The future of spine technology: 13 surgeon predictions

Surface Technology

Spine technology is always evolving to provide better value-based care options.

Here are 13 spine surgeon predictions on technology in the future.

Learn more about spine industry trends at the Becker's 16th Annual Future of Spine + Spine, Orthopedic & Pain Management ASC Conference in Chicago, June 14-16, 2018. Registration is now open, click here.

This is article is an excerpt from "50 spine surgeon predictions for 2018" – to see the additional predictions, click here.

John Finkenberg, MD. Sharp (San Diego): The most important trend for 2018 will be seen as the creation of instrumentation and procedures that blur the lines between MIS and minimal-access surgery. 2018 will bring on a new tax code, which may positively affect many professional businesses. Tax ceilings and opportunities to buy digital radiograph equipment with advantageous depreciation rules should be considered.

Richard Chua, MD. Northwest NeuroSpecialists (Tucson, Ariz.): I believe there will be continued growth in the application of minimally invasive spine surgical techniques, including improvements in implant technology, biologics, instrumentation and biomechanical considerations. In addition, the move toward outpatient spine surgical services may continue to grow as reimbursement and payers demand more efficiency, reduced cost and better resource utilization.

Kern Singh, MD. Co-Director of the Minimally Invasive Spine Institute at Rush (Chicago): 2018 will be the year of the robot in spine surgery. Almost every major spine company will have released their next-generation robot. Look for robots to do more than just help place pedicle screws. Navigation, surgical assistance and even help with the surgical decompressions are on the horizon.

Mick Perez-Cruet, MD. Director of Minimally Invasive Spine Surgery and Spine Program at Oakland University William Beaumont (Rochester, Mich.): The most important spine technology trend for 2018 will be the further development of minimally invasive spine surgery and stem cell-based biologics. The best opportunity for spine surgeons will be to bring cases into outpatient spine surgery centers in which they hold an equity stake.

Michael Musacchio, MD. NorthShore University HealthSystem's Neurological Institute (Evanston, Ill.): Technology is the game changer for spine surgeons and their patients, especially 3-D capabilities. A paradigm shift is in play; 3-D navigation has improved accuracy and safety of screw placement and the overall procedure. It has further advanced minimally invasive techniques and it reduces, if not eliminates, redo surgeries for screw misplacement. Robotics has better enabled the integration of 3-D navigation through software to aid in deformity correction. Deformity correction technologies include preop planning software, intraoperative assist devices, rod benders and more.

Brian Gill, MD. Nebraska Spine Hosptial (Omaha): I am interested in seeing how 3-D technology/printing capabilities will translate into implant design and function; whether this technology translates into quantifiable better outcomes remains to be seen.

Andrew Hecht, MD. Chief of Spine Surgery at Mount Sinai Hospital and Health System (New York City): The most important technology trends in 2018 are continuing to find the appropriate carriers and doses for the use of BMP-2 (Infuse) to minimize complications and yet harness its effective capabilities. In addition, spine surgeons continue to explore the appropriate indications for minimally invasive fusions for degenerative, trauma and deformity applications. Lastly, spine surgeons continue to define the appropriate indications for cervical disc replacement and how to minimize heterotopic ossification after TDR.

Jocelyn Idema, DO. Advanced Orthopaedics and Rehabilitation (Washington, Pa.): There is recent data with regard to lumbar disc replacement and a five-year follow-through that has shown highly favorable patient outcomes and reduction in overall healthcare costs due to a significantly decreased revision rate for adjacent-level pathology. As more insurance companies and hospital systems begin to align and recognize these significant changes in spine surgery, there will be more opportunities in the near future for improved quality of care.

Other innovative technologies, such as improved navigation systems, robotics and the various implant techniques, will continue to positively impact the spine industry in the future. It is important to note that although these technologies continue to change and improve, the spine industry must also balance the cost-effectiveness and value of these technologies, always striving for the best patient outcome and experience for the patient.

Todd Lansford, MD. South Carolina Sports Medicine & Orthopaedic Center (North Charleston): The most important trend in spine technology would be the continued integration of biplanar fluoro to navigation. I say this especially because the use of robotics is an expanding field; advances in imaging will increase the speed for robot procedures. Once navigation improves in speed and ease, robots will be used more frequently. The second trend I see is use of titanium/tritanium implants. This has shown superiority over PEEK and will gain in use throughout the year.

Thomas Schuler, MD. Founder of Virginia Spine Institute (Reston): The top two areas affecting spine surgery are artificial intelligence and arthroplasty. Both of these shift the paradigm of decision-making and treatment options. Artificial intelligence applied to robotic surgery simplifies surgeries, decreasing complication rates while enabling smaller, less invasive operations. These preserve more natural passive and active stabilizers of the spine, minimizing adjacent segment disease. Arthroplasty is achieving a similar outcome by protecting adjacent segments. Regenerative medicine is impacting nonoperative care and providing a new option for mild adjacent segment pathology.

Paul Slosar, MD. President of SpineCare Medical Group (Daly City, Calif.): The focus is now on surface technologies for fusion implants. The most sophisticated and advanced surface has a unique titanium nano-technology to stimulate the host bone to grow rapidly, promoting early osseous-integration. This should lower surgeons' dependence on expensive or inflammatory biologics. The porous implants may be better than smooth surfaces, but still lag behind in terms of stimulating a cellular response.

William Tally, MD. Athens (Ga.) Orthopedic Clinic: The biggest technical change will be the continued rise of minimally invasive spine and the correlated transfer of spine procedures into an ambulatory surgery center setting.

Christian Zimmerman, MD. Saint Alphonsus Medical Group (Boise, Idaho): Advancements in onsite hardware creation may be a thing of the extreme future, but online custom-made hardware may realize a place in the implant market.


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