As spine surgery continues to accelerate to the outpatient setting, five spine surgeons recommend essential technologies for ASCs to invest in.
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.
Next week's question: What payer changes do you anticipate in your market in the next 3-5 years?
Please send responses to Alan Condon at acondon@beckershealthcare.com by 5 p.m. CDT Wednesday, July 14.
Note: The following responses were lightly edited for style and clarity.
Question: What spine technologies should ASCs invest in over the next 3 years as cases accelerate toward the outpatient setting?
Brian Gantwerker, MD. Craniospinal Center of Los Angeles: If I were running or choosing tech for an ASC, I would discuss with our surgeons where they feel they can do the best, most efficient work. Certainly the bread and milk should be a good quality fluoroscope that can double as an intraoperative CT scanner for navigation. Another worthwhile purchase is a spinal exoscope. They tend to be a fifth of the cost of a microscope. Also, to try to attract patients from other places, a solid spinal endoscopy system I think will allow physicians to market themselves as well as the center.
John Burleson, MD. Hughston Clinic Orthopaedics (Nashville, Tenn.): First and foremost, augmented reality. I think this really is the future of specialized orthopedic and spine surgery. Robotics might be the answer in the future as well, but over the next three years, the price point doesn't make sense for most surgery centers.
Sanjay Khurana, MD. LA Spine and Orthopedic Institute (Los Angeles): As the majority of elective spine surgery migrate to the outpatient arena over the coming decade, surgeons will need access to technologies that allow higher-acuity surgeries to be performed with precision and predictability in the least traumatic manner. Intraoperative imaging that allows real-time 3D navigation, whether with a pre-op CT scan or an intra-op CT spin, will allow surgeons to perform fusions and motion-preservation surgeries with full confidence in desired interbody device as well as posterior instrumentation placement. Whether this is done with the assistance of a robot or done manually, the ability to confidently predict or actually visualize postoperatively will be paramount. Endoscopy and advanced microscopic technology will also be critical in these surgeries for careful and minimally invasive neurological decompression. The exciting forefront of coupling endoscopic/microscopic technologies with advanced imaging and AR speak to an even more promising future for patients and physicians.
Rojeh Melikian, MD. DISC Sports & Spine Center (Newport Beach, Calif.): I believe it will be important for ASCs to invest in navigation and robotic platforms that allow for increased complexity of instrumented cases to be done in an outpatient setting.
Andrew Hecht, MD. Mount Sinai Health System (New York City): Intraoperative imaging, navigation, robotics and endoscopy.