Four key elements have helped Justin Scheer, MD, of Los Angeles-based Cedars-Sinai, assess the value of new spine innovations in a growing landscape.
Note: This response was lightly edited for clarity.
Question: How do you stay current with the rapidly changing landscape of spinal implants and devices? What criteria do you use to evaluate new technologies?
Dr. Justin Scheer, MD, Cedars-Sinai: In spine surgery we rely on spinal implants and devices to augment the surgical goals, which can vary drastically from patient to patient depending on the etiologies being treated. Given the wide array of pathology treated in spine surgery, there is a vast number of implants and devices all with different purposes. Not only can it can be overwhelming to learn which implants/devices are best for which surgical indications, but even more so to keep up this knowledge base with the ever-expanding options of new implants and devices.
There are a number of options to stay current with new implants, all of which work together. One of the best ways is to attend the national/international spine conferences and spend some time on the exhibit floor exploring the new implants/devices and talking to the company representatives. Most of the time you can demo these technologies and start getting a feel for them. Although attending many conferences can be cost prohibitive, if you do find yourself at one, make sure to set some time aside to explore. Another option is to peruse the scientific literature on a regular basis as many new implants/devices can be studied or used in certain studies. And lastly, having a regular conversation with your local company representatives about new and upcoming products can also be beneficial as they will most likely have an idea of what's in the works.
Evaluating new spinal technologies can be challenging as well, especially without firsthand use of them. However, it's good to have a basic framework that can be applied to all new devices/technology that you encounter. First would be the features of the device/technology. Do the design features fit with your surgical goals? Does it do what you want it to do? If so, then it might be worth further investigation. Next would be how easy (or difficult) is it to actually use. The device may be perfect for your intended use but if it's too difficult to actually use or it prolongs the surgery by too much time, then it might not be the best choice. If the technology has great features for your intended application and can be easily used, the next criterion would be how well it integrates into your current workflow as well as other members of the team and devices/technology. If the new technology cannot integrate into your current ecosystem, it is very unlikely to add any benefit to you or more importantly, the patient. And lastly, the cost of the technology including maintenance cost must be taken into account. Unfortunately, if the perfect device or technology is available for your given application but is cost prohibitive, then that too won't be in the best interest of accomplishing your surgical goals.