Spine surgery is in a “renaissance” with new ideas regularly emerging, Tan Chen, MD, said. As more data comes out, he said he expects two techniques to stand out in the playing field: endoscopic spine and awake spine surgery.
Dr. Chen, of Fairfax, Va.-based Inova, spoke with Becker’s about his outlook for spine innovation.
Note: This conversation was lightly edited.
Question: What are some of the top healthcare trends you’re following?
Dr. Tan Chen: I think everybody nowadays is talking about decreasing reimbursements and trying to balance. How does a system or how a group continues to grow with the market with the ever changing technologies, but also keeping costs controlled. I don’t know if anybody really has a really great answer, but I think that’s going to be one of the big challenges of this year and the years to come, not just in spine, but in healthcare in general.
From a technology standpoint, spine is an ever-evolving field where there’s always new technologies, implants, concepts and strategies for surgery. It’s still in a renaissance where people are trying all these different things. Nobody really knows for sure what the gold standard is or what’s actually going to work well. It’s always this balance between trying out these new things with good, good, predictable patient care.
Q: What innovations are you looking into the most?
TC: I think endoscopic surgery has definitely grown a lot. Right now the majority of endoscopic spine cases is more about endoscopic decompression. At least for lumbar cases, the differences of endoscopic spine versus minimally invasive decompression are still fairly minimal from a patient standpoint because they both let you go home the same day. Where endoscopic could really shine is in endoscopic fusion procedures where there’s even less soft tissue trauma, smaller incisions. It’s a very focused procedure where more and more patients can have it even if they may not normally be able to have a traditional surgery.
Along the same lines, I think awake spine surgery is also going to really start to take off.
Q: Is awake spine surgery something you want to integrate into your own work?
TC: There are definitely hubs around the country where people are testing the waters with high-volume endoscopic spine and awake spine. But I don’t think any of this stuff has really taken off yet, especially with awake spine. A lot of people still get kind of weary about having a patient awake during spine surgery, especially if they kind of move around a bit. But as the technology continues to grow and research papers continue to come out and talk more and more about the benefits and risks, down the line it’s going to become more popular.
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