Anthony Yeung, MD, founder of Phoenix-based Desert Institute for Spine Care, published an opinion piece in the Journal of Neurological Disorders.
Dr. Yeung identified the gap between fusion-oriented surgeons and those with a pain management background. Transforaminal endoscopic surgeons can bridge that gap, he offered.
"Current surgical philosophy by key opinion leaders focus on attaining fusion of the painful spinal segment by emphasizing femoral-pelvic and overall spine sagittal alignment, representing another phase in the evolution of the technique," he wrote. "For pain management, neuromodulation of the spinal cord and more recently the dorsal root ganglion is the area of focus as represented by the key opinion leaders, Gabor Racz and the World Institute of Pain."
He posited as the trend toward minimally invasive and endoscopic spine surgery moves forward, transforaminal decompression is undervalued and underused due to a lack of formal training. Here are three key notes from the article:
1. Dr. Yeung calls on competing factions in the healthcare space between physicians and other providers to cooperate on providing the best care for their patients and develop a warrantee for their procedures.
2. He feels current payment guidelines from payers are too restrictive and would prefer a focus on the patient's pathoanatomic source of pain, which endoscopic visualization can achieve. Dr. Yeung wrote physicians can understand pain better with in vivo visualization and endoscopic transforaminal access instead of symptom diagrams and image correlation.
3. He developed the Yeung Spinal System, an endoscopic approach that received FDA clearance in 1997. The procedure and technology has been refined since then.
"With the current interest in biologics, we are destined to improve spine care by moving away from fusion as a first line surgical treatment because of the techniques available in the endoscopic platform," he concluded.