Dr. Scott Sanderson: The biggest obstacle in spine, next big trend & more

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Scott Sanderson, MD, is a neurosurgeon practicing out of Danbury (Conn.) Hospital and Norwalk (Conn.) Hospital, as part of Nuvance Health — formerly Western Connecticut Health Network — and Neurosurgical Associates of Southwestern Connecticut, both of Danbury, Conn. He is also an assistant clinical professor of neurosurgery at New York University Medical Center in New York City.

He specializes in the treatment of complex and minimally invasive spinal surgery for both degenerative disease and trauma.

Dr. Sanderson earned his medical degree at State University of New York in Syracuse. He completed a surgical internship and residency at NYUMC, where he was awarded an internal fellowship in complex spinal surgery and instrumentation. Here are his key thoughts on the big trends in spine today.

Question: What do you think is the biggest obstacle facing spine at the moment?

Dr. Scott Sanderson: The biggest obstacle facing spine at the moment is creating effective and safe surgical techniques for the active octogenarian. We are seeing a greater number of older patients with major spine conditions that are more vibrant than ever. They want to maintain their active lifestyles, whether playing golf, tennis, traveling, or caring for their grandchildren or even great-grandchildren.

Our older patients deserve the best treatment, and if they have a surgically treatable spine condition, we want to help them. This is a challenge because spine surgery complication rates increase with age. So what we could have done surgically when they were in the 60s may not be the safest option now that they are in their 80s. We need to be able to offer older patients effective treatment for their spine conditions that are safe for their age, and also not deny them treatment because of their age.

Q: Is there a single initiative your organization has undertaken recently that you are particularly proud of?

SS: I'm proud of two recent initiatives from Danbury (Conn.) Hospital and Norwalk (Conn.) Hospital, as part of Danbury, Conn.-based Nuvance Health. 

Robotic Technology: We invested in robotic technology which enabled us to develop new surgical processes that are overall less invasive. This has resulted in major benefits for patients and operational efficiencies. Through this investment in robotic technology, and also in highly skilled surgeons and care teams, we can offer the most advanced spine surgery options to people living in our communities, so they don't need to travel far for the best care.

Pain Management: Danbury Hospital and Norwalk Hospital offer multimodal pain management. By combining complementary pain management therapies, like a local anesthetic nerve block around the site of surgery, intravenous acetaminophen and anti-inflammatory medication, patients are now ambulatory sooner after spine surgery. This results in faster recovery and reduced length of hospital stay. Multimodal pain management is possible and effective because of the less invasive surgical processes we implemented, the pain management teams we developed and the preoperative pain management education we offer to patients.

Q: What recent spine device has dramatically enhanced patient outcomes?

SS: The advent of technology to enable minimally invasive lateral access spine surgery has dramatically enhanced patient outcomes. For example, at Norwalk Hospital, we use a new robotic guidance and navigation system, ExcelsiusGPS, for spinal fusion surgery. With this technology, we can access the spine through a single side, without repositioning the patient during surgery. The benefits to patients of this minimally invasive surgery versus open surgery are significant and include: faster surgery which means less time under anesthesia; smaller incisions which result in less blood loss, less scarring, and faster healing; less radiation exposure during surgery because only one CT scan is needed to show the surgeon where to place the screws; greater accuracy with placement of the screws; fewer complications; shorter hospital stay; and faster recovery.

Q: What do you see as the next big trend in spine?

SS: Minimally invasive procedures and techniques to treat spine conditions will continue to be a trend as we become more precise through practice and as more technology develops. This trend will also continue because data shows that less invasive procedures and techniques result in decreased length of hospital stay, faster recovery, and overall increased patient satisfaction, to name a few of the key benefits to patients. This means that our spine patients are getting back to living their lives sooner and without pain. 

In addition to less invasive techniques and procedures, I think the next big trend will be less hardware too. Today, we use screws and rods to stabilize the spine. In the next 10 to 20 years, we might be treating spine conditions with biological reconstruction rather than hardware. For example, what if we altered the DNA of a disc so it could repair itself and hardware wasn't needed? Biological reconstruction could include platelet rich proteins, stem cells and other modalities.

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