The musculoskeletal environment is at an important inflection point with technology developing at a faster pace, procedures becoming more minimally invasive and broader focuses on patient wellbeing, spine surgeons discuss their own roles in healthcare’s future.
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: What keeps you most optimistic about the future of spine surgery?
Please send responses to Carly Behm at cbehm@beckershealthcare.com by 5 p.m. CDT Tuesday, Dec. 2.
Editor’s note: Responses were lightly edited for clarity.
Question: What role do you see spine surgeons playing in the broader musculoskeletal care ecosystem over the next decade?
Jordan Iordanou, MD, PhD. McHugh Neurosurgery (West Islip, N.Y.): Spine surgeons will increasingly collaborate within multidisciplinary musculoskeletal teams, integrating with physiatrists, pain specialists, and physical therapists. Our role will expand to include preventive care and non-surgical interventions, driven by patient demand for holistic solutions. I’m focused on fostering these partnerships to optimize outcomes across the care continuum.
Philip Louie, MD. Virginia Mason Franciscan Health (Seattle): The next decade won’t just need the “traditional” spine surgeons in the OR, it will need spine surgeons designing the entire MSK ecosystem. So we can no longer just be carpenters, we need to be architects: Architects of an MSK system in which spine surgeons will be shaping care pathways, guiding responsible adoption of enabling technologies, and ensuring patients receive the right care at the right time.
As value-based models expand and reimbursements tighten, surgeons will increasingly lead efforts to reduce unnecessary variability, integrate data-driven decision tools, and coordinate multidisciplinary MSK care. Our system seems a bit fragmented right now, so spine surgeons will be essential in aligning quality, cost, and innovation across stakeholders.
The scalpel will still be important. But the system that we design and build around the scalpel will be far more meaningful.
Jeremy Smith, MD. Hoag Orthopedic Institute (Irvine, Calif.): Over the next decade, spine surgeons will evolve from primarily operative specialists into central coordinators of the entire musculoskeletal care pathway. They will play a major role in value-based care by standardizing appropriateness criteria, reducing variation, and improving outcomes. Technology, including robotics, navigation and AI-driven diagnostics, will expand their capabilities and shift their role toward oversight and advanced decision-making. Surgeons will increasingly integrate and sometimes deliver non-operative care, overseeing multidisciplinary teams across PT, PM&R, pain psychology, and digital MSK platforms. Workforce changes and new training models will push surgeons to lead broader care teams and manage population-level spine health. Overall, they will function as tech-enabled, data-driven architects of comprehensive spine and musculoskeletal care.
Vijay Yanamadala, MD. Hartford (Conn.) HealthCare: The spine surgery field appears to be moving toward a more collaborative, conservative-first approach within broader musculoskeletal care teams. This includes closer integration with pain management specialists, physical therapists, and mental health providers. Value-based care models incentivize this collaboration by focusing on functional outcomes rather than procedure volumes. Spine surgeons may increasingly serve as consultants in complex cases rather than primary providers for all back pain. The challenge lies in defining appropriate surgical candidates more precisely while developing non-operative expertise or partnering effectively with conservative care providers.
Jacky Yeung, MD. Yale School of Medicine (New Haven, Conn.): With AI on the horizon to assist in decision-making, surgeons must remain the guardians and safety checks of that process. AI will make us more efficient and help personalize care, but it can’t replace human judgment or empathy. It will be difficult for patients to trust algorithms alone. Trust in healthcare is built through human connection, compassion and communication. The surgeon’s role is to ensure that as technology evolves, we don’t lose that human element.
Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): The assertion of core strengthening, overall health and aging is recognized and benefit-touted for longevity and wellbeing. The designated surgical patient with accompanying mishap or degenerative condition, irrespective of treatment pathway, is usually necessitous of an involved build-back process of musculoskeletal strengthening and stamina accretion. The role of the surgeon and one’s auxiliary staff is facilitation and vigilance. Albeit, logistics are ordinarily in place with allied therapies and consistent in most complex spinal surgery practices, incumbent recommendation of sequent care and renewable encouragement remains paramount in an outcome-based society.
