Endoscopic spine surgery is a fast-developing technique drawing attention and praise from surgeons and patients alike. A minimally invasive procedure, endoscopic spine surgery has grown significantly in the last year.
Six things to know:
1. Endoscopic spine is a growing market: Market researchers project that the global endoscopic spine surgery will grow 8 percent from 2021-31. The endoscopic spine market was valued at $573.6 million in 2020, and growth is credited to an increase in spine surgeries and minimally invasive procedures.
2. More places are implementing endoscopic spine programs: Thousand Oaks, Calif.-based Los Robles Health System, Downers Grove, Ill.-based DuPage Medical Group and the Steadman Clinic in Vail, Colo., are all adopting endoscopic spine procedures.
3. Endoscopic spine surgery needs to catch up in the U.S.: Endoscopic spine surgery in the U.S. is behind Europe and Asia in terms of technology, said Issada Thongtrangan, MD, of Microspine in Scottsdale, Ariz. He said factors including costs, lack of training and misperceptions are limiting adoption in the U.S.
4. ASCs will help boost endoscopic adoption: Endoscopic surgery is a minimally invasive procedure, and the surgeon uses a small incision to access the spine. This makes it a strong technique for outpatient settings.
"Patients are often up and about with minimal to no pain within hours," said Armen Oganesian, DO, who used the procedure at Los Robles Health System. "This approach can be used for multiple spinal disorders, including herniated discs and spinal stenosis, with excellent success."
Michael Gallizzi, MD, who is joining the Steadman Clinic on March 14, echoed this, saying outpatient migration will help endoscopic spine surgery become more widespread.
"I think the movement of spine cases to outpatient settings will help drive this change because the surgery is significantly less disruptive," Dr. Gallizzi said. "I think quite honestly, once people know it's available, consumers are going to start demanding it."
5. Endoscopic-specific training is necessary for growth: As a more novel technique, education could make or break widespread adoption.
"Endoscopic spine surgery offers a lot of advantages to patients as being the least invasive option currently available in spine surgery," said Vladimir Sinkov, MD, of Sinkov Spine Center in Las Vegas. "It is a very new and different set of skills for a spine surgeon to learn, however. Therefore, there is a lot of hesitancy in adoption and a steep learning curve. For better adoption, there needs to be more and better courses that surgeons can attend and learn, just like the industry did with minimally invasive spine surgery techniques."
Another spine surgeon, John Burleson, MD, of Hughston Clinic Orthopaedics in Nashville, Tenn., also said endoscopic surgery can be intimidating for newer surgeons.
"Endoscopic surgery can be daunting to tackle for a new surgeon if they didn’t see these performed by their mentors in training," he said. "New surgeons are also a little intimidated to ask a hospital to purchase equipment that they might not end up using much."
6. Endoscopic technology is evolving: Awake and robotic techniques are being used with endoscopic procedures. In August, Saqib Hasan, MD, performed California's first endoscopic lumbar fusion with robot-assisted technology. Six months later, the patient has recovered well. At Midwest Orthopaedics at Rush in Chicago, Kern Singh, MD, is using awake endoscopic techniques to complete cases in about 30 minutes.