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26 Patient positioning. e way spine patients are positioned in the operating room can make the procedure easier on surgeons and more comfortable for patients. Surgeons traditionally achieved the optimal patient position by rolling up blankets or using pillows to prop up the patient in different ways. e Bone Foam Sideline Lateral Positioning System is designed to position patients so surgeons have optimal access to the spine. From the way patients are positioned to instrument attachments on the table, a more personalized experience than ever before can be curated by surgeons. Precision medicine. EHR data within organizations and large national patient registries gather data points, and artificial intelligence can gather information based on specific parameters to help spine surgeons see trends among large and small, select patient populations. ey can then use the data in discussions with patients for shared decision-making. Coupled with patient-specific implants and robotic-guided procedures, surgeons are able to provide a customized care experience for patients from their first meeting until they are pain-free. Prone transpsoas approach. Spine surgeons in partnership with Alphatec Spine developed the prone transpsoas approach as a more streamlined alternative to the traditional lateral approach. Surgeons can use the approach to perform spinal fusions on patients in the prone position, accessing the disc space laterally through the psoas muscle. e technique reduces preoperative positioning time, and surgeons can perform posterior surgery simultaneously when needed. Robotics. Nearly every major orthopedic company has a robotic spine surgery offering, with Medtronic's Mazor X Stealth Edition holding the largest market share. Most spine-focused robotic systems offer surgical pre-planning based on the patient's CT scans and pedicle screw guidance during surgery. Robotic systems are becoming the preference for early career surgeons who train on them during fellowships, and some systems are even making their way into ASCs. While the systems have evolved a long way in the last decade, there are still opportunities for robotic systems to provide the same value in the spine field as they do for total joints. Scoliosis surgery. Technology advancements are making complex spine surgeries less invasive and hold big promise for improving scoliosis surgery outcomes. Robotic technology will have more applications beyond pre-planning scoliosis procedures to predict the amount of lordosis surgeons can achieve with fusions. Surgeons also have also begun using augmented reality technology in scoliosis cases to make procedures more precise. Vertebral tethering for pediatric patients with idiopathic scoliosis was approved in 2019 and is being evaluated for long- term outcomes as an alternative to fusion. Spinal cord injury treatment. Exciting advancements in spinal cord injury treatment are returning motor function to patients who experience severe trauma. A study from Yale University in New Haven, Conn., published in April, found patients who were injected with stem cells derived from their own bone marrow reported improved motor function aer spinal cord injuries. Baltimore-based Johns Hopkins scientists have also begun developing ultrasound devices for patients with spinal cord injuries with a $13.5 million grant from the Defense Advanced Research Projects Agency. Stem cells. Medtech companies are in the beginning stages of testing stem cells for spine patient applications. In January, the first spinal fusion using a ViBone Moldable cell bone matrix was performed. e technology, designed by Aziyo Biologics, promotes bone growth with cancellous bone particles and demineralized cortical bone fibers and particles within the matrix. UC Davis Health in Sacramento, Calif., also launched a human clinical trial using stem cells to treat spina bifida in fetuses before birth. Telemedicine. e COVID-19 pandemic forced physicians and patients to rapidly adapt to virtual care options, and the spine field was no exception. Spine surgeons quickly transformed their practices to see patients via video conferencing, gather information through online forms and share images seamlessly between providers. ey were also able to conduct postsurgical visits and second-opinion consultations virtually. Telemedicine is here to stay and moving forward, there will be more functional monitors and text communications to track back pain and spine surgery patients as they recover. 3D printing. e spine field continues to expand applications for 3D printing, both for model spines and implants. Orthofix received FDA clearance for its 3D-printed device, Construx Mini Ti Spacer System, in April. Nexxt Spine and Stryker also have 3D-printed implants. In other fields, companies use 3D printing for customized implants and developing customized spine implants could be an opportunity for companies in the future. n Stryker is one of the world's leading medical technology companies that offers innovative products and services in Orthopaedics, Medical and Surgical devices, Neurotechnology and Spine to help make healthcare better. Procedural volumes, particularly with total joints, have been migrating from the hospital outpatient department to ambulatory surgery centers (ASCs). With the potential to provide over $55 billion per year in healthcare cost savings in the U.S., this shift in site of care is expected to continue beyond the post-pandemic environment. To meet the unique needs of this emerging customer, Stryker launched an ASC-focused business in 2020. With thousands of unique and clinically proven products spanning more than 20 procedural specialties, a wide range of flexible financial options and teams who understand the ASC landscape. Stryker is committed to delivering tailored solutions for ASCs to achieve their mission and goals.