Spine surgery is a dynamic and rapidly evolving field. Four spine surgeons weigh in on the clinical trends that they believe is changing the face of spine surgery.
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: Will the Sunshine Act dissuade young spine surgeons from forming relationships with device companies? Do you see this as a positive trend?
Please send responses to Anuja Vaidya at avaidya@beckershealthcare.com by Wednesday, Sept. 17, at 5 p.m. CST.
Question: What are some of the most innovative clinical trends in the spine surgery industry today?
Neel Anand, MD, Clinical Professor of Surgery, Director, Spine Trauma, Cedars-Sinai Spine Center, Los Angeles: Minimally invasive spine surgery is probably the most innovative [clinical trend] out there and biologics. As long as they are reimbursed and surgeons are getting paid for them, these technologies and techniques will advance and will be used more.
Christian G. Zimmerman, MD, Neurosurgeon, Idaho Neurological Institute at SARMC, Boise, Idaho: One of the most innovative products to cross the surgical wires for use has been the intervertebral body cage made of trabecular metal. This inert metal's light weight construction allows for maximal friction coefficients between bone surfaces, compression strength within its sagittal placement and nearly reproduced porous aggregation that mimics the course weave of bone marrow. Animal studies lauded its fusion and osteoblastic migration capabilities, deeming it more than suitable alternative to PEEK and other plastic cage matrices.
William Taylor, Director, Spine Surgery, Vice Chairman, Division of Neurological Surgery, University of California, San Diego: I continue to believe that minimally invasive spine surgery holds the immediate promise for improved spine care and outcomes. Future biologics may change the way we view and treat the degenerative disc and painful low back. But these are years away from implementation. Our failure to adopt MIS as a standard of care for appropriate procedures based on the available literature does not bode well for our ability as a specialty to adapt and change quickly.
Ara Deukmedjian, MD, CEO, Medical Director, Deuk Spine Institute, Melbourne, Fla.: The most innovative spine surgery trend in 2014 is [endoscopic spine procedures like] Deuk Laser Disc Repair. This new peer-reviewed and published surgical procedure allows for herniated and bulging spinal discs that are symptomatic to be treated endoscopically by repairing the damaged disc with laser technology.
Traditionally, symptomatic disc disease has been treated with open surgery like spinal fusion or laminectomy. Both of these surgical treatments use large incisions and cause extensive collateral damage to nearby muscles, ligaments and bone not to mention, extensive scaring. Deuk Laser Disc Repair uses a four millimeter (cervical disc herniation) or seven millimeter incision (lower back) to endoscopically view and repair the damaged disc. There is no fusion or artificial disc needed. Recovery is in days rather than weeks or months. No metal, plastic or biological material is left in the patient and no bone is removed as this may cause delayed instability.
The surgery is so gentle it can be performed outpatient in a surgery center. Patients go home one hour after the surgery, being completely independent the following day. There is no other spine surgery that has the high success rate for treating back pain, neck pain or sciatica along with no complications in the seven years the procedure has been performed at the Deuk Spine Institute.
Currently, there are 500,000 spinal fusions performed annually in the U.S. and we believe that the Deuk Laser Disc Repair will be able to eliminate 75 percent of these fusions for the much safer and less invasive endoscopic procedure. There are millions more people suffering with chronic discogenic neck and back pain that can be cured as well with the Deuk Laser Disc Repair.
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