In spine surgery, innovation rarely arrives as a single breakthrough. More often, it is iterative, shaped in operating rooms, refined in cadaver labs and tested in the quiet friction points of real procedures.
That process is beginning to change. With the recent FDA 510(k) clearance of a new 3D-printed implant system, the Ventana A anterior lumbar interbody fusion device, the way spine technology is developed is becoming more integrated, with surgeons helping shape it from the earliest stages. The system received clearance in March and has already been used in initial cases as part of a limited market release.
For Keven Burns, MD, a spine surgeon at the Scottsdale-based Spine Institute of Arizona, that shift has been hands-on. Over the past 18 months, he has worked alongside biomedical engineers as a design surgeon, refining both the implant and the instruments before its clearance.
What that collaboration reveals is not just a new product, but a different model for innovation.
A field still taking shape
Part of what makes spine surgery unique, Dr. Burns said, is how much remains unsettled. “Spine is still in the early stages of its development, and there’s significant opportunity in where it can go next,” he said.
That sense of possibility is what drew him into the design process, not to recreate existing tools, but to solve persistent challenges. “You want to improve efficiency. You want to improve surgical outcomes and surgical workflows,” he said.
Designing for what actually happens in surgery
The Ventana A system, part of a broader platform of 3D-printed titanium implants, is designed to improve how bone graft is delivered, contained and integrated during surgery.
At the core of the design is a hinged architecture that allows surgeons to place a greater volume of graft material while maintaining containment throughout implantation, alongside improved visualization and load sharing across the implant.
“There’s a 3D-printed trap door, a lid that opens so you can place a large volume of graft material and then close it back down,” Dr. Burns said.
That design shifts how force is distributed. “What that does is allow for full endplate-to-endplate surface contact,” he said.
The result is improved stability and alignment, with measurable implications for outcomes. “It decreases the subsidence risk by up to 21%,” he said, referring to early performance data.
Why surgeons are now part of the build process
For Dr. Burns, the design process itself is just as important as the final implant.
“[Designers] don’t know the ins and outs of the pain points that surgeons experience during an actual operation,” he said. Surgeon involvement fills that gap through direct, real-time input.
“We actually provide intraoperative feedback,” he said. That feedback can be highly specific and immediately actionable.
“We can troubleshoot and say, ‘This is a great idea, but I can’t get the right angle with your implant. I need you to make a different angle for an inserter,’” he said. The result is faster iteration and more practical solutions. “It shortens the innovation cycle,” he said.
What changes for patients
For patients, the impact is measured in recovery. “The quicker they get to fusion, the quicker they get back to enjoying their activities,” Dr. Burns said. That includes everything from sports to everyday movement.
“It’s about getting back to a normal sense of being,” he said.
Looking ahead, he sees 3D printing moving beyond standardized implants. “3D printing will allow us to have patient-driven custom implants and fine tune the surgical experience,” he said.
Smaller surgeries, stronger outcomes
Dr. Burns has built much of his practice around minimally invasive techniques, and he sees advances in implant design expanding what those approaches can achieve. “We’re going to be able to put stronger implants through a smaller incision, while maintaining strength and integrity,” he said.
Future designs may also better replicate natural bone properties, adjusting stiffness based on patient-specific needs and reducing complications.
A data-driven future
Beyond hardware, the next phase of spine surgery may be shaped by data. “We’re going to have more information telling us what potential success rates will be with certain procedures,” Dr. Burns said.
That shift could move decision-making toward more individualized care. “I think we’re moving toward more customizable, patient-centric treatment algorithms,” he said.
The shift to outpatient care
At the same time, broader healthcare dynamics are reshaping where spine surgery takes place. As procedures move into ASCs, implants and techniques must evolve alongside them.
“We need to offer things that provide superior outcomes with less of a footprint,” he said.
Even procedures traditionally performed in hospitals are beginning to transition. “You will see single-level L5-S1 ALIFs being done at the ASC,” he said.
That shift has influenced design decisions. “We needed to package this implant for the ASC, because we know that is where we will go,” he said.
Innovation, and the risk of overreach
As innovation accelerates, so does the volume of information patients encounter.
“Patients have become consumers,” Dr. Burns said. With access to multiple opinions and treatment options, decision-making has become more complex.
“You can get what you want. You just have to shop for it,” he said.
That environment makes adherence to evidence more important. “We have to hold true to the known data and the known outcomes,” he said. Without that discipline, the field risks drifting toward hype-driven care.
“There’s just not a lot of data,” he said, referring to emerging treatments gaining attention without sufficient validation.
What comes next
For Dr. Burns, the direction of spine surgery is clear. “I think ultimately we’re going toward a more minimally invasive, or ultra minimally, invasive approach,” he said.
And the pace of change is accelerating. “You’re going to see that adoption happen quickly in the next five years,” he said.
As innovation moves forward, the shift may be less about any single device and more about how those devices are built, with surgeons no longer just using technology, but helping define it.
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