Five spine surgeons discuss technologies that excite them and what they view as the next big breakthrough in spine:
Noam Stadlan, MD. NorthShore Orthopaedic & Spine Institute (Skokie/Evanston, Ill.): We have excellent technology for fixation and for encouraging fusion. Currently, most surgeries are done for pain and we lack advanced technology to help us identify sources of pain. I think advanced MRI imaging and other technology may help with that. The widening use of hospital and outcome databases hopefully will fuel an increased emphasis on quality and outcome prediction.
Srdjan Mirkovic, MD. Northshore Orthopaedic & Spine Institute (Chicago): I see two big minimally invasive spine surgery innovations in spine care. First, robots have advanced in spine surgery. Robotic and free-hand spine surgical procedures are proving to insert screws with great precision and accuracy for surgeons. Secondly, we are managing pain much better through more aggressive, nonoperative steroid injection protocols.
Vladimir Sinkov, MD. Sinkov Spine Center (Las Vegas): MIS spine surgery is an excellent option for most patients. It has been shown to be safer, with less postoperative pain and quicker recovery times than traditional open techniques. We now have multiple studies with long term data to prove this. The next innovation would be to make MIS spine surgery more common through better technologies and surgeon education. Intraoperative computer navigation and robotic technology allow for precise preoperative planning, accurate hardware placement and lower radiation exposure. This technology will make it much easier for spine surgeons to adapt minimally invasive techniques and eventually make it the standard of care.
Steven Cyr, MD, SASpine (San Antonio): I think most people would agree that restoring spinal cord function would be considered the ultimate breakthrough in regenerative medicine for the spine. There are many conditions affecting the spine that would change lives, including reproducible regeneration of degenerated, painful discs and chronically injured nerves. I believe there is potential for all those conditions to be improved. Our only limitation currently is a standardized system and research outlining the safest techniques and most effective source of stem cells and growth factors.
Brian Gantwerker, MD. Craniospinal Center of Los Angeles: Seeing the exciting developments in robotics and endoscopy remain two of my most anticipated developments. Current techniques in endoscopy look promising, although I am not totally sold on endoscopic transforaminal lumbar antibody fusions. I think decompressions and discectomies will all be done endoscopically in 10 years. For surgical robotics, I would love to see a Mako-like robot that helps us with more than just the screw placement. Other than that, electromagnetic navigation is very exciting and I think is a game changer in terms of mutual radiation exposure for surgeon and patient.