00:00:00 Mr Robert Klupacs I’m delighted to welcome my guest today. Justin Zenanko, co-founder, CEO and president of SynerFuse, a medical device company based in the United States developing an innovative solution to reduce chronic back pain and improve patient quality of life. Justin and his team have patented the SynerFuse E-TLIF™ procedure which aims to make traditional spine implant surgery more successful and cost effective by combining neuromodulation at the time surgeons are performing fusion back surgery. SynerFuse has completed a proof-of-concept study of 15 patients and they’re coming up to a 12 month review of post-surgery results in October. A certified public accountant, Justin has experience in corporate finance, entrepreneurship and startup development. He has previously held senior leadership positions at Recombinetics Incorporated where he led fundraising efforts resulting in $68 million of investment, including $34 million in angel funding and 34 million in Series A funding from a strategic investor. Welcome to the podcast, Justin.

00:01:17 Mr Justin Zenanko Thank you for having me. Happy to be here and to be with you today.

00:01:22 Mr Robert Klupacs Fantastic. Let’s just jump in. Justin, we’ve got a few questions for you today. First one we wanted to ask you, you and your team at SynerFuse are really working a truly exciting and much needed – and I can speak from personal experience – space in the healthcare, chronic pain management and lower back pain in particular. But before we delve into that area, can you just tell us a little bit about how you in particular ended up working in med tech? Because looking at your profile, you, you didn’t necessarily come from a technical background and you’re now in the into the heart of Med tech.

00:01:57 Mr Justin Zenanko Yeah, so it’s an interesting story, one of either coincidences or divine characteristics, but basically, you know, I was a certified public accountant trained and I was really encouraged at a young age to pursue business or being a CPA certified public accountant. And as I was learning about business from my father and learning from other business owners, the one thing that every business has in common is the language of numbers. And from that I ended up meeting the founder of Recombinetics, which the idea there was to create pig organs, or pig kidneys in particular, for the transplantation market where there’s 100,000 people per year on the waiting list waiting for kidneys. And we were innovating gene editing technology. And as we went through the development process there and we brought in a large institutional investor, the writing was kind of on the wall of what is next to come.

00:03:16 Mr Justin Zenanko And as I started looking around for a large need and something to do, interestingly enough, I was looking at investing in a restaurant in Minneapolis, Minnesota. And I met this doctor, a pain physician, who was looking at treating his patients who had fusion surgeries that were done, fusion procedures that were done successfully.

00:03:46 Mr Justin Zenanko And what ended up occurring was these patients had chronic leg pain, chronic back pain and nothing was working. They were, they were thinking about ablations and all these other things. And we had a neuroscientist from the University of Minnesota and a neurosurgeon who dealt with stimulation. And together me as the business owner was like, what can we do to solve this problem?

00:04:16 Mr Justin Zenanko And fortunately, this is right before COVID I skipped out on the restaurant and went directly into back pain, of which I had no knowledge of other than it’s a big problem. 600,000 patients per year have this problem and 240,000 or 40% suffer from this chronic pain and go through a 10 year cycle of opioid addiction, additional surgeries and eventually, if they’re lucky and they’re proactive enough, can get a stimulator. And it was the beginning of where we are today.

00:04:58 Mr Robert Klupacs Wow, what a fantastic story. I love that. So you accidentally met a doctor while you’re going to buy a restaurant and now you’re running potentially an innovative and groundbreaking med tech company. It’s a fantastic story.

00:05:10 Mr Justin Zenanko Yeah, it’s really about being non-conventional and not having conventional thinking. And I think today’s problem with a lot of entrepreneurs or corporate America and probably corporate culture around the world is we don’t think outside the box. We’re not willing to take the risk. And I’ve always been a risk taker from a young age, which is very contra to being a certified public accountant, which is boring.

00:05:44 Mr Justin Zenanko You know, stay in the corner, don’t speak to anybody, don’t, God forbid, look someone in the eyes, you know, do spreadsheets. And here I am interacting with people and being compelled to tell a story. In my opinion, the gospel of SynerFuse is the good news because we’re looking at solving this problem of chronic back pain and in the in the United States, 51 million Americans suffer from chronic low back pain. That’s a large number. And of that number, 1.1 million final procedures per year are performed in the United States alone.

00:06:26 Mr Robert Klupacs My God, that’s huge. We’re trying to work it out before we got you on the call, what’s the SynerFuse product? How does it actually work? And what are you aiming to do in terms of the indication you’re looking to get registered and commercialise? Is it to basically cure back pain or is it just to relieve the symptoms?

