Becker's Spine Review

29 DEVICES & IMPLANTS Spinal technologies that will rise to prominence in 2021: 5 surgeons weigh in on emerging trends By Alan Condon F rom the expansion of robotic spine surgery to disc replace- ment and augmented reality, five surgeons discuss the technol- ogies and procedures they expect to play a bigger role in 2021. Note: e following responses were lightly edited for style and clarity. Question: What spinal technologies do you see becom- ing more prominent in 2021? Jeremy Smith, MD. Hoag Orthopedic Institute (Irvine, Calif.): Innovation in spine surgery continues to revolutionize the field. Techniques used in the future will make our current ones look archaic. e most fascinating and applicable technology that will be welcomed in 2021 will center around minimally invasive tech- niques. With COVID-19 limiting hospital beds and resources, the drive toward outpatient surgery will accelerate. Techniques involv- ing single-position surgery (lateral or prone) will continue to im- prove and allow 360-degree fusions with minimal blood loss and perioperative morbidity. Endoscopic spine surgery continues to grow, and as surgeons continue to refine their skills, indications will become broader. Industry competition has allowed for multiple navigation and robotic technologies that continue to maximize ac- curacy and minimize invasiveness. Vladimir Sinkov, MD. Sinkov Spine Center (Las Vegas): Minimally invasive surgery and technologies that enable MIS procedures will continue gaining popularity. ere is more scientific evidence on benefits of MIS surgery and patients demand it. ese technologies also make it easier to do more advanced spine surgery, such as lumbar fusions, at an ASC. at will drive better outcomes, cost savings and avoid the need to take elective spine surgery patients to the already overwhelmed acute care hospitals. Robotic-assisted spine surgery will continue gaining popularity as newer capabilities (beyond plac- ing pedicles screws) become more available and accessible. Todd Lanman, MD. Lanman Spinal Neurosurgery (Beverly Hills, Calif.): I think arthroplasty is going to continue to grow, with new- er technology discs that are evolving and will be used more oen. Discs with not just mobile cores, but potentially compressible cores that mimic normal physiologic motions of discs, will be more in use next year. Furthermore, expanded indications in arthroplasty will continue to broaden. is means not only placing artificial discs in people with significant degenerative discs or even facet joint disease in the cervical spine, but also patients who have severe motion re- striction from prior multilevel fusions who will now be able to have those reversed. We are doing reversals of such fusions in order to restore motion in certain patients. We call this restorative motion surgery, used for pa- tients who have had multilevel spinal fusions. So far, it has been very successful with no significant complications. We are continuing to study this and we'll be publishing more on it in the near future. Brian Gantwerker, MD. Craniospinal Center of Los Angeles: Ex- pandable and augmented reality technologies will become more prominent in the coming year. Implantation through an endoscop- ic-type approach will be more feasible and allow for patients to have much less invasive surgery. Some of my colleagues are now doing awake fusion surgery, which I think is fascinating. Unfortunately, it requires a lot of buy-in from anesthesia. Adoption in some places, like my own, will likely be slow. Lastly, I see technologies involving virtu- al learning and teaching become more prevalent. As the COVID-19 pandemic hopefully starts to recede, the way people learn is going to be forever changed. e companies that can do that effectively will be front and center in 2021 and beyond. John Burleson, MD. Hughston Clinic Orthopaedics (Nashville, Tenn.): I believe robotics will continue to increase next year. We will also start to see the first wave of adoption of augmented reality in the clinic and the operating room. n Stryker's net sales drop to $14.4B in 2020 amid pandemic: 6 details By Laura Dyrda Stryker's 2020 net sales dropped 3.6 percent, largely due to the COVID-19 pandemic. Six details: 1. Net sales last year dropped to $14.4 billion, but the company is showing signs of recovery. Fourth-quarter net sales were up 3.2 percent year over year to $4.3 billion. 2. Orthopedic net sales dropped 5.6 percent in 2020 to hit $4.9 billion. Spine sales dropped 9.5 percent to just over $1 billion. 3. Full-year knee sales were down 13.7 percent to $1.6 billion in 2020. Hip sales dropped 12.8 percent to $1.2 billion. 4. Trauma and extremities sales grew 5.1 percent in 2020 to $1.7 billion. 5. The company expects 2021 organic net sales growth of 8 percent to 10 percent over 2019 numbers, assum- ing recovery from the pandemic allows for more nor- mal elective procedure levels in the second quarter. 6. Stryker Chair and CEO Kevin Lobo said its integration of Wright Medical is "off to a good start." The company completed its acquisition of Wright Medical in Novem- ber 2020. n

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