Biologics, MIS, non-fusion technologies: 4 spine surgeons discuss 20 years of clinical development

Written by Anuja Vaidya | November 05, 2015 | Print  |

Here four spine surgeons discuss the most significant clinical innovation in spine care in the last 20 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: Does your practice have an EHR? Has it proved beneficial?

Please send responses to Anuja Vaidya at by Wednesday, Nov. 11, at 5 p.m. CST.


Question: What has been the most important clinical development in spine in last two decades?


Richard Kube, MD, Founder, CEO, Prairie Spine & Pain Institute, Peoria, Ill.: I would say the general category of non-fusion technologies has had a huge impact. The treatment methods for patients have grown enormously with these products, and there is hope for greater long-term results with these options as well. Whether disc replacements, Coflex or biologics including stem cells, patients truly have greater choice, and hence, better autonomy. Patients aren't faced with just one or two poor options. They can now have more hope for the future in coping with their spine ailments.


Brian R. Gantwerker, MD, The Craniospinal Center of Los Angeles: Cervical arthroplasty has been the most important development. I think the spine community is finally acknowledging that fusion is not always the answer, and certainly not the best option in all surgical scenarios.


Mark Nolden, MD, NorthShore Orthopaedic Institute, Chicago: The most important clinical development in spine in the past couple of decades certainly has been less-invasive approaches to performing surgery.

New instrumentation systems along with intraoperative computer-assisted navigation systems, which are now widely available, have enabled surgeons to minimize surgical exposure and therefore lessen postoperative discomfort and shorten hospital stays. Additionally, surgeons have fine-tuned techniques to allow for these minimally invasive procedures. Advancements in biologics, such as bone morphogenic proteins, have greatly improved the success of lumbar fusions. Osteointegrative implants are showing great promise in fusion applications as well. Many new osteointegrative devices have been introduced to market and many more are in the pipeline.


Thomas A. McNally, MD, Medical Director, Chicago Spine Center at Weiss Memorial Hospital: The refinement of minimally invasive surgical techniques over the past 20 years has improved the clinical experience immensely. Because of it, patients are spending less time in the operating room, recovering more quickly and experiencing less pain and risk of infection. Minimally invasive surgery has been evolving and the best improvements have been seen in optics and the optimization of visualization in small spaces. It has allowed surgeons to access more areas of the spine, with more predictable outcomes.


More articles on spine:
6 key notes on deep wound infection after pediatric scoliosis surgery
8 things for spinal surgeons to know for Thursday — Nov. 5, 2015
Gateway Medical Center unveils neuro-suite led by Dr. Robert Bejnarowicz: 5 observations

© Copyright ASC COMMUNICATIONS 2019. Interested in LINKING to or REPRINTING this content? View our policies here.

Top 40 Articles from the Past 6 Months