00:06:48 Mr Justin Zenanko So you always have to be in the medical world very cautious and very skeptical of anyone that says a cure. You have to be very careful about what you state, because we are not FDA approved, and we are. We conducted our first feasibility center feasibility study under an investigational device exemption. And so our mission is to get rid of or reduce chronic low back pain and leg pain, which also reduces the need for addictive opioids. And just speaking from experience, in the United States, opioids are a scourge in our country and accounts for $1.5 trillion of lost economic productivity from misuses. It’s a huge problem. And our goal as a company is to make it where procedures are better, more effective, and allow patients to get their lives back.

00:08:03 Mr Justin Zenanko And what I can say is that of the patients that I am aware of, we are seeing remarkable, remarkable early data that makes us very enthusiastic about the prospects of giving people their lives back and having something where they’re not relying on a drug which then becomes the path towards, you know, death and and other destructive things that occur within the family, which occur among friends and then greater to society in general.

00:08:42 Mr Robert Klupacs So how does it actually work? Is it a variation of spinal cord stimulation or is it something different?

00:08:49 Mr Justin Zenanko So the way it works is it’s direct nerve stimulation. So when the spine surgeon goes and performs a spine procedure, which is the decompression, meaning getting the bone off bone, bone off nerve, freeing the nerves, instead of just closing that up after they install the mechanical structure of the rods and the screws to hold the decompression in place, what we’re doing is we’re adding our technology, which is the integration of stimulation, those leads or those wires that go directly on the nerve to treat the damaged nerves in the back. It’s never been done before, never been attempted before, and we’ve done that successfully in 15 patients to date.

00:09:43 Mr Robert Klupacs Which particular nerve are you highlighting in the back? Is it. Is there a particular one you’re doing, or is it a generic subset of nerves?

00:09:52 Mr Justin Zenanko So in our case, we’re going after the dorsal root ganglion, the DRG, which are the nerves that have been shown through other studies that if you stimulate those nerves, you have dramatic effects on pain reduction. The problem with today’s procedures is those nerves are targeted in the thoracic region of the spine to address pain. So this is where there are no prior fusion surgeries. In our case, we’re the only ones in the world that are doing the dorsal root ganglion, or DRG at the time of a spinal fusion which is in the lumbar. And no one’s ever shown data that shows that when you stimulate the lumbar, you get back pain relief.

00:10:49 Mr Robert Klupacs Wow.

00:10:51 Mr Justin Zenanko And we are on the cutting edge of technology showing that there is a correlation between pain improvement for legs and low back. And until you actually do it, you don’t actually know. And we, you know, we’ve shown this on 15 patients in the feasibility study, which is focused primarily on safety, which is amazing.

00:11:18 Mr Robert Klupacs So do, is it an implanted system? Do you have to implant an electrical stimulator or is, is this, is there the wires put in to stimulate the DRGs and they externally stimulate?

00:11:30 Mr Justin Zenanko No, it’s a fully implantable device. So this is a device that is intended to be with the patient for their entire lives.

00:11:40 Mr Robert Klupacs Right. Fantastic. I mean as you said, you’ve done 15 patients to date. How many more patients and safety. But I imagine you’ve got some secondary efficacy. That’s what I think you’re talking about. How much more data do you need to get? I know you’re coming up to the 12 month follow up review of post-surgery results which sometime will be announced sometime in October. What do you need to generate to be able to get FDA approval with your, with your device? 00:12:09 Mr Justin Zenanko So I gotta be a little careful here. But based upon early feedback, we think that we’re gonna have to have somewhere around 150 patients in a national trial, multi states, multiple surgeons and having the, our, you know, showing that with a control group that our outcomes are superior. So on 15 patients, it’s not statistically powered, so I can’t make claims, we don’t have indications. But the patients that we are treating are patients that we’re selecting. If you want to think about it, the worst of the worst. The patients that are, that are defined as having chronic low back pain and chronic leg pain. And the way they define chronic for back or leg pain is by having from 0 to 10, 5 or greater of a pain score for greater than three months.

00:13:24 Mr Justin Zenanko And what we do know is that the more surgeries that you’ve had, you know, conservative surgeries like decompressions, laminectomies, where they’re freeing up the bone, they’re freeing up the nerves and they’re not trying to get to a fusion because those patients haven’t gotten there yet. And their progression of their disease, we’re looking at how do we actually, you know, when we’re going to the therapy of last resort, that means lot of these other measures probably failed.

