Despite challenges in the healthcare landscape, many spine surgeons remain optimistic for the specialty, especially as innovations are unveiled.
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. Becker’s invites all spine surgeon and specialist responses.
Next question: How will your approach to outpatient spine surgery change in the next five years?
Please send responses to Carly Behm at cbehm@beckershealthcare.com by 5 p.m. CDT Tuesday, Dec. 9.
Editor’s note: Responses were lightly edited for clarity.
Question: What keeps you most optimistic about the future of spine surgery?
Jordan Iordanou, MD, PhD. McHugh Neurosurgery (West Islip, N.Y.): Advancements in minimally invasive techniques and biologics keep me optimistic about spine surgery’s future. These innovations reduce recovery times and improve outcomes, enhancing patient quality of life. Coupled with AI-driven diagnostics, the field is poised for transformative growth, making surgery safer and more effective.
Pierce Nunley, MD. Spine Institute of Louisiana (Shreveport): The future of spine surgery inspires great optimism because our field remains in a state of active discovery. Despite remarkable progress, there is still so much left to learn about spinal pathology, biomechanics, and biologic healing. Advancements continue to emerge in both operative and non‑operative treatment, expanding our ability to restore function and improve quality of life. The field of biologic therapies, in particular, remains in its infancy, holding promise for regenerative and disease‑modifying interventions that may someday transform current paradigms. The combined momentum of innovation, research, and collaboration ensures that spine care will only grow more precise, effective, and personalized in the years ahead.
Noam Stadlan, MD. Endeavor Health Neurosciences Institute (Skokie and Highland Park, Ill.): The factors that keep me optimistic about the future of spine surgery are the young, smart, and talented residents and fellows who are entering the field. Most of those with whom I interact want to practice spine surgery for the right reasons: Helping patients and making their lives better. There are a lot of challenges facing the field and having talented, energetic, and idealistic physicians moving the field forward gives me hope for the future. Our responsibility is to give them the best training and tools possible to accomplish what needs to be done.
Casey Slattery, MD. Hoag Orthopedic Institute (Irvine, Calif.): I believe spine surgery still has a lot of growth left. We continue to learn more through research about specific alignment goals and treatment options that are more individualized for each patient. All the new technology available today can be helpful in the right circumstance. However, it is expanding our knowledge so that we choose the right treatment for the right patient that keeps me optimistic about the future.
Vijay Yanamadala, MD. Hartford (Conn.) HealthCare: Technological advances in navigation, robotics, and minimally invasive techniques continue to improve precision and reduce morbidity. Biologics research shows promise for enhancing fusion rates and potentially treating disc degeneration. Perhaps most importantly, there’s growing recognition of the biopsychosocial nature of spine pain, leading to better patient selection and more realistic outcome expectations. The development of validated outcome measures and registries is improving understanding of what works for which patients.
Jacky Yeung, MD. Yale School of Medicine (New Haven, Conn.): I’m incredibly optimistic about where spine surgery is headed. We’re entering a new era defined by less invasive, more targeted, and patient-friendly solutions. The continued advancement of minimally invasive and endoscopic techniques means we can achieve the same or better outcomes with less tissue disruption, quicker recovery and less pain.
I’m also excited by the integration of interventional pain therapies like basivertebral nerve ablation and peripheral nerve stimulation. These options give us more ways to help patients who fall into that gray zone, where conservative management hasn’t worked, but a major reconstructive surgery isn’t the right next step.
We’re finally bridging the gap between conservative care and ‘monstrous’ surgeries, offering patients personalized, stepwise solutions instead of extremes. That evolution of combining innovation, precision, and patient choice is what makes the future of spine surgery so exciting.
Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): Optimism in healthcare and its delivery can help promote resilience, assist with managing stress, stave off burnout, and importantly, cultivate compassion for patient and co-worker by example and action. With that, tabulated consequence of positivity and assimilation of inclination and lifestyle is recognized and indisputable.
What keeps this observer optimistic in spinal surgery, especially in the realm of complexity, is a recent cultural shift of surgeon acknowledgement in one’s limitation of practice, which ultimately better serves the patient and community. Realizing boundaries within diagnosis and administering care to the most complicated pronunciations is a function of experience and resource. The process of complicated delivery is a drawn-out derivative of acumen and resource. Granted, the exclusion of certain higher acuity patients for most indefensible variances will continue to annoy; the judicious realization of capability and competence within the specialty seems to be more apparent in referral patterns and concession.
