5 Spine Surgeons on Operating Room Innovation

Written by Heather Linder | February 07, 2013 | Print  |
Five spine surgeons discuss what types of innovation they would like to see in the operating room in the next five years.
Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. We invite all spine surgeon and specialist responses. Next week's question: On what topic would you like to see more spine research focused?

Please send responses to Heather Linder at hlinder@beckershealthcare.com by Wednesday, Feb. 13, at 5 p.m. CST.

Vincent Arlet, MD, Orthopedic Spine Surgeon, KneeFootAnkle Center of Kirkland (Wash.): Imaging technologies; neurophysiology improvement with more sensitivity than what we have, even though the improvements have been already spectacular; new technologies that will avoid, prevent or decease the junctional syndromes in spinal deformities and degenerative spine

Ara Deukmedjian, MD, Neurosurgeon and CEO, Deuk Spine Institute, Melbourne, Fla.: [I would like to see] widespread acceptance of endoscopic spinal disc repair as a replacement for fusion. I believe endoscopic cervical [disc repair] will become the treatment of choice worldwide for most symptomatic herniated or bulging discs causing neck or arm pain, radicular symptoms and cervicogenic headaches. Right now, patients suffering with these symptoms usually receive open surgery and spinal implants, usually fusion with plates and screws and bone graft. Arthroscopic spine surgery is the future treatment of choice for disc herniations and stenosis with pain, and this procedure has a 95 percent success rate for resolving pain with no complications to date. The entire surgery is performed through a 4 millimeter skin incision or as wide as the letters on this screen are tall.

Jeffrey Wang, MD, UCLA Spine Center: I would like to see more practical technology in the OR in the next five years — easier ways to account for sponges and items used in the OR using electronic monitoring; more detailed interactions between the surgical team, anesthesia and the nursing staff; a team-building atmosphere in the actual operating room; better ways to access and view our imaging systems, X-rays and more detailed digital imaging in the OR that will make the process of the operation easier, more automated and better for our patients; perhaps an integration of our imaging systems with our microscopes and imaging screens during the surgery. I think there are practical technologies that can benefit everyone.

William Taylor, MD, Spine Surgeon, UC San Diego Health System: The promise of navigation has yet to be realized in many operating rooms throughout the country. Navigation and its related field of neural monitoring in conjunction with available technology would allow tremendous advances in patient safety, operative speed and complication reduction. Unfortunately, this technology remains expensive, occasionally cumbersome and slow adoption remains the norm. I feel strongly that the operating room of the future will have neuronavigation and neural monitoring as a primary focus to reduce complications and improve patient outcome.

Jeffrey Goldstein, MD, Director of Spine Service, NYU Langone Medical Center's Hospital for Joint Diseases: I would like to see biologics with efficacy proven with level I data which are affordable with minimized side effects. This may include advances in stem cells which act to regenerate injured or degenerative discs in addition to bone graft substitutes. With respect to fusion devices, we have implant surface technology available which can program bony in-growth and enhance fusion. As we become more aware of the need to restore sagittal balance, we will also have implants available which can restore spinal alignment. Motion preservation procedures will evolve to the next step with implants which are more compatible with MRI and allow better imaging in the cervical spine.

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