Six spine surgeons weigh in on the future of spinal instrumentation.
Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. We invite all spine surgeon and specialist responses.
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Please send responses to Anuja Vaidya at avaidya@beckershealthcare.com by Wednesday, May 31, at 5 p.m. CST.
Question: What innovation in spinal instrumentation would you like to see over the next five years?
Jeffrey C. Wang, MD. Co-Director of the USC Spine Center at Keck Medicine of USC (Los Angeles): I would like to see some new innovations that bring a new class of treatments into the realm of spinal disorders. Technology has been stunted lately, due to multiple factors, and it would be refreshing to see a new type or class of devices. I suspect this will be in the areas of biologics or stem cells with good supporting evidence, or perhaps techniques to prevent adjacent segment pathology.
Kern Singh, MD. Co-Director of Minimally Invasive Spine Institute at Midwest Orthopaedics at Rush (Chicago): I would like to see continued innovation with minimally invasive surgery. These procedures are beneficial for patients because they are safe, effective and reduce healthcare costs. Further developments in minimally invasive procedures will provide more options to offer patients and will allow me to help them get back on their feet faster.
Payam Farjoodi, MD. Spine Surgeon at Center for Spine Health at Orange Coast Memorial Medical Center (Fountain Valley, Calif.): I would like to see a "silicon valley" type disruption in the spinal instrumentation market. Most companies develop and deliver their products in the same ways. It is rare that there is an innovative product that has not evolved from another current product. I would like to see closer collaboration between surgeons and engineers in order to solve the many challenging problems that face us in spine surgery.
Vladimir Sinkov, MD. Spine Surgeon at New Hampshire Orthopaedic Center (Nashua): Performing proper thorough discectomy during minimally invasive fusions is still tricky and time-consuming. Better instruments that can take out the disc and not damage bony endplates in a safe and time-efficient fashion will be designed as more lumbar fusions are done through minimally invasive approaches. I would also like to see more instruments being navigated to minimize radiation exposure during spine procedures. Spine robotics will help to achieve both of these goals.
Brian R. Gantwerker, MD. Founder of the Craniospinal Center of Los Angeles: I would love to see fewer expensive custom implants for arthroplasty. We will see a day when we utilize a computer design program and email specs to the manufacturer. A week or so later, we have a custom sterile implant ready to go.
Neel Anand, MD. Clinical Professor of Surgery and Director of Spine Trauma at Cedars-Sinai Spine Center (Los Angeles): There are three key innovations I would like to see in spinal instrumentation and they are:
• Robotics
• Biologics and injectables
• Sterile packages implants