Trends in spine to watch from Dr. Ashutosh Pradhan — lumbar disc replacement, practice demographics and cost control

Laura Dyrda -   Print  |

Ashutosh Pradhan, MD, is the chief of neurosurgery at Ascension St. Vincent's Riverside, a 528-bed hospital based in Jacksonville, Fla.

The hospital has been recognized as among the best hospitals in the nation for spinal surgery by Healthgrades. Here, Dr. Pradhan discusses the big trends in spine technology and how the field will change within the next few years.

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

Dr. Ashutosh Pradhan: Lumbar arthroplasty and robotics. Lumbar arthroplasty is not necessarily a new idea, but we have had limited improvement on current offerings. I think we still need to evolve in maintaining motion in the spine rather stopping motion. There are only two FDA approved lumbar arthroplasty devices: Centinel Spine's prodisc-L and Aescalup's Active-L. I hope there will be more products to come to market.

Robotics have a lot of possibilities, but we are not there yet. Improving outcomes and decreasing revisions would go a long way in spine. The robots are currently limited in capabilities and do not have live feedback. I think the growth of use will force improvement and indications.

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

AP: The aging population is forcing the average age of my patients to go up. I am trying to be more aware or proactive in general health issues that will affect operating on this population. A good preoperative checklist and education for this population will be important to reduce complication rates.

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

AP: I am concerned that there is a race to the bottom to control cost without necessarily evaluating patient benefit. We should all be good stewards of our healthcare system. In a race to improve our cost structure, I think we are eliminating opportunities for new technology and burdening physicians with documentation requirements that seem unnecessary. In addition, it seems like I am spending more time on the phone with insurance companies for patients I have documented appropriate conservative treatment.

To participate in future Becker's thought leadership articles, contact Laura Dyrda at

More articles on spine surgery:
8 spine, neurosurgeons making the news
Dr. Gregory Lekovic: Emerging technology in spine and the reimbursement headwind to watch
Dr. Robert Brady: Robotics in spinal fusion and how the trend will develop in spine

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