Four spine surgeons discuss what innovations or initiatives have impacted their practices for the better.
Note: Responses are lightly edited for style and clarity.
Question: What development has significantly improved OR efficiency in your practice?
Paul Houle, MD. Cape Cod Healthcare Neurosurgery (Hyannis, Mass.). The modern technology that dramatically improved efficiency in the OR is the O-Arm. In our hands, the time to obtain images and place pedicle screws for a single- or two-level lumbar fusion dropped to under 15 minutes. This technology eliminated the return to OR for malpositioned screws for our past 3,500 cases.
Steven Nichols, MD. Andrews Sports Medicine & Orthopaedic Center (Birmingham, Ala.). An innovation that has had a positive impact on my practice is the Mazor robotic spine system for the placement of pedicle screws. My experience goes back to the initial Steffee stainless steel 'bone screw' for pedicle fixation, so I was very skeptical that the Mazor system would improve my efficiency. I have to say the system is more efficient, more accurate, less physically demanding and with only a fraction of the radiation associated with manual placement. If you are fortunate enough to have your hospital purchase this unit, I am confident you will have a similar, positive experience.
John Wilson, MD. Wake Forest Baptist Health (Winston-Salem, N.C.). The minimally invasive tubular retractor system has transformed most spinal surgery. The surgical approach is accomplished quickly with minimal tissue disruption. Hemostasis is easily obtained, and closure is literally one to two minutes.
In the circumstance of incidental durotomy, cerebrospinal fluid leak is virtually unheard of. As experience with this minimally invasive technique has increased, the types of cases that can be done have expanded beyond decompressive procedures to include fusions, intra and extra dural tumors, and at any level in the spine.
James Chappuis, MD. Atlanta Spine Center. Consistent first class OR staff. I have the same first assistant, scrub tech and circulating nurse for every case. This significantly improves efficiency and decreases OR time and is generally not possible in an inpatient setting.