Healthcare policy and spine surgery trends were among topics drawing interest from Becker's Spine Review readers.
Here are five stories to know:
Ozempic's impact on spine patients
Weight loss and diabetes medication semaglutide were linked to a significantly greater risk for repeat operations in patients with diabetes who require lumbar surgery, according to a study. The risk of an additional procedure was higher among patients who took semaglutide over long periods of time. While spine and orthopedic surgeons have considered the effect of semaglutides on patient care, this is the first study providing evidence of spine surgery effects. Of the patients, 447 patients used semaglutide and 1,334 did not. Total medical complications were higher in the semaglutide group, at 13.4%, compared with 7.7% in the no-semaglutide group. Total surgical complications were lower in patients taking semaglutide, at 3.8% vs. 5.2% in those who did not, but those taking the medication were nearly 12 times more likely to have an additional lumbar surgery at one year than did those who did not use the drug.
The FTC's potential noncompete ban
In April, the FTC issued a final rule that would effectively ban noncompetes. However, that rule is being challenged. Plans to ban noncompetes are now "in doubt," according to Bloomberg Law.
But if the ban goes through it would have many implications for spine surgeons at health systems and private practices.
CMS' 2025 physician fee schedule, which was finalized in November, includes a 2.8% pay decrease. The pay decrease marks another consecutive year that CMS rates have fallen, prompting concern from spine surgeons.
"Sadly, Medicare's strategy to slash prices has not worked to curb unnecessary care for the last 20 years," Vijay Yanamadala, MD, told Becker's when CMS' proposal was shared in July. "We need a different, more systematic approach. And we need to interrogate every problem, like the current epidemic of unnecessary surgery in this country, as well as potential solutions, before we introduce or change healthcare policies. If we don't, we risk unintended consequences."
Overutilization in spine surgery persists
Spine surgeons have warned of overutilization, especially with spinal fusions, and a report from the Lown Institute found that unnecessary procedures have cost Medicare about $2 billion over three years. On average, 14% of spinal fusions and/or laminectomies were considered "overuse." An average 11% of patient visits for osteoporotic fractures led to an unnecessary vertebroplasty.
Endoscopic spine surgery's rise
Endoscopic spine surgery has had a slower adoption rate in the U.S. compared to other parts of the world, but in 2024 many physicians have added the technique at their workplace.
Two of those surgeons include Max Kahn, MD, and Sohail Syed, MD, who work at hospitals with Peoria, Ill.-based OSF HealthCare. They surpassed double-digit numbers in case volume and utilize endoscopic spine surgery regularly.
"I think that right now the biggest indications for endoscopic spine surgery is in minimizing the degree of destruction, and it's pretty much applied for degenerative disease," Dr. Syed told Becker's. "But I think as the instruments that are available improve, it's going to be applied to a wider variety of diseases. We're really hoping that it'll eventually be used in cases like trauma or even oncology cases. Especially with the latter, it's really important to try to minimize your incision because these patients tend to be immunocompromised. They are going to require chemo and radiation post-op. So smaller incisions mean quicker time to chemo, radiation and less likelihood of complications from that."