00:13:59 Mr Justin Zenanko And so now they need a fusion because their spine is mechanically unstable. So you need to fix the mechanical pain, which is bone on bone, bone on nerve. But the thing that has been elusive is the nerves until now.

00:14:20 Mr Robert Klupacs That’s amazing. So 15 patients, 12 month follow up. You clearly are pretty excited about what you’re seeing and you’ve got a pathway to approval in terms of what you need to do. And that’s another 100 or so patients that need to be obtained. Will you do those studies primarily in the United States or have you considered doing those studies elsewhere and pitched to you? Australia is a great place to do these type of studies and we’ve got some fantastic neurosurgeons and in this country and our listeners would be very interested to know how this is going to happen, how quickly it can be done. And for all of us here, whether or not there’s a role perhaps Australia can play in your development.

00:15:03 Mr Justin Zenanko So we’re primarily focused on the United States just because it’s in our own backyard, if you will. It’s where we are. It’s where we’re headquartered in Minnesota, which is, you know, the, where Medtronic was founded. So there’s a lot of history here. But we are very interested in going beyond the United States. But like in any company, you have to be very conscientious of your dollars because you were raising capital. These pursuits are capital intensive and because of all the regulation and all of the costs, we’re looking at, you know, about $25 million when we go to this national trial. I’d be very interested in exploring how we could help with our development in Australia. And if there is the, you know, if we have the right mix. And I think, you know, like, for example, the United States has a big problem with obesity and obesity is not going away. Obesity is increasing in the United States. And with more obesity, there’s going to actually come more spinal procedures, which means we’re going to have a bigger need to have this done.

00:16:37 Mr Justin Zenanko I think like in any country we need to be, you know, forward thinking and go beyond. Because I don’t want to just solve this problem in the United States, I want to solve this in Australia, Europe, wherever there’s the need to address chronic back pain and we can implement our procedure we want to be there because it’s going to actually help people.

00:17:07 Mr Justin Zenanko And that’s what the company is about, is how do we actually help people get back to their lives so they can actually not only pursue their own goals and dreams, but also, you know, be an active member in their family, but also an active member in society.

00:17:27 Mr Robert Klupacs Yeah. Well, I can assure you that chronic back pain is not limited to the United States. It’s all over the world, particularly in Asia and Australia. There’s a number of people needing these procedures. So you’ve got to. You have a an issue and a problem that needs to be solved worldwide. And clearly you’re coming at it from the United States, which makes enormous sense. One thing to let you know that there is a community and many of them listen to this podcast that look for technology to invest in the med tech space. This is a major problem that’s got a huge market, and it needs a problem to solve it. Because the field of opioid addiction for pain is not just limited to the United States, it’s here as well. And people are looking for something to alleviate these things just for quality of life and for no other reason. And so one of the reasons we wanted to get you on the call was to let our listeners know that there is technology being developed for this major problem. You’re in the early stage of fundraising. You’ve mentioned just before you’re looking to raise another $25 million to expand it. And there are groups of people here who could be quite interested in that approach. And I know you’re probably going down the traditional routes and about raising it from the next stage of capital, but there are people in Australia who do invest venture capital, but also the public markets here, people are quite interested in this type of approach. So maybe we can follow that up. And also our listeners and I know some of the investors who listen to this may want to get in touch with you. Would that be okay?

00:18:56 Mr Justin Zenanko Absolutely. Like you said, this is a world problem. And I would be very interested in speaking to investors and people who want to. Want to join us in this cause, but also, you know, be part of, you know, the revolution, which is addressing addressing the pain and doing in a way where people are getting off of opioids. And, you know, if you even go to our website, which is www.synerfuse.com, and go to news, there are two news stories from patients that the media actually sought out. And in those cases, one patient ended up going back to riding her motorcycle and another patient was off of opioids within five days. That doesn’t happen in spinal fusion procedures.

00:20:10 Mr Justin Zenanko You don’t see that when people get fusions, they’re trying to go from being able to walk 10ft to walking 100ft. We’re talking about. We’re talking about people getting back to their lives. And that to me, you know, as an entrepreneur, as a co founder, as somebody who is the largest shareholder and investor in the company with two and a half million dollars in the company, my number one thing or goal is how do we actually get this to the masses? Because there’s a better way of doing it. And we’ve been very fortunate. We work with some of the top neurosurgeons in the United States. And at first the neurosurgeons were very skeptical, but now they have gone from being skeptics to being ambassadors, if you will, to harness this technology to move it forward.

