There is tremendous change in minimally invasive spine surgery internationally. Surgeons around the world are learning less invasive techniques to treat spinal disorders and injuries, and surgeon instructors are learning things from their counterparts overseas.
"The surgeons in other countries are talented and see an unbelievable amount of pathology," says Neel Anand, MD, clinical professor of surgery and director of spine trauma at Cedars-Sinai Spine Center in Los Angeles. "There is a lot we can learn from them. They are dealing with a different patient pool; generally, patients in those countries don't complain about back pain so they don't have back pain patients coming into their office. The patients have true instability, deformities and neurologic issues, and the surgeons are treating them with whatever equipment they have. They don't need the perfect group or technology; it's more about the thought process to achieve the outcomes patients need."
Dr. Anand has traveled to several countries, including China and India, to meet with the local surgeons and instruct them in minimally invasive techniques. There is a cultural difference for patients in other regions of the world; they are more realistic about spine outcomes and minimally invasive surgery has tremendous appeal.
"The volume of patients surgeons are treating in these other countries is huge, and the pathology is vast. These surgeons' talents are fantastic," says Dr. Anand. "But there is often a cost and regulatory issues for surgeons to obtain the most advanced technology. Each country has its own regulations and can't just import their equipment."
Global device companies are seeking out local partnerships in countries with stiff regulations. Countries like China and India have huge markets and international gatherings are bringing specialists together to educate them about the most advanced technologies out there.
"There is more and more knowledge available, and the companies are becoming increasingly comfortable providing the appropriate educational materials," says Dr. Anand. "They're also able to keep costs down for those countries so the technology is cheaper there."
In the future, increased partnerships in local communities will bring some of the best technologies to remote parts of the world. "An amalgamation and union between local and international companies in some fashion could be internationally beneficial," says Dr. Anand. "The world is becoming a smaller place. We'll see international meetings grow around the world and soon more countries will have the same courses we have. There will be one big market."