Looking ahead to 2016: What excites spine surgeons most?


Here five spine surgeons discuss the most exciting aspects of the spine industry in 2016.

Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. We invite all spine surgeon and specialist responses.


Next week's question: What are your biggest concerns going into 2016?


Please send responses to Anuja Vaidya at avaidya@beckershealthcare.com by Wednesday, Jan. 6, at 5 p.m. CST.


Question: What are you most excited about going into 2016?


Brian R. Gantwerker, MD, The Craniospinal Center of Los Angeles: My son will be turning four and I will have been in practice seven years. I am looking forward to moving more of my cases into an outpatient surgery center setting.


Richard Kube, MD, Founder, CEO, Prairie Spine & Pain Institute, Peoria, Ill.: We are excited to be providing stem cell treatment to large joints and spinal discs. I think this technology has promise and will provide yet another option for those with debilitating degenerative orthopedic conditions.


Richard D. Guyer, MD, President, Texas Back Institute, Plano: What I am most excited about going into 2016? That my family, friends and TBI family will continue to enjoy good health and prosperity; that the FDA will continue to loosen the reigns allowing easier entrance of new technology that has been used abroad and allow our U.S. patients to benefit from this; and that mobile medicine will continue to evolve through the use of our smart phones. Perhaps not too far in the distant future, the smart phone will be able scan our bodies as they did in Star Trek and monitor all of our vital functions or response to treatment.


I am also excited that genomics will further identify treatment specific regimens for diseases or for individuals; that immunotherapy will continue to evolve taking us closer to curing all kinds of cancer; that 3D printing will evolve in the OR so that we will have patient specific spine implants not just those designed for the average person; and that our understanding of stem cell technology will help unlock incredible regeneration options for our patients.


And lastly I am hopeful that our government will correct the missteps with the Affordable Care Act and truly provide basic care to all instead of putting the decision-making process into the hands of insurance companies through the poorly conceived exchanges.


Thomas A. McNally, MD, Medical Director, Chicago Spine Center at Weiss Memorial Hospital: I'm most excited about less invasive surgeries. We are seeing more predictable results and rapid recovery with less collateral tissue damage.

Coflex is a motion sparing device, implanted minimally invasively, that is showing great promise for patients with moderate to severe spinal stenosis. Implanted after laminectomy, the interlaminar stabilization device is inserted between the vertebrae. It is an alternative to fusion and it results in less stress to the adjacent levels.

In 2016, it will still be necessary to have open surgery for some of the complex, larger cases, but the emphasis on less invasive treatments will ultimately benefit patients with improved outcomes.


Purnendu Gupta, MD, Spine Surgeon, NorthShore Orthopaedic Institute, Chicago: I'm most excited about the better understanding of spino-pelvic balance. The literature in spine is now pointing to other patient factors that may be key to understanding how to spatially align the spine in reconstruction and particularly spinal osteotomies.

This is a very challenging group of patients. There's always been a concern with long-term patient outcomes when attempting to achieve spino-pelvic balance in spinal reconstruction. While we strive to make it "perfect," we are learning that we should consider the patient's age and underlying neurological disorders when realigning the spine. In other words, we need to take a better look at the patient as a whole, as opposed to just the spinal alignment.

We're finally putting the pieces together with this "big picture" approach, and I expect we'll make great strides in 2016 with a better tailored approach that meets the needs of the patients.


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