Andrew Hecht, MD, is chief of spine surgery for Mount Sinai Health System and Mount Sinai Hospital, and serves as director of the Spine Center of Mount Sinai Doctors in New York City. Here he discusses the biggest trends for 2018.
1. Most important clinical trend for 2018: The most important technology trends in 2018 are continuing to find the appropriate carriers and doses for the use of BMP-2 (Infuse) to minimize complications and yet harness its effective capabilities. In addition, spine surgeons continue to explore the appropriate indications for minimally invasive fusions for degenerative, trauma and deformity applications. Lastly, spine surgeons continue to define the appropriate indications for cervical disc replacement and how to minimize heterotopic ossification after TDR.
2. Key clinical and business challenges this year: The key business challenges are the increasing difficulty with getting spine surgery approved from insurance carriers who continue to impose greater restrictions despite textbook conservative care prior to surgery. The spine surgeon must step up front and center to be central to help hospitals defining "bundled care" for various spine procedures and diagnoses.
3. Best opportunity for spine surgeons in 2018: The best opportunity for spine surgeons is to continue to collect outcomes to demonstrate the effectiveness of the treatment they provide for the best indicated diagnoses.