Nigel Price, MD, chief of the section of spine surgery at Children's Mercy Kansas City (Mo.) examines the big technology trends in spine today.
Question: What emerging technology or technique do you think will have the biggest impact on the spine field five years from now?
Dr. Nigel Price: The emergence of assistive robotic technology will probably become very common. I have been to several robotic courses in the last several years, and as the technology advances and the workflow improves, it will likely become widespread. Surgical trainees are now learning spine surgery with navigation and other assistive technologies so in five years this will become entrenched.
Q: What do you think will fade or disappear from the spine field over the next few years?
NP: Several value-driven practices are changing the outcomes. We will see fewer infections, less need for transfusions, early mobilization and earlier discharges from the inpatient side. We will hopefully make better decisions in terms of preoperative planning and execution so avoidable complications necessitating revision surgery will be reduced. Collaboration across many institutions will help refine technique through sharing of data. There will be fewer spine fusions for deformity in the younger age group as techniques and technologies for doing guided growth will encourage more fusionless surgery.
Q: Where do you see the biggest room for innovation in spine? What do you need to provide better care that doesn't currently exist?
NP: We are adopting nonoperative and non-fusion strategies to avoid permanent instrumentation and fusion surgeries. We are promoting earlier detection of spinal deformity so that we can initiate effective multidisciplinary, team-based, nonoperative care which has been shown to be effective in avoiding surgery. We need effective growth-friendly techniques and technologies for the challenge of early onset scoliosis, that does not leave the patient with chronic spine problems that will require revision surgery in adulthood and maintains good function.
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