Frank Phillips, MD, is heading into the new year with a new spine tool in his arsenal.
In November, he performed the first spine case with Augmedics' new CT-to-fluoroscopy registration method. The FDA-cleared technology eliminates the need for 3D intraoperative imaging.
Dr. Phillips discussed the advantages of the technology and how spinal navigation will evolve in 2025.
Note: Responses were lightly edited for clarity.
Question: What advantages does the CT-Fluoro registration have, and how do you see this growing in the spine tech space?
Dr. Frank Phillips: The ability to obtain two X-ray fluoroscopy images intra-operatively and then begin 2- and 3D navigation is extremely attractive. This process eliminates the need for intra-operative CT imaging which is time consuming and is limited by availability of intra-operative CT machines, which are inordinately expensive and have a large footprint in the OR. The CT-Fluoro registration with augmented reality allows these cases to move to the ASC (which I have personally performed) where the pricing of intra-operative CT scans and legacy robotics are prohibitively expensive.
Q: What does the next generation of spinal navigation and imaging look like? What can spine surgeons expect in 2025?
FP: In 2025, navigation techniques will increase in sophistication and likely involve a combination of augmented reality and robotic technologies. More complex surgeries such as multilevel decompressions and osteotomies will be performed with augmented reality technologies. We will also see the ability to create segmented CT scans from routine pre-operative MRI studies eliminating CTs from the process. Machine learning technologies will further facilitate our ability to navigate without the need for advanced imaging. Enabling technologies will likely evolve to include superimposed real time bone and soft tissue images (such as nerves or blood vessels) visualized with 3D augmented reality.
Q: What advice do you have for spine surgeons, especially seasoned physicians, who want to adopt newer technologies from medtech companies?
FP: Put patient safety first. Get trained, prepare, practice and have well thought out "bail out" strategies to ensure you are not subjecting your patients to unnecessary risks.
Q: What are two things spine surgeons should do to thrive in 2025?
FP: 1) Be engaged and advocate for spine care and our patients' well-being. We cannot passively allow insurance companies and legislators to dictate how we practice medicine.
2) Spine surgery is a stressful existence! Focus on life-work balance. You are replaceable at work, but not at home!