The future of artificial disc replacements: Dr. J. Brian Gill discusses trends & challenges


J. Brian Gill, MD, of Nebraska Spine Hospital in Omaha, discusses new trends in artificial disc replacement and challenges spine surgeons face.  

Dr. Gill's clinical interests include minimally invasive cervical and lumbar spine surgeries, deformity and degenerative conditions, disc herniation, spinal tumors and artificial disc surgery, among others.


Question: What are some of the most exciting new trends in artificial disc replacement surgery?


Dr. J. Brain Gill: I think the exciting trends are that most insurance companies are authorizing these procedures whereas a few years ago only a handful of insurance companies were authorizing them. The lumbar disc replacement interest has continued to wane, but cervical disc replacements are gaining significant interest as the long-term results are promising. The fact that cervical disc replacements are indicated for multilevel use is important as many patients have more than one-level involvement.


Q: What are the most pressing challenges facing artificial disc replacement surgeons?


JBG: One of the biggest challenges that we all face are reimbursement issues from authorization to payment. Recently, more insurance plans have been authorizing cervical disc replacements. [However] this issue has been one of the greatest hurdles for performing lumbar disc replacements — thus, the lack of widespread use in the United States.


The second issue is appropriate indications for surgery. Cervical pathologies for cervical disc replacement are more definitive and generally accepted than lumbar disc replacement indications. Finally, the outcomes need to show that artificial disc replacement surgeries are comparable and even superior to the standard treatment of an arthrodesis.


Q: How can artificial disc replacement surgeons best navigate those challenges?


JBG: The insurance issue is being solved presently with data that supports the technology. I am a big believer in outcomes, which should support surgeons' clinical decision making. I am interested to see the results of these technologies from surgeons who are not perceived to be biased in terms funding support, royalties, etc. Time will tell if these technologies will set a new standard or fall by the wayside. There have been several great ideas over the years in spine surgery, which have sounded phenomenal only to fail miserably with the test of time.  

Learn more from Dr. Gill at the 15th Annual Spine, Orthopedic & Pain Management-Driven ASC Conference + The Future of Spine in June 2017! Click here for more information.


Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.