Jeffrey Nees, MD, a neurosurgeon with Laser Spine Institute based in Oklahoma City, discusses minimally invasive spine surgery and opportunities for future development. Q: Over the past few years there has been a trend toward minimally invasive spine surgery techniques. Do you think this trend will continue?
Dr. Jeffrey Nees: I think minimally invasive surgery is going to expand, not only in the scope of different procedures and areas of the spine, but also in the number of practitioners who engage in it. I think it will be a trend in the future while heavy use of implants is going to be less commonplace.
In the future, we are not only going to improve technique but also minimally invasive stabilization technology. There will be developments in artificial and synthetic disc replacements. Disc replacements more closely mimic the physiology of a normal disc. The other area that will continue to grow, in my opinion, is the use of biologics, which is growth and regenerative factors along with stem cell technology.
Q: What are the most exciting and innovative developments happening right now?
JN: The most exciting things are in biologics. They are still in the late basic science, early clinical phases for some of the growth and regenerative factors. We are further along with stem cell technology, but it needs to be perfected and redefined. Then we need large randomized prospective trials to document the efficacy of stem cell technology. This is the strongest level of research possible.
For stem cell replacement, we use fluoroscopy and it's done primarily through needles. Depending on what you have to do to the disc — if there is a disc herniation you have to remove that before beginning the stem cell treatment — you can perform the procedure all through needles and not even use a scope.
Q: How will these developments impact the field in the future?
JN: We could be looking at dramatic improvements in a patient's spine condition far above anything we were able to achieve before with less cost of medical care and dramatic improvements in the realms of recovery time and postoperative pain. There could be some fairly revolutionary changes in spine care just about all around.
Q: Where will there be the best opportunities for device development in the future?
JN: Innovations are happening all the time to improve our actual metal fixation. There has also been improvement in the materials and expandable grafts. I think one area for future work will be to couple some of the biological technologies with minimally invasive stabilization techniques so surgeons can continue to have good fusion success with smaller operations.
Q: How will healthcare reform impact innovation in the field?
JN: We will have to wait and see. I do have a suspicion that the healthcare reform laws that have been put in place will have a natural tendency to stifle innovation but I believe we will continue to see some innovation going forward. Laser Spine Institute is committed to staying on the forefront of technological advances in patient care.
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Dr. Jeffrey Nees: I think minimally invasive surgery is going to expand, not only in the scope of different procedures and areas of the spine, but also in the number of practitioners who engage in it. I think it will be a trend in the future while heavy use of implants is going to be less commonplace.
In the future, we are not only going to improve technique but also minimally invasive stabilization technology. There will be developments in artificial and synthetic disc replacements. Disc replacements more closely mimic the physiology of a normal disc. The other area that will continue to grow, in my opinion, is the use of biologics, which is growth and regenerative factors along with stem cell technology.
Q: What are the most exciting and innovative developments happening right now?
JN: The most exciting things are in biologics. They are still in the late basic science, early clinical phases for some of the growth and regenerative factors. We are further along with stem cell technology, but it needs to be perfected and redefined. Then we need large randomized prospective trials to document the efficacy of stem cell technology. This is the strongest level of research possible.
For stem cell replacement, we use fluoroscopy and it's done primarily through needles. Depending on what you have to do to the disc — if there is a disc herniation you have to remove that before beginning the stem cell treatment — you can perform the procedure all through needles and not even use a scope.
Q: How will these developments impact the field in the future?
JN: We could be looking at dramatic improvements in a patient's spine condition far above anything we were able to achieve before with less cost of medical care and dramatic improvements in the realms of recovery time and postoperative pain. There could be some fairly revolutionary changes in spine care just about all around.
Q: Where will there be the best opportunities for device development in the future?
JN: Innovations are happening all the time to improve our actual metal fixation. There has also been improvement in the materials and expandable grafts. I think one area for future work will be to couple some of the biological technologies with minimally invasive stabilization techniques so surgeons can continue to have good fusion success with smaller operations.
Q: How will healthcare reform impact innovation in the field?
JN: We will have to wait and see. I do have a suspicion that the healthcare reform laws that have been put in place will have a natural tendency to stifle innovation but I believe we will continue to see some innovation going forward. Laser Spine Institute is committed to staying on the forefront of technological advances in patient care.
More Articles on Spine Surgery:
5 Spine Surgeons on Operating Room Innovation
5 Healthcare Reform Threats to Spine Surgeons & How to Overcome Them
7 Cost Cutting Strategies for Spine Surgery