From endoscopic cases to payer relations and more, several experts in spine surgery shared their insights with Becker's during the third quarter.
Five quotes to know:
On what's next for endoscopic spine surgery:
"I think that right now the biggest indications for endoscopic spine surgery is in minimizing the degree of destruction, and it's pretty much applied for degenerative disease. But I think as the instruments that are available improve, it's going to be applied to a wider variety of diseases. We're really hoping that it'll eventually be used in cases like trauma or even oncology cases. Especially with the latter, it's really important to try to minimize your incision because these patients tend to be immunocompromised. They are going to require chemo and radiation post-op. So smaller incisions mean quicker time to chemo, radiation and less likelihood of complications from that." — Sohail Syed, MD, OSF Healthcare (Peoria, Ill.)
On the new "gold standard" of spine surgery:
"We live in an exciting era of technological innovations. The goals of spine surgery have not changed, namely decompression, stabilization, and deformity correction. As spine surgeons, however, we have a plethora of tools in our toolbox to accomplish those goals with more accuracy, efficiency, reliability, and reproducibility. We hope that continues to translate to clinical significance in the immediate and long-term postoperative periods. Therefore, the new gold standard of surgery will likely involve larger use of technology, depending on the healthcare system and surgeon comfort. These technologies likely will focus on motion preservation, minimizing surgical footprints and optimization of spinal parameters. Artificial intelligence also will become an increasingly bigger part of spine surgery and healthcare, in general, to facilitate patient care optimization." — Jimmy Zhu, MD, Endeavor Health Orthopaedic & Spine Institute (Naperville and Plainfield, Ill.)
On the spine surgeon and payer relationship:
"Collaboration between payers and providers is a key determinant of success. What has previously been missing from this conversation and what is further needed is the alignment of goals between these two groups. Historically, this relationship at its surface has been contentious — with both groups at odds regarding their differing objectives; cost efficiency versus patient outcomes. Improving this relationship will require action on three fronts, communication, data sharing (and how that data is measured, acquired and what patient populations), and price transparency. Alignment of interests between payers and surgeons can reduce both financial risk and improve patient outcomes resulting in the delivery of better-quality care to patients." — Rachel Bratescu, MD, George Washington University (Washington, D.C.)
On what's next for spine implants:
"The future of personalized spine implants is poised to revolutionize spinal surgery through the cutting-edge technology of 3D-printed titanium spinal interbody fusion cages. These implants, precisely tailored to each patient's unique anatomical and mechanical needs, will deliver unparalleled patient outcomes by promoting robust bone growth and providing exceptional bio-support for spinal fusion procedures. Leveraging titanium's superior biocompatibility, strength, and corrosion resistance, these custom implants will ensure optimal osseointegration and long-term success. The true game-changer is the meticulous design flexibility of 3D printing, allowing for varied pore sizes and shapes that enhance osteoinduction and osteoconduction. This creates an ideal environment for bone growth, facilitating the migration, attachment, and differentiation of bone-forming cells while supporting vascularization and nutrient diffusion. Ultimately, adjunctive bone grafts will be eliminated, costs reduced and surgical procedures streamlined. Surgeons can anticipate a new era where these state-of-the-art implants not only meet but exceed the demands of complex spinal surgeries, delivering unmatched precision and patient care." — Morgan Lorio, MD, of Advanced Orthopaedics and Pain Management (Orlando, Fla.) and ISASS president (2024-2025)
On spine medtech consolidation:
"Acquisitions have been the standard corporate business model in spine/orthopedics for close to 20 years. The days of internal organic development are mostly over for the big five to six companies who, in spine, have about 7% market share based on revenue. Many have reduced their internal engineering staff numbers, which makes getting custom instruments challenging and product development an afterthought. It's a corporate decision to derisk. It means they are buying proven revenue generating products and not taking the risks of development, approval etc. [It] makes corporate sense but makes it exceedingly hard for surgeon innovators where they basically need to bring products to market themselves. The surgeons are the future of innovation so there needs to be a clearer pathway for this and acquisitions in the short term make sense but in the long term may stifle innovation as the development road becomes too long. I know this, because I have lived it with two medical device startups." — Lali Sekhon, MD, PhD, Reno (Nev.) Orthopedic Center