Christian Zimmerman, MD, a neurosurgeon at Saint Alphonsus Medical Group and SAHS Neuroscience Institute in Boise, Idaho, discusses his thoughts on the biggest spine technology trends moving forward.
Q: What is the biggest spine technology trend for 2018?
Dr. Christian Zimmerman: In as much as surgical healthcare has become increasingly more scrutinized, the current technological trends center on several insurance-based factors. Tighter indications and outcome-driven derivatives have transformed practice patterns as appeal processes and resubmission attempts for most surgical interventions are the expectation. These "cost containment" measures will impact sales and ultimately detract from the innovation mindset.
As other implant-positioned specialties have absorbed the consolidation and bundling of procedures, the spinal medicine macrocosm will not be exempt. Health systems have become so reliant on higher-reimbursing surgical specialties, forging trends to scale back lost leaders or expand business initiatives in more accommodating methods for spinal business models. The trends currently balance outcomes with payer affirmation and referral.
Q: Where do you see the biggest innovations in implant material?
CZ: Anterior cervical plate systems with "stand-alone" graft technology seem to follow the bundling schedules for cervical surgery reimbursements. The interchangeable plug (Sea-Spine) allows for certain variance in size of plug placement to the plating system and the different arrays of screw insertion offer significant options dependent on vertebral body surface area.
Q: Where do you see biologics and stem cells in spine headed for 2018 and beyond?
CZ: Current payer reimbursements of orthobiologics are steadily ratcheting their cost structures despite the continual strong demand in spinal instrumented care. Striking a truce in these markets seems to have come about of recent, yet time will render the uncertain.
The indications and usage of platelet-rich plasma technology seem to on the rise, with indications also expanded to include most soft tissue injury and repair.