Spinal cord injury — Treatment evolution and what to expect in the future from Dr. James Harrop

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James Harrop, MD, is chief of the division of spine and peripheral nerve surgery at Jefferson University Hospitals in Philadelphia as well as the neurosurgery director of the Delaware Valley SCI Center in Philadelphia and neurosurgery director for adult reconstructive spine.

He details the most interesting advancements of the past decade for spine surgery and spinal cord injury, as well as which treatments are most promising for the future.

Note: Responses were edited for style and clarity.

Question: What emerging technology are you most interested in today and why?

Dr. James Harrop: Although there are many interesting developments in the structural spine world, I believe the greatest advancements are happening in the neurologic recovery space, around improving patients with neurologic deficits quality of life. For example, in the last 10 years, there have been numerous clinical trials that have shown benefits to stem cells in the spinal cord injured population. This was not conceivable 20- to 30 years ago and not only are advances being made in the acute population but also in the chronic spinal cord injury population. Further, this has led to greater understanding of the biology of a spinal cord injury and recovery mechanisms. Lastly, neuromodulation and advances using electrical stimulation and computer programs have provided patients the ability to perform functional actions by bypassing there spinal cord and using a direct brain to peripheral nerve stimulation or interface.

Q: How do you think your practice will change in the next three years? What are you doing today to prepare?

HH: The greatest changes I believe will be in patient quality [practices], in terms of making practices more efficient and consumer friendly. Our department has dedicated numerous efforts into maximizing spine processes and protocols. We have used a team approach and have created a dedicated spine unit and are in the process of protocoling our surgical procedures such to reduce the number of instrumentation and maximize efficiency. In addition, we have recognized the difficulties for patients to be seen in congested downtown areas and have relocated clinics into the community to better serve the patients.

Q: What is the most dangerous trend in healthcare, spine or orthopedics today and why?

HH: Healthcare has rapidly expanded hospitals goals to increase patient volumes. This led to a disconnect between the patient and the physician. Physicians conducting bedside rounds are becoming a rare event as electronic modalities and the use of computer-based systems have become mainstream. Physical examinations and understanding patients' goals and expectations is the art of medicine. Computers will not be able to overcome this in our lifetimes.

To participate in future Becker's thought leadership articles, contact Laura Dyrda at ldyrda@beckershealthcare.com

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