Vladimir Sinkov, MD, of Las Vegas-based Nevada Orthopedic & Spine Center, discusses the big trends and opportunities in spine technology today.
Question: What emerging technology or technique will have the biggest impact on the spine field five years from now?
Dr. Vladimir Sinkov: Minimally invasive techniques, navigation and robotic-assisted spine surgery will continue to evolve and improve over the next several years with expanding indications, shorter learning curve and improved patient safety and operative efficiency. As the need for spine surgery remains high and will likely increase with aging population, minimally invasive procedures will provide safer care with less complications and quicker recovery. Navigation and robotic technology will make it easier for more spine surgeons to adapt to minimally invasive techniques.
Q: What do you think will fade or disappear from the spine field over the next few years?
VS: I cannot confidently say that any treatment or technique currently employed in spine surgery would actually disappear over the next few years. As minimally invasive surgery becomes more prevalent, open lumbar fusion techniques, especially for simple degenerative one-to-two level cases, will be used less often as more and more surgeons will see the significant patient benefits of less blood loss, shorter hospital stay, less postoperative pain and less complications with MIS spine surgery. Given the difficulties in transitioning to new techniques in terms of time involved in training and the learning curve, it will probably take a decade before these open techniques fade away.
Q: Where do you see the biggest room for innovation in spine?
VS: Continued improvements in minimally invasive spine surgery and eventual adoption of endoscopic spine surgery for decompression and possibly fusion.
Q: What do you need to provide better care that does not currently exist?
VS: My biggest barriers to providing better care for my patients have nothing to do with clinical medicine. Government regulations and private insurers' rules are becoming more and more burdensome and consuming more and more of my time and resources (without providing any benefit to healthcare practitioners or patients) that would otherwise be directed to direct patient care. Declining reimbursement for performing the same services (not even counting the inflation) make it difficult to concentrate on quality care and drive most providers to increase their volume in order to sustain their practices.
The constant threat of frivolous medical liability litigation also distract from providing proper and more efficient care, forcing providers to "cover their bases" instead. If those burdens would be decreased or go away, I can definitely concentrate more on providing better care for my patients.
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For a deeper dive into the future of spine, attend the Becker's 17th Annual Future of Spine + Spine, Orthopedic & Pain Management-Driven ASC in Chicago, June 13-5, 2019. Click here to learn more and register.