Becker's ASC Review

83 ORTHOPEDICS 'Dr. Death' series starts filming — 6 things to know By Alan Condon T he TV adaptation of podcast network Wondery's "Dr. Death" series began filming in New Mexico in March. Six things to know: 1. The series follows the case of former neurosurgeon Christopher Duntsch, MD, PhD, who is serving a life sen- tence after he was convicted of aggravated assault associated with care provided in the operating room. 2. In 2011, Dr. Duntsch began practicing with the Minimally Invasive Spine Institute in Dallas and received surgical privi- leges at Baylor Regional Medical Center in Plano, Texas. Several of the procedures he performed at Baylor resulted in lawsuits and permanent physical damage to patients. 3. From 2011 to 2013, Dr. Duntsch's operations left 31 patients paralyzed or seriously injured and two of them dead. 4. In a spinal fusion procedure on his childhood friend Jerry Summers, Dr. Duntsch penetrated an artery and paralyzed Mr. Summers from the neck down. Mr. Summers died in February from an infection acquired after he was left a quad- riplegic, according to ABC affiliate Local 24 News. 5. In 2017, Dr. Duntsch was convicted for aggravated assault associated with care provided in the operating room. 6. The series is being produced by NBC's Peacock streaming service, according to a March 25 news release. Joshua Jack- son, Alec Baldwin and Christian Slater will star in leading roles. n Endoscopic spine surgery to become more prevalent at ASCs: 5 surgeon insights By Alan Condon T he need for minimally invasive spine procedures is boosting the demand for ASCs, with endoscopic spine sur- gery a prime procedure for the outpatient setting due to its lower risk of complica- tions, reduced blood loss, smaller incisions and faster recovery time. Here, five surgeons discuss benefits of endoscopic approaches to spine surgery and how the procedure is likely to grow in the outpatient setting: Kenneth Nwosu, MD. Neospine (Puyal- lup, Wash.): I see endoscopic spine surgery becoming the standard of care for spinal decompression. We will be able to per- form a decompressive surgery through an incision less than 1 centimeter safely and as effectively as open spine surgery. It's a no- brainer. In my perspective, I see that being a standard of care for most providers, and I think that will be the expectation by payers and patients as well. Peter Derman, MD. Texas Back Institute (Plano): One of the cool things about en- doscopic procedures is it's allowed me to do decompressions on many different patients who would have traditionally obtained a fusion. You can sometimes decompress transforaminally even to the center of the canal without destabilizing the segment in any way. As our disc replacement devices improve, and our ability to decompress without destabilizing improves, we're going to see more and more of a trend away from fusion as a treatment paradigm. Daniel Lieberman, MD. Phoenix Spine & Joint: Over the last five years we've seen real energy pulling away from deformity correction and multilevel fusion surgery, and the entire field of spine surgery moving into much more focused interventions based on structure. I think the next horizon is focused interventions based on symptoms. What patients really are concerned about is their pain. Our surgery centers offer endoscopic dorsal rhizotomy, so ultra-minimally invasive surgeries that eliminate pain are really the next horizon. It's almost like we're going to see spine surgery absorb and move into more of a pain management approach, rather than a structural correction approach. Brian Gantwerker, MD. Craniospinal Cen- ter of Los Angeles: We are looking forward to the purchase of an endoscopic surgery system for the ASC setting. It would be won- derful to recruit patients from other places to a center of endoscopic spine excellence. As more patients realize its benefits and legiti- macy as a procedure, the more patients will be looking for someone to perform it. Saqib Hasan, MD. Webster Orthopedics (Oakland, Calif.): I think the migration to endoscopic procedures is just one com- ponent of the larger shi to the outpatient setting. is move is largely facilitated by more surgeons utilizing minimally invasive techniques and leveraging technologies to provide reliable outcomes and faster postop- erative recovery. However, most simple de- compression surgeries are typically already done as outpatient procedures. e move toward endoscopic spine surgery is more intuitive — if you can utilize a 7mm camera to achieve equivalent or superior outcomes compared to current standard techniques, the question becomes, "Why wouldn't I use endoscopic techniques?" n

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