00:21:26 Mr Robert Klupacs Yeah, that was one of the questions I wanted to ask you because clearly it’s a major problem. The spinal cord community, fusion community, knows that this procedure can be done, but it’s got limitations. And you’re coming up with this new approach to target the DRGs. For our listeners, what was the journey that you and your colleagues had to go through to convince the clinicians who actually try what you’ve done? Because you’ve gone out on the edge a little bit here doing something no one’s done before. So when you’re a pioneer, it’s always difficult. Now you’ve got patient data, it probably looks a lot easier for everyone to say this is going to work, but there must have been a path to get to that. It would have been quite circuitous. And I know my listeners would love to hear how you went through that to, at least at first instance, to enable a clinician to even try what you’re doing.

00:22:18 Mr Justin Zenanko Well, yeah. And, you know, one of the things about our, our this journey is, the thing about the journey is we knew there was a major problem. So therefore, you have faith, you have belief, even though you do not have evidence, if you will, that faith, that belief was talking to the surgeons and all. And by the way, when we first started, the surgeon said, well, there is no problem. My patients do well. And it was well. What is well? How do you define well? And in a lot of cases, they’re telling patients, you know, a 40% reduction in your pain is success. Well, that is not success in my book, as an outsider, you know, going from a 10 to a 6 and you’re having to utilise opioids is not. Is not a good solution, in my opinion. So I had that internal belief that we have to get this done. And as we started out, we got some really bold surgeons who understood that there has not been true innovation in spinal fusion for the last 30 years. When you look at the spinal fusion world, they’re making little incremental improvements on the rods and the screws. And the idea is, well, if you want a better outcome, you need to better place the screws and the rods. And we’ve seen the development of the robots and using robots to help with better placement. But the problem is we’re still seeing these patients who are not doing well. And so as we start having the conversation about attempting this and convincing the surgeons to get on board, it was when he actually sat down and he had the conversation.

00:24:51 Mr Justin Zenanko A surgeon could tell you, you know, it’s a flip of a coin if someone gets better. They could have two patients where they do two exact same procedures under the X ray they both look the same. However, one’s in tremendous pain and one is out of pain. Why is that? And the thing that everybody had been missing, which was right in front of them, were the nerves. And, you know, having a, having one of the co-inventors being a neurosurgeon helps, having a neuroscientist understanding stim helps. But then it was really about, we need to move the needle and let’s try this. And you know, this is, this is, this is really a story about faith and perseverance. Because when we started this trial, it took us 18 months to get our first patient from the time that we had FDA approval to do the feasibility study. We got hit with COVID and we got hit with the cultural norms within the surgeons, which is, well, you know, I don’t know if I really want to try to talk to the patients about this and, and going through that process. But we found patients who had failed prior surgeries, laminectomies, discectomies, and were now going for a fusion because they had more instability in their spine, but their pain had not subsided. Which means that there was better evidence that those nerves were damaged and they were, they became chronic. Well, that’s a no brainer when you’re doing revision surgeries or doing additional surgeries in the same area. And I was in all but one of the procedures. And a spine surgery is a dramatic event because you’re literally moving bones, vertebrae, you’re getting rid of scar tissue. And that actually is the best time under direct visual placement, to place the stimulation leads on the nerves that are exposed. Because once you go beyond that, those, if you do not implant at that time, those nerves scar over and you can’t access those nerves.

00:27:49 Mr Justin Zenanko And we were able to get the first patient and it was kind of like, oh, I don’t know if this is going to work. And then we turned on the stim and you could see the patients describing where they felt electrical currents in their legs and then their back. And when you see that, where someone has a burning sensation and the burning sensation goes away and you see it with your own, in your own experience, it just, it catches the room on fire about what we’re doing and the impact and how do we get this for even more people?

00:28:38 Mr Robert Klupacs That’s amazing. It really does sound amazing. One question that’s coming to my mind. So that just getting into the patients would have been a huge undertaking, but there’s a leap of faith as the word you used. But how did you get there? Was there animal studies that someone had done to at least give some people confidence that this might work? Or was this basically, look, we think this is an approach we need to do. Let’s go straight to humans. How did that come about?

00:29:05 Mr Justin Zenanko So that, that, that’s a very good question. We went straight to humans. And the reason why that is is because today you have two therapies of last resort. You have fusion, which has been around for 30 plus years, and you have stimulation, which has been around for 20 plus years. And DRG, more specifically, the problem with DRG is placing the nerves, because today the way it’s done is they have to go through pleural imaging to get close to the nerves. And they’re never quite right, they’re never quite on. And over time, you have lead migration and other problems. So we had DRG, that’s already been done for studies. We had fusion was already done for studies. So the key here was to show that when we combined fusion with stim, is it safe? And we almost didn’t get that approved. We almost did not get that study approved through the FDA, but through faith, through commitment. And I gotta give, you know, one of my co-founders a lot of credit, one of the neuroscientists, he helped push that through. But it, it was, a lot of it was. And when you are an entrepreneur, you go down the path of you don’t know what you don’t know, so you’re not afraid to try anything. And that’s what we did.

00:30:52 Mr Robert Klupacs I love that story, I really do. But major clinical problem, faith manoeuvring through the FDA, because I imagine their major problem would have been surgery safety. But you just need to bring all the data together from the disparate parts, by the sound of it, to convince them that you weren’t doing something completely different. But someone had to do it first. So that Must have been a huge challenge, but congratulations on getting through.

00:31:18 Mr Justin Zenanko Well, thank you. Yeah. When we first to give you an idea of the challenge and I think your listeners will appreciate this. When we first started, I was given the number of roughly a million dollars to get this thing through to the first feasibility study. $22.7 million later. We have gotten to this, to this point in time and it was supposed to be two years prior. However, if you have something that you have faith in, belief in, and you’re seeing the results, you’re seeing people gain their lives back, you have no choice but to push it forward.

00:32:12 Mr Robert Klupacs Yeah, I mean, the question that comes up for me because we saw that $23 million raised and being spent to date, how did you get it? Because that’s what my listeners are going to want to know because you were taking a real shot here, a one in a million shot really, with going straight to humans and with no guarantee of success. So how did you raise that money to get to where you are today?

00:32:38 Mr Justin Zenanko I had to lead by example, by putting my own money in and leading every round. And it was finding individual investors who believed in the cause and wanted to be part of this endeavour. Every investor to date that joined our effort joined this cause, either themselves or knew somebody who struggled with chronic back pain and leg pain. And so when you, when you put the right people in the room to solve a problem and can join you, and the problem is that a company like ours traditionally would not be here, you either couldn’t get the funding because a VC never would have taken the risk, or if we would have taken the risk, the VC would have pulled the plug on us because of the 18 month delay.

00:33:47 Mr Justin Zenanko Well, clearly there’s no patients because you can’t get any patients. That’s not acceptable. Because the other side of that outcome is we have 50 plus million people in the United States suffering from chronic low back pain on opioids, on this addictive path and have the. There’s nothing worse than seeing somebody who has hope and then after every surgery that doesn’t produce the outcome of the relief that they wanted, seeing the light go out of them. If you do not have a zealous mentality to push the boundaries, to push forward, you will never get there. And unfortunately, that is most of corporate America and probably corporations in general, probably. They’re very risk adverse and they’re not willing, they don’t have the mentality of. I kind of, I kind of view it almost like D Day, if you will, in World War II. You’re storming the beach, there’s bullets coming at you. You only have one goal. You need to take the beach. Well, the beach for us is chronic pain, chronic low back pain and leg pain. There is no other option but to address it. And if we don’t address it, that means, that means you have tens of millions of people, not just the United States, but around the world, that will continue to suffer. And when you know there’s a better way to do it, you have no choice but to push that forward.

00:35:45 Mr Robert Klupacs I’ve got to say, frankly, this was, this is an incredibly, Justin, an incredibly inspirational story. To get to where you’ve got to is extraordinary. Just while we’re finishing up, what’s the expectation now? How long will it take you to do the next 150 patients before we can see that this procedure could become part of the mainstream treatment for chronic pain?

00:36:10 Mr Justin Zenanko So as it goes in medical, it’s always longer than you would like, always takes more time, more money, but based upon what we’re doing, so what we did is we took our clinical study data and we used all that real human data to develop our novel proprietary device, which is one fourth of the size of today’s stimulator that was used. By utilising that development, that’s a 16 month development from the time that you get done with your study, which is going to be in October. Then you go back to the FDA with your clinical data, with your device, and then it’s going to be a two-year study. But it’s going to probably take one year to get 150 patients implanted.

00:37:15 Mr Justin Zenanko So you’re talking about another three years or 36 months. So you’re looking right around five years. Now there are things that could also be done in theory to help speed up that process. Like for example, I view this, I view our applications could have military applications to help soldiers in the battlefield or soldiers that need, that got injured, that need help from their pain, from their work-related issues. So I think there’s some things that could be done to help speed it up. But as of now, we’re looking at a five-year process. And then you got to go through the process of getting codes because there are no codes for this procedure. And what’s really unfortunate about today’s medical device world, and I’ll speak about the United States in particular, because I don’t know how it works in Australia, but in the United States in particular, if there is no code, that therapy does not exist.

00:38:35 Mr Justin Zenanko So today’s procedure you cannot get treated for in the United States. Unless you were in our trial, which when you’re talking to people who are calling you up who’ve had six surgeries and they’re in constant pain, it’s, it can become a very hard question to navigate of how do I get this? And I have to be so careful because as the CEO of a medical device company in the United States, if I’m viewed as making claims, I could have all sorts of problems for myself personally. So the stakes are high, but at the same time we have to get the word out and that’s through publications. But it’s also, you know, and it’s now really a function of money doing these studies not just in the United States, but Australia, for example, if we had the right partner that came to the table we could look at doing a similar study in Australia and that would be a way to advance this technology faster. Otherwise we’re, you know, we’re on this path that I laid out which is, you know, five plus years.

00:40:10 Mr Robert Klupacs Yeah, well, I think one of the things that’s really exciting me from this call is that the usual way we go is we’ve got Australian entrepreneurs thinking how do I break into the United States market? And it’s we need money, we need partnerships. One of the things I’m thinking about as we’re speaking is that we’ve got a great group of neurosurgeons here. There is some risk capital for these type of things. And what we know, from the Bionics Institute in particular, is that using Australian clinical data to get FDA approval is now a well-trodden path. And there’s some particular incentives here that you can do the same type of study that you’re doing in the United States for a significantly less amount of money and probably because of the relations we have here, probably just as quick or perhaps quicker. So I think all our listeners, I imagine a lot of the listeners that I know are listening to this know exactly the problems you’re going through and potentially could help you. So hopefully they can reach out to you. And how would they do that, Justin? Would they do that through the website? Would, should they make contact with me and I pass it on to you? What would you like us to do?

00:41:17 Mr Justin Zenanko It can go either way, either to you, to me or to our website where we have a contact, or they can reach out directly to me at Justin – j u s t i n – at Synerfuse.com but if they go to the website, they’ll be able to see our team, they’ll be able to see the medical surgeons, the spine surgeons that we brought on from all across the United States. But yeah, I mean they can reach me directly and we are very open to exploring all opportunities. It’s just, you know, like in anything you have to, you know, you have to get on the various platforms to get your word out and what we’ve done and you know, to talk about capital and how hard it is, all the capital that’s been raised has been local money to the state of Minnesota.

00:42:24 Mr Robert Klupacs Yeah. Interesting. Your governor was in Australia about six months ago and spruiking up the capabilities between Australia and Minnesota in particularly in med tech. So I know you’re really busy running the company in where you are, but if you get time to jump on a plane and escape a Minnesota winter in the next few months, I’m sure there’s quite a few people here would love to talk to you. So.

00:42:47 Mr Justin Zenanko Well, and I’m sure it wouldn’t be very hard to convince my wife of that. She’s been talking to me. We were, we were married in last December and we went on a short honeymoon and of course I’m always being accused of overworking, but the thing about it would be it wouldn’t be very hard to convince her to, hey, let’s go to Australia and explore. And I can’t help it, whenever in any country I go to or any place I go to that’s new, as an entrepreneur you’re trying to understand what are the current problems and how you can solve them and it sometimes can drive the people you’re around nuts. But then you find those other likeminded people that think the same way and that’s when you get true collaboration. And if we find the right people or have the right people, that makes it very easy to hop on a plane and really explore the true opportunities that exist. And the nice thing is our chief medical officer co invented the eTLIF procedure, Dr. Rohan Lall, and he did 11 of the 15 procedures. So it also would not be very hard to, you know, have Dr. Lall also come out with me and explore the opportunities and having, you know, spine surgeon to spine surgeon conversation.

00:44:30 Mr Robert Klupacs Fantastic. Well, let’s see how this plays out in the next few months. I think once this podcast goes live, I think you might be inundated with some very interested inquiry. Justin, we’ve reached the end of our podcast today and I thank you for sharing your insights on med tech commercialisation, the SynerFuse technology and your passion and faith in overcoming chronic back pain. To our listeners, I hope you enjoyed listening and I look forward to introducing you to our guests in future podcasts. There are links to everything we talked about in the show notes, and we look forward to welcoming you next time.