Future sight: What 14 spine, orthopedic surgeons are looking forward to in 2024

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Spine and orthopedic surgeons are looking ahead to 2024 with many expectations for the industry. From the development of artificial intelligence to ASCs and value-based care, here's what 14 spine and orthopedic surgeons are excited about for next year:

Question: What are you excited about for 2024?

Ali Anissipour, MD. Western Washington Medical Group (Everett): In 2024, I'm excited about the continued development of spinal technology and its applications in spine surgery. I'm particularly interested in the expansion of robotic usage beyond screw placement and the integration of live feedback for intraoperative changes in spinal alignment, deformity and foraminal height evaluation. High-powered light array technology [is a] promising development that could revolutionize procedures by mapping preoperative scans to real-time 3D representations of patients' anatomy.

Tan Chen, MD. Geisinger Musculoskeletal Institute (Wilkes Barre, Pa.): Spinal knowledge and innovation will continue to evolve in 2024, and I’m excited to see and work with companies as they develop and release new technology in minimally invasive surgery, interbody cage design, navigation and robotics, biologics and motion sparing technology. I think spine surgery is still in its infancy much like how hip arthroplasty was 50 years ago, and patients will continue to have better outcomes and faster recoveries as our understanding of spinal pathology evolves and our surgical tools become more advanced.   

David Garelick, MD. Illinois Bone and Joint Institute (Chicago): I am excited to see how AI will continue to impact how we practice medicine in 2024. In talking with my tech colleagues, they have never seen anything evolve so quickly. While innovation is important, as physicians, we are going to have to monitor this closely and make sure the appropriate "guardrails" are in place. More locally, we are opening a physician-owned surgery center that will also change many ways in which we practice. All super exciting things in 2024.

Brian Grawe, MD. University of Cincinnati: I am most excited about the rapidly evolving ways surgeons can now share. The advent of virtual meetings and virtual reality simulation/learning is something that is truly wonderful. Surgeons are going to begin to be able to exponentially leverage their own expertise to help take care of difficult pathologies.

Roger Härtl, MD. Och Spine at NewYork-Presbyterian Weill Cornell Medical Center (New York City): The things I'm working on and that I'm excited about are in minimally invasive surgery. We've done a lot of work using expandable technology like interbody cages and expandable technology for the lumbar spine. I'm working on improving the design of these cages, and I'm excited about that because I think it's going to really help us achieve better results with minimal invasive surgery in terms of lordosis restoration in the lumbar spine with minimal invasive approaches. 

The other technology that I'm very involved with and I'm very excited about is augmented reality for minimally invasive spine surgery to improve the workflow and efficiency of these procedures. The third thing is biologics. We're working on an annular repair using tissue-engineered collagen and riboflavin. We have a patented technology that we want to get into clinical trials, and we're working with the FDA to hopefully get this done over the next few years. 

Earl Kilbride, MD. Austin Orthopedic Institute: Personally, I have started performing peripheral nerve stimulators. They have been performed in the pain space for a few years, but there are a handful of orthopedic surgeons who are now incorporating this technology into their surgical practices. I have been at the forefront of that technology.

Philip Louie, MD. Virginia Mason Franciscan Health (Seattle): As a field, I am excited to see how we improve our understanding of how ASCs fit into the value-based care equation that is dominating our healthcare landscape. Patient care and outcomes will always be the most important factor. But in a world where we are seeing a shift to value-based healthcare and reimbursement, we will also need to reevaluate how spine surgical care is delivered and billed. In this upcoming year, I think we will all develop new evidence to disseminate the safety, efficacy and the economic factors are underway.

As a spine team, we have ambitious plans to incorporate additional patient care pathways and newer surgical techniques. We have various staff members leading and engaged in many different projects and I cannot wait to see how they foster their passions and grow our ability to provide exceptional spine care.

