Interventional pain management physician Claudio Vincenty, MD, has focused his career around back pain management. He has a special interest in spinal cord stimulation and advanced implant therapies.
Dr. Vincenty is a featured speaker at the Becker's 17th Annual Future of Spine + The Spine, Orthopedic and Pain Management-Driven ASC Conference, June 13-15 in Chicago. Click here to learn more and register. For more information about exhibitor and sponsor opportunities, contact Maura Jodoin at mjodoin@beckershealthcare.com.
Dr. Vincenty practices with Jacksonville, Fla.-based Jax Spine & Pain Centers. Here, he discusses key technology trends for back pain management in the future.
Question: What technology and techniques are most exciting for you in the future?
Dr. Claudio Vincenty: Medtronic won FDA approval and is releasing in the U.S. its Intellis spinal cord neurostimulation platform, which includes the world's smallest fully implantable spinal cord neurostimulator. The system delivers both high-dose and low-dose therapy, depending on the patient's needs, and tracks patient activity to help physicians improve how the therapy targets an individual's pain. It is made to wirelessly, and securely, interface with a Samsung Galaxy Tab S2 tablet which is used by the physician to adjust settings and set parameters that best address the patient's needs. The same tablet can be used to upgrade the neurostimulator implant with new versions of its firmware.
One thing in particular [is] that Medtronic touts is its Overdrive technology, which makes it a reality to recharge the implant from null to full in about an hour. Moreover, the Samsung tablet provides estimates of how long the device will last on a charge based on selected parameters combined with data gathered previously on the patient's activity levels and pain reduction requirements.
The implant is also safe to wear while inside an MRI machine, given certain conditions and as long as precautions are taken. Even full body scans are possible, so having the device does not limit the patient's future diagnostic options.
Abbott also introduced the DRG [dorsal root ganglion] Stimulator which looks very promising.
The FDA has given a regulatory green light to the first device that reduces opioid withdrawal symptoms. The NSS-2 Bridge from Innovative Health Solutions, a Versailles, Ind.-based firm, is stuck to the skin behind the ear and relies on four electrodes that are attached around the ear. The electrodes are used to deliver electric current to a set of occipital and cranial nerves (V, VII, IX and X), hopefully helping addicts to avoid agitation, insomnia and other symptoms of kicking opioids. The same device was approved by the FDA three years ago for use in acupuncture and the current approval went under the de novo review process intended for uniquely new low- to moderate-risk technologies.
Q: How do you evaluate new technologies and techniques?
CV: I typically look for value, which includes examining prices and whether it is covered by insurance. I typically wait until there is significant evidence of its benefits.
Q: Is your practice moving toward value-based care? How does new technology fit in, whether you're taking cases to a hospital or outpatient surgery center?
CV: The shift of total joints into the ambulatory center seems to finally have broken through, and we will continue to move cases to the lowest cost location.
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