Five spine surgeons discuss how implant technology and material will likely evolve in the future.
Paul Slosar, MD. President of SpineCare Medical Group (Daly City, Calif.): The focus is now on surface technologies for fusion implants. The most sophisticated and advanced surface has a unique titanium nano-technology to stimulate the host bone to grow rapidly, promoting early osseous-integration. This should lower surgeons' dependence on expensive or inflammatory biologics. The porous implants may be better than smooth surfaces, but still lag behind in terms of stimulating a cellular response.
Todd J. Lansford, MD. South Carolina Sports Medicine & Orthopaedic Center (North Charleston): The most important trend in spine technology would be the continued integration of biplanar fluoro to navigation. I say this especially because the use of robotics is an expanding field; advances in imaging will increase the speed for robot procedures. Once navigation improves in speed and ease, robots will be used more frequently. The second trend I see is use of titanium/tritanium implants. This has shown superiority over PEEK and will gain in use throughout the year.
Christian Zimmerman, MD. Saint Alphonsus Medical Group (Boise, Idaho): Advancements in onsite hardware creation may be a thing of the extreme future, but online custom-made hardware may realize a place in the implant market.
Michael Musacchio, MD. NorthShore University HealthSystem's Neurological Institute (Evanston, Ill.): Over the next five years, we will see a full conversion to 3-D navigation in spine surgery, further simplifying procedures, and that will mostly benefit patients in need of correcting deformities. Meanwhile, 3-D printing and custom implants are providing a better fit for patients, resulting in potential cost reductions.
Brian Gill, MD. Nebraska Spine Hospital (Omaha): I am interested in seeing how 3-D technology/printing capabilities will translate into implant design and function; whether this technology translates into quantifiable better outcomes remains to be seen.