How endoscopic spine surgery will evolve in 2024: Dr. Paul Houle


Next year could see increased integration of endoscopic spine techniques, according to Paul Houle, MD. 

Dr. Houle is the chief of neurosurgery at Cape Cod Healthcare in Hyannis, Mass. He recently spoke with Becker's about the changes he expects to see in spine surgery in 2024. 

Editor's note: This response was lightly edited for clarity and length. 

Question: What changes do you expect to see in spine surgery in 2024?

Dr. Paul Houle: In 2024, I anticipate significant developments in the spine industry, with a primary focus on the increased integration of endoscopic spine techniques into standard medical practice. One of the key factors driving these changes is the entry of Arthrex into the spine market, a development poised to have a profound impact on the industry.

Historically, one of the main barriers to the widespread adoption of endoscopic spine surgery has been the challenge of training a large number of surgeons in these specialized techniques, along with the need for cost-effective solutions that hospitals and surgery centers can readily embrace. Arthrex, in my view, possesses the financial resources and infrastructure required to tackle these issues effectively. With their established relationships and existing equipment, Arthrex is well-positioned to provide the necessary training to a substantial number of surgeons, facilitating the broader adoption of endoscopic spine procedures.

Additionally, the landscape will see other players such as MaxMoreSpine, Joimax, Elliquence and RIWOspine experiencing increased adoption of their techniques. This is especially true in cases where Arthrex is developing new relationships with spine surgeons interested in offering these innovative methods. A significant indicator of this shift is the substantial attendance at endoscopic symposiums held by Eurospine and [the North American Spine Society], underscoring the growing interest and desire among medical professionals to learn endoscopic spine surgery.

As the utilization of decompressive endoscopic techniques continues to rise, it will naturally lead to greater awareness and adoption of endoscopic-assisted spine fusion procedures. The synergy between endoscopic techniques and expandable interbody cages, such as FlareHawk, will play a pivotal role in driving lumbar fusion surgery toward ambulatory surgery centers. This is because endoscopic-assisted fusions can now be performed while patients are "awake," thanks to innovative conscious sedation techniques in combination with erector spinae muscle blocks. This advancement enables outpatient-based lumbar fusion surgeries to become a reality.

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