Why spine surgery became even more essential during the pandemic: Key ideas from Dr. Evalina Burger


Evalina Burger, MD, is the Robert D'Ambrosia Chair of Orthopedics at the University of Colorado Anschutz Medical Campus in Aurora.

Dr. Burger focuses her practice on spine surgery and has been a leader in the field for many years. She participated in a fireside chat during the Becker's Spine, Orthopedic and Pain Management-Driven ASC + the Future of Spine Virtual Event on June 19, discussing her outlook for spine, technology and private practice in the future.

Click here to view the full interview on-demand as well as access several other fireside chats, panels and workshops during the event.

In this excerpt, Dr. Burger talks about how the focus on essential surgery and technology during the pandemic will shape the spine field. Note: responses are edited slightly for clarity.

Question: There has been a lot of talk during the pandemic about which surgeries are essential and which can be delayed. How do you think that will affect orthopedic and spine procedure volumes in the future?

Dr. Evalina Burger: During the pandemic, we were ordered by the governor to stop all elective surgeries, but we were still performing around 37.5 percent of our volume. Looking back at the surgeries that we did during the close down, these were all surgeries for worsening pathology. In a busy practice, you don't notice it as much because you see the patient and decide that the surgery is urgent and you work the patient in, but at the end of the day many procedures need to be done in a timely manner, such as the next week or 10 days. The surgeries we did were all urgent and emergent, and patients would phone in or arrive at the ED and say they couldn't feel their legs or bladder anymore.

It was interesting to see patients that were on our waiting list before that actually did experience significant deterioration. We saw this with patients who had disc herniation and specifically with cervical myelopathy where the patients got significantly worse. It sort of made us more vigilant for the future when we see patients in the clinic to really get that baseline exam and explain to them the symptoms that should drive them back to the clinic or to give us a phone call so we can get them in quicker and put them on our waiting list.

Q: What technology will be essential in spine going forward?

EB: There are two technologies. The first one is data collections with outcomes. There are multiple platforms available for quality outcomes collection, and I think it would be essential to have this. If you cannot participate in this, I think it would be very detrimental. It's absolutely a must. A lot of places were collecting outcomes over the last 10 years, but we know that the compliance was in the low 30th percentile for patients filling out all these forms. As modern technology and apps have developed, it has become much easier for patients to fill this out. Patients have become more app-based because they all have cell phones. Technology also helped us to collect their outcomes. I think that would be phenomenal to see how this massive data collection and technology on outcomes will be essential in the future in the surgical realm.

I do think that navigation, robotics, making sure that surgery is more accurately done and that there are less and less never events in the OR is going to play an important role in the future as well.


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