive into our questions, could you just introduce yourself and share a bit more about your background?

[C]

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. Being here for over eight years and did my Irish, did my medical school in Ireland, came over here, did my training in my residency in Washu and St. Louis Fellowship in San Francisco, and then moved here. And here I do have 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 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.

[B]

Absolutely. That's all very fascinating. And Dr. 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.

[C]

Yeah, this is very topical. I had two or three people in clinic today, and 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 know, find out what they hope to achieve and improve and then try and give them the options that potentially match their goals the best. Ultimately, disc replacement, arthroplasty versus fusion. Currently the data says that they are about the same. We have prospective information and in data from Norway and Sweden saying that there's no difference between them, the disc replacement is not better nor worse than a fusion and similarly effusion is not better nor worse than a disc replacement. Other data from the US especially industry sponsored studies suggests that disc replacements may have some benefits over effusions. 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.

[B]

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.

[C]

Yeah. Age stage in life. There are other medical challenges. These are very important things to take into account. So this is a very topical conversation. We're going to be debating this at the Spine Summit in a month's time here in Phoenix and Desert Ridge. So myself and Dr. Alpesh 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 going to 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 Dr. Patel would do the same for three level fusions. And we'll go through the different pros and cons of both. So it's, I think everyone agrees that there is a role for three level arthroplasty. In some people, there's three level fusions better than other people and we just have to try and match the best solution to the person.

[B]

Absolutely. And that sounds like a really exciting opportunity you have ahead. And Dr. Murphy, I was wondering if you could dive into some of the research that you'll be doing this year at Barrel, whether it is, you know, into fusion or arthroplasty or is any other interesting areas of spine and neurosurgery.

[C]

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 2 level arthroplasty at 4, 5 and 5 and 6 and she is developing symptoms, severe symptoms and radiculopathy, C7, radiculopathy and changes, C6, C7. 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 a third arthroplasty. So I think there's a lot of information we need to get out there. We need to they're reasonable or their logical reason to deny it is the FDA has only 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 certain people, three level arthroplasty is safe and effective and have the FDA acknowledge that. And 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 a 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 doing a disc replacement and a the continuous level of fusion. So that's one study we're looking forward to being part of this year.

[B]

That's awesome. And then I was wondering what are some of the top trends that you're following in healthcare today?

[C]

Well, a couple things. I am a trustee for an excellent charity called myelopathy.org, which is set up by people with degenerative cervical myelopathy to help advocate for them, help with diagnosis and help educate people with degenerative myopathy. So that group 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 onto 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 a family member with degenerate cervical myopathy. So the myelopathy.org charity is really growing in the US this year. I think there's going to 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 Dr. Alan Levi from University of Miami, his 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 12 to 18 months. So I'm 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 spinal cord straight away, maybe done cooling, maybe use different medications, if they don't improve after 12 to 18 months, what options do we have? And there's a huge growth in neural prosthetics. 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 Paradromics, Phantom Neuro. It's really an exciting time for neuroprosthetics and helping people with spinal cord injuries or strokes or other neurological injuries.

[B]

Yeah. And I'm curious, you know, with that technology, particularly the brain computer interfaces, your neuralink chips, what's your outlook for this technology, let's say as soon as, even in the next five years?

[C]

Well, I think every time, you know, we always see kind of a cycle. So there usually it takes five to 10 years for a 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 10 years before we really get comfortable with it. And we really see the benefits. Examples being stereotactic 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 neuro prosthetics will be quite different in five, 10 years. And we'll be using them in ways that we didn't quite expect. So I'm looking forward to that.

[B]

Great. And then a couple other questions. What do you think will be the biggest headwind that you'll be facing in 2026?

[C]

It's really hard for people to navigate the healthcare system. You're unwell, you have a severe brain or spine problem, you're in pain. Navigating the system is very tricky. It's hard to get 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.

[B]

Got it. And then the last question I had for you is how are you thinking about growth over the next 12 to 24 months?

[C]

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, more they understand the options, the better they do. Practice wise, we're always trying to refine our practice and make it better.

[B]

Growth.

[C]

Research wise, hoping to add more new help options to help people with cervical myelopathy 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, 12 to 18 months. So I think that'll be a big growth area. Great.

[B]

Well, I'm Dr. Murphy. Thank you so much for joining us today. Look forward to connecting down the line.

[C]

Excellent. Thank you very much.