Big advancements and opportunities for growth in complex spine surgery: Q&A with Dr. Tobias Mattei


Tobias Mattei, MD, a neurospine surgeon with SLUCare Physician Group based in St. Louis, has a practice focused on complex spine surgery as well as artificial disc replacement.

He is an assistant professor and chief of spine surgery in the department of neurosurgery at Saint Louis University School of Medicine. 

Dr. Mattei was recently named to the inaugural "20 Under 40" list by the North American Spine Society's publication, SpineLine.

Here, Dr. Mattei examines the key factors affecting his practice and where the best opportunity for growth is in the future.

Question: What are the biggest concerns for your practice today? What keeps you up at night?

Dr. Tobias Mattei: The mission of providing excellent care in complex spine surgery certainly involves many challenging aspects, ultimately requiring utmost dedication from the whole multidisciplinary team involved in the integrated care of such patients. Such efforts are not exclusively related to the technical aspect of performing complex spinal operations, but involve a constant strive for efficiency and cost-effectiveness at every step of the care of patients with spinal disorders, from the referral process to initial evaluation, ordering of ancillary tests, proper coordination of initial conservative care with other healthcare members such as physical therapists and pain management, timely processing of authorizations for tests and surgeries as well as postoperative rehabilitation and coordination of follow-up in a multidisciplinary fashion. The responsibility of playing a central leadership role in such a complex and integrated process unquestionably involves a significant amount of time as well as personal efforts and concerns.

Q: What are you most excited about in terms of technology advancement in the spine space? Where do you see the best opportunity for growth?

TM: The possibility of incorporating intraoperative imaging guidance to intraoperative CT scan and spinal robotics represents a major development toward improving surgical accuracy and precision, which are crucial technical aspects especially when considering complex spine surgeries for correction of spinal deformity. Additionally the development of a new generation of spinal implants, such as expandable cages and cages with improved bone-implant interface to enhance fusion, has opened a new avenue which is expected to enable better correction of severe spinal deformities through minimally invasive approaches.

Despite the exponential growth observed in the past few years, the technological landscape in spine surgery is still quite incipient and the next decades will definitely witness even greater innovations, such as the possible incorporation of micro-electro-mechanical sensoring devices to current spinal implants in order to provide live feedback regarding the biomechanical status of that specific spinal segment.

Q: Where do you see your practice growing or evolving in the next 5 years? What is the next step or evolution in your career?

TM: As the tertiary reference center of SSM Health and with an expressive referral basis spanning both Missouri as well as a large portion of the state of Illinois, the spine division of the department of neurosurgery at Saint Louis University has the potential of becoming a major national reference center in complex spine surgery for a broad spectrum of pathologies from traumatic spinal injuries to spinal deformity as well as primary and metastatic spinal tumors.

The building of a new hospital — a $550 million project which is expected to inaugurate in 2020 — represents a crucial milestone in the development of our level I trauma center which will include state-of-the-art technology in spine surgery, such as the already in use O-Arm technology integrated with spinal navigation as well as spinal robotics. From the scientific standpoint, the Walter E. Dandy Society, an international academic entity focused on collaborative educational efforts in the field of neurosurgery and which has its headquarters at Saint Louis University, is expected to be launching a new scientific periodical 'The Walter E. Dandy Archives of Neurosurgery' in the near future.

The prospect of leading such a journal which is expected to play a central role in the global neurosurgical scenario certainly represents a great and exciting personal challenge.

Learn more about the big trends in spine at the Becker's 17th Annual Future of Spine + Spine, Orthopedic & Pain Management-Driven ASC Conference in Chicago, June 13-15, 2019. Click here

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