Dr. Thomas Gruber: Cost-effective spinal fusion and the future of robotics in spine

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Paducah, Ky.-based Thomas Gruber, MD, is a board-certified neurosurgeon affiliated with Baptist Health Medical Group in Jacksonville, Fla.

Here, Dr. Gruber shares his insight on cost-effectiveness in spinal fusion as well as the future of robotics and navigation in spine.

Question: How can spine surgeons help make spinal fusions more cost-effective without sacrificing quality? How do you see spinal fusions evolving in the future?

Dr. Thomas Gruber: Continued investment in the development of minimally invasive procedures that can be done in an ASC setting is the most promising way to decrease cost of spine surgery without sacrificing quality. Additionally, hospital systems continuing to work closely in good faith with medical device companies to control the cost of spinal implants will also go a long way toward maximizing our reimbursements and controlling costs of spine surgery.

Q: What spine device has dramatically improved OR efficiency in your practice?

TG: No question. The O-arm stealth navigation system has most dramatically improved OR efficiency. Procedures are done quicker and more efficiently and allow us to run multiple navigated rooms simultaneously.

Q: What are the most pressing issues for outpatient spinal fusions?

TG: Developing minimally invasive techniques that allow more complicated fusion procedures to be done safely in an ASC setting and pushing navigation out to the ASC.

Q: How do you think robotics will impact spinal fusions in the future?

TG: Robotics will be the standard of care, not only for spinal fusion surgery, but their role will likely expand into other areas of neurosurgery as the technology continues to develop.

Q: In your opinion, what is the next big trend on the horizon in spine?

TG: The future is not in the next screw that is released or the next coated implant, it is in technology such as the relationship of robotics and navigation, the role of dorsal column stimulators in spinal cord injury and integration of artificial intelligence in spinal surgery planning. These are the developments that are going to change how we do our jobs in the future.

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