Becker's ASC Review

87 ORTHOPEDICS His AR glasses cut pedicle screw placement time in half, Dr. Chetan Patel says By Alan Condon C hetan Patel, MD, developer of augmented reality system iSight, said the device has reduced the time taken to place pedicle screws during spine surgery by 51 percent. That 51 percent translates to 10 minutes saved in the operat- ing room per spine procedure, according to Dr. Patel, execu- tive medical director for spine surgery at Altamonte Springs, Fla.-based AdventHealth. Augmented reality technology determines the position of surgi- cal tools and superimposes them on the patient's CT data. Last May, Dr. Patel has been using the technology with the iSight glasses, which allow users to simultaneously look at the patient and the navigation data. "Basically, what we do is: I leave my traditional loops on, the magnification, and then all I have to do is put on my augmented reality glasses right on top," Dr. Patel said. "Essentially, it gives me a 55-inch screen, right in front of my eyes." Dr. Patel is founder and medical director of the Spