Here, Steven C. Anagnost, MD, discusses minimally invasive spine surgery and where it is headed.
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MIS spinal surgery will be the gold standard for spinal procedures within five years. This does not mean that all spinal procedures will be MIS, but when the procedure can be done MIS, it likely will be done that way. There are certainly circumstances where MIS may not be the best decision for a particular patient. However, with the industry adoption of MIS procedures, most surgeons now have several different MIS options to offer their patients, which offer improved outcomes and lower cost.
Most training programs will be training residents and fellows in modern techniques and pearls of MIS spinal surgery. In the early days of pioneering these procedures, surgeons have had to train themselves and visit ground-breaking surgeons to collaborate on MIS procedures. Now, with the adoption of MIS by implant manufacturers, there are so many more options available. This has had a positive impact on residency and fellowship programs to be able to offer modern techniques of MIS to residents and fellows.
More long-term data will be available in five years, for surgeons to compare traditional techniques of spinal surgery as well as less invasive MIS procedures. More and more surgeons are performing these MIS procedures now, and thus the learning curve is flattening out, producing more accurate and reliable data and outcomes for MIS spinal surgery. This will allow surgeons, patients, insurance companies and legislators to more accurately decide on what MIS surgeries are and how they can help patients.
Biologics will likely be utilized more and more via MIS spinal surgical approaches. The soft tissue preservation of MIS procedures is a perfect match for allowing biologics to do more. Platelet rich plasma, stem cells and other biologics can and will provide much more for patients when coupled to MIS spinal surgical procedures.
Outpatient spinal procedures are already on the rise, and this trend will likely increase exponentially in the next five years. Insurance companies and legislatures will hopefully continue to take notice of the positive benefits of MIS spinal surgery, especially in the outpatient setting. This not only helps large hospitals, but also ASCs and especially rural hospital communities to treat patients closer to home at lower cost and improved outcomes.