Vladimir Sinkov, MD, a spine surgeon at Nashua-based New Hampshire Orthopaedic Center, discusses trends and challenges in spinal fusions.
Dr. Sinkov focuses on spinal decompression, fusion, minimally invasive techniques, scoliosis correction and disc replacement.
Q: What are some of the most exciting new trends in spinal fusions?
VS: While minimally invasive surgery is not a new trend any more, new and less invasive techniques, tools and implants are currently being developed. Benefits of minimally invasive lumbar fusions over the open techniques have been clearly demonstrated in current literature.
Wider adoption of these techniques is still lagging, however. This is likely due to the steep learning curve and fairly significant additional cost and complexity of these procedures. New techniques and instrumentation will allow these procedures to be done faster, cheaper and more effectively. I am hoping this will help with wider adoption of MIS surgery, which will be highly beneficial to our patients.
Another trend is computer navigation and robotics. There is still a lot of work to be done to improve robotics applications in spine surgery, but the future is promising and new devices will be coming out on the market soon.
Q: What are two to three of the most pressing challenges facing surgeons who perform fusions?
VS: Declining reimbursements and increased surgery denials make it harder to help our patients and remain financially afloat. Additionally, as the population ages we are seeing more spine problems in patients that are more complex — with higher number of medical co-morbidities, lower bone mineral density and more spine deformity.
Finally, surgical innovations such as MIS fusions, computer navigation and robotic surgery increase the cost of the procedures. We must justify their use by showing greater safety and efficiency as well as improved outcomes.
Q: How can surgeons overcome those challenges and grow their practice?
VS: Surgeons will increasingly consider opting out of insurance networks or not accepting insurance payments completely and making financial arrangements directly with the patients. Also, aging patients will need a more multi-disciplinary approach to their spine problems to deliver most effective and safe care. Continued research and implementation of innovations in spine fusion surgery will likely need more industry support in the future.
Learn more from Dr. Sinkov at the 15th Annual Spine, Orthopedic & Pain Management-Driven ASC Conference + The Future of Spine in June 2017! Click here for more information.