Here three spine surgeons weigh in on the most disruptive technologies and techniques in spine care today.
Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. We invite all spine surgeon and specialist responses.
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Question: What are the most disruptive new technologies in the spine market today?
Isador Lieberman, MD, Director, Scoliosis & Spine Tumor Center, Texas Back Institute, Plano: The most disruptive new technologies are robotics for automated surgery and biologics to arrest degeneration.
Plas T. James, MD, Atlanta Spine Institute: I think O-Arm is a good disruptive "robotic" technology to put in powerful self-guided screws, but I don't think we're close to robots performing spine surgery. I think you've got to be hands-on in spine surgery as much as possible. I think you use certain kinds of image-guided techniques with your own hands to fix the problem. But I'm not sure whether robots have a huge promise in spine surgery versus, for example, prostate or heart surgery where you have problems accessing certain areas anatomy-wise.
I think in surgeries, where your hands can't reach, a robot may be helpful, but using a robot to replace human hands is not necessarily the best way to go. I always use the analogy, if you're going to buy a pair of shoes that are hand-made or machine-made, which kind do you want? You want hand-made shoes because nothing is better than the human hand.
Mark Nolden, MD, NorthShore Orthopaedic Institute, Chicago: The more routine use of computer-assisted CT navigation platforms has been positively disruptive in the spine market today. It's now widespread use enables more predictable and accurate placement of spinal implants in complex and minimally invasive procedures.
The application and cost-effectiveness of robotics technologies in spine surgery has yet to be defined. Its utility for routine placement of pedicle screw implants is questionable.