Personally, I am excited for the opportunity to serve as co-program chairs of the Safety and Spine Summit as well as the Society for Minimally Invasive Spine Surgery Annual Forum. Contributing the knowledge sharing, collaborations and education of my colleagues has always been an area of my work that I enjoy.

Peter McCunniff, MD. Pain Center of Arizona (Peoria): I believe that we are witnessing the power that we have as physicians, surgeons and advanced care providers when we come together for a common cause. There've been physicians strikes in the United Kingdom, as well as resident strikes here in the U.S., and I believe that we have reached this tipping point where physicians can no longer stomach all of the extraneous duties and inefficiencies that prevent us from directly caring for patients or being present and active in our personal lives and in those of our family members. We physicians are collectively a group of very altruistic people who really want to help others, and frequently we forget to stand up for ourselves because of some of those traits that make us great doctors. I want to be clear, I'm not advocating that we all need to go on strike! However, I am pleasantly surprised with the results that certain physician groups have demonstrated is still possible in a time when we have a profession united for our own well-being, and with that better care for our patients. This ties into my previous discussion about lobbying for technologies and equipment that can improve patients' safety and our efficiency. Rarely is the request of one surgeon or physician going to result in a significant change or capital purchase, depending on the situation, but when we take the time to organize and come together you can see the dramatic effect it has and the swift changes that can result. I hope to see more collaboration amongst physicians in general and for us to gain back some control of those things that directly impact our efficiency, production, job satisfaction and improve patient care.

Joel McClurg, MD, PhD. Reid Health (Richmond, Ind.): 2024 will be another chaotic year full of seismic changes in who, where and how medical care is delivered. I am excited about 2024 because where there is turmoil, there is opportunity for growth and transformation. I think about people and institutions as orchids and dandelions.  Orchids thrive and are beautiful under particular conditions. They need close to ideal conditions to survive and thrive. On the other hand, dandelions adapt to thrive in adverse environments, even a parched crack in the sidewalk. We have all seen dandelions grow in the most inhospitable of places. It always reminds me to "think" like a dandelion. People and institutions that take on that mindset will be the ones that succeed in medicine in the decades ahead.

Ryan Molli, DO. Whole Health Orthopedic Institute (Meadville, Pa.): I started a podcast about three and a half months ago, and I'm starting a second podcast with one of my good buddies. It's called "Red Carpet Healthcare Solutions," and it is essentially the vehicle upon which I'm trying to help swing that pendulum back. We'll have monthly podcasts that will bring different guests from different areas of the country and the world that are in the private practice setting, or maybe physician-owned hospitals or ASCs to really give young physicians the opportunity, knowledge and hopefully the confidence that they can move to private practice.

Amit Momaya, MD. University of Alabama at Birmingham: I am most excited in 2024 to initiate a new randomized controlled trial looking at if we can augment an allograft ACL to supplant the use of autograft ACL by augmentation, both mechanical and biological. This would be a game changer and disrupt the industry.

Jason Snibbe, MD. Snibbe Orthopedics (Los Angeles): In 2024, I’m excited to start a course at DOCS Spine and Orthopedics centered on outpatient total joint arthroplasty. It will be a course that focuses on the patient experience and how to maximize patient satisfaction when performing total joint surgeries. There will be lectures on anesthesia, physical therapy and enhancing the patient experience. I am very proud that we are hosting this course and hope to continue to expand it over the next several years.

Michael Venezia, DO. Orthopedic Specialties of Tampa Bay (Clearwater, Fla.): I am most excited about us catching up with other areas such as total joints in moving care to a more ambulatory setting, safely and with all our technology that we have started utilizing. I think it is exciting to see the advances we have made in spine surgery using more ultra-minimally invasive techniques such as endoscopy to help advance this movement, and I think it is only going to grow over the next year. 

Barrett Woods, MD. Rothman Orthopaedic Institute (Philadelphia): Despite the increasing challenges we face on a daily basis, I'm still in love with spinal surgery and enjoy going to work every day. I'm excited to continue to take care of patients and constantly evaluate ways to improve every step of the process.

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