Advancements in the field of spine and orthopedics are being made every day, and a number of game-changing procedures are coming down the pipeline in the next few years.
Two surgeons spoke with Becker’s about what they expect some of these procedures to be.
Ask Orthopedic Surgeons is a weekly series of questions posed to orthopedic surgeons around the country about clinical, business and policy issues affecting spine care. Becker’s invites all orthopedic surgeon and specialist responses.
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Please send responses to Claire Wallace at cwallace@beckershealthcare.com by 5 p.m. Central time Friday, March 28.
Editor’s note: Responses were lightly edited for clarity and length.
Question: What new procedure do you expect to be the most gamechanging?
Scott Blumenthal, MD. Orthopedic Spine Surgeon at Texas Back Institute (Plano): Revision to a cervical disc replacement: Artificial disc replacement in the U.S. reaches its 25th anniversary this year. Over time, there has been significant innovation in technology, as well as technique. We have been able to overcome barriers we didn’t think possible, such as wider boundaries for patient selection, insurance coverage and, most recently, disc replacement revision with an artificial disc. Although CTDR has a revision rate of around 1.5%, increasing use will generate a significant number of revisions. It was previously believed a revision on an artificial disc had to be done as a fusion. However, it is now known that is not the case. You can replace an artificial disc with an artificial disc. We have published a series of over 50 cases and have a proposed treatment strategy. Most of the cases were converted to fusion, but about one-third were true disc-to-disc revisions. This new approach to disc replacement revision will help patients continue to experience the benefits of an artificial disc and preserve motion in their spine.
Peter Derman, MD. Spine Surgeon and Director of the Tiny Incision Division at Texas Back Institute (Plano): Advances in endoscopic techniques will continue to expand the breadth of spinal issues that can be effectively managed using this ultra-minimally invasive technique. I predict that a new subspecialty of “sports spin”e will develop. Just as there are orthopedic surgeons who scope knees and a separate group that replaces them, I expect that there will increasingly be those of us who scope spines while others perform larger, open operations. Spine surgeons today can do three things — decompress, fuse and replace. Endoscopy will allow us to broaden this list of possibilities. In addition to the current procedures, endoscopic soft tissue repair and augmentation will revolutionize spine surgery. Endoscopic spine surgery is a game changer today and will be even better tomorrow.
