The next 5 years in spine: 5 surgeons on technology to watch


Five spine surgeons discuss where they expect technology to evolve over the next half-decade.

Question: What emerging technology or technique will have the biggest impact on the field over the next five years?

Andrew Cordover, MD. Andrews Sports Medicine & Orthopaedic Center (Birmhingham, Ala.): I believe image-guidance technology (intraoperative imaging) and biologics will have the biggest impact on the spine field five years from now. Currently, the cost of image guidance can be intimidating to hospitals and surgery centers. As this technology advances with consequent reduction in cost, this will help clear the economic hurdle and allow for this technology to gain more universal acceptance. On the biologics front, there will have to be more accountability with spending and outcomes with resultant improved patient care.

Roger Hartl, MD. Director of Spine Surgery at Weill Cornell Medicine (New York City): Biologics are starting to enter the surgical arena, but we are still at the beginning. We need better data that biologics really have an impact on disc regeneration and repair. Many groups are working on this and we will likely have much more and better evidence soon. Also, the advantages of tissue engineering (in addition to just injecting cells) have not been taken advantage of. So far, we just use cells but a combination with tissue engineered materials and strategies for annular repair and disc regeneration may have an additional positive impact.

Khalid Kurtom, MD. Medical Director of System Operations at University of Maryland Shore Regional Health (Easton, Md.): Robotics and neuro-navigation are two areas receiving national and international attention in spine surgery. Currently there are systems that are used in placing spinal instrumentation with great accuracy. The goal moving forward is to develop systems that can complete the entire spinal operation, not just the instrumentation. This requires innovations in micro-optics and micro-instrumentation.

Vladimir Sinkov, MD. Nevada Orthopedic & Spine Center (Las Vegas): Minimally invasive techniques, navigation and robotic-assisted spine surgery will continue to evolve and improve over the next several years with expanding indications, shorter learning curve and improved patient safety and operative efficiency. As the need for spine surgery remains high and will likely increase with aging population, minimally invasive procedures will provide safer care with less complications and quicker recovery. Navigation and robotic technology will make it easier for more spine surgeons to adapt to minimally invasive techniques.

Avery Jackson, MD. Michigan Neurosurgical Institute (Grand Blanc, Mich.): Vertebral augmentation. As the population is aging, there's more of a need to develop techniques and be more aggressive with decreasing the knowledge gap for osteoporosis management and diagnosis as well as treatment of compression fractures of the spine and other osteoporotic fractures. The impact to society is increasing as the population is aging. Also, when these fractures occur it adds to the opioid epidemic as these patients are untreated and undiagnosed. Therefore, [they] are requiring more and more narcotic and analgesic management.


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