Spine and orthopedic experts and leaders spoke with Becker's Spine Review on key topics in January from endoscopic surgery to the potential of Neuralink brain implants.
1. "Neurosurgeons and orthopedic spine surgeons have undergone the training necessary to evaluate and perform spinal fusions. There is more that goes into evaluating a patient for fusion other than the presence of disease. There are other considerations — symptoms, presence of deformity, age, level of functionality and risk/benefit analysis. As I tell most patients, surgery is the first step. There is no place for scope creep when it comes to performance of spinal fusions. Simply put, if one cannot fix the complication, one should really carefully consider if you should be doing the surgery in the first place. This is a necessary red line." — Brian Gantwerker, MD, of The Craniospinal Center of Los Angeles, on whether nonsurgeons should perform spinal fusions.
2. "[Anterior cervical discectomy and fusion] will continue to be a workhorse procedure over the next 10 years. The two biggest factors affecting the development of ACDF will be the continued movement of the procedure to the ASC setting and the increasing adoption of cervical total disc replacement. These factors will bifurcate the development of ACDF into an outpatient procedure as well as a complex, inpatient procedure." — Domagoj Coric, MD, of Carolina Neurosurgery & Spine Associates in Charlotte, N.C., on predictions for anterior cervical discectomy and fusion procedures.
3. "Restoring people's functionality with Neuralink both physically as well as cognitively to allow patients with devastating neurologic ailments an improved quality of life, with the possibility to regain independence, is a fantastic goal. This deserves to be deeply researched, encouraged and peer reviewed to allow all of us to contribute where we can and always remain critical but applaud and celebrate its successes."— Kornelis Poelstra, MD, PhD, of The Nevada Spine Clinic in Las Vegas, on the potential of Elon Musk's Neuralink implants.
4. "I think the movement of spine cases to outpatient settings will help drive this change, because the surgery is significantly less disruptive. I think quite honestly, once people know [endoscopic spine surgery is] available, consumers are going to start demanding it. We also need industry support. We need major players in the industry and medical device companies to really step up and start large training programs to get more people interested and get them the skill set. A surgeon doesn’t want to introduce the technology without the right training behind it." — Michael Gallizzi, MD, an incoming spine surgeon at The Steadman Clinic in Vail, Colo., on what needs to happen to make endoscopic cases more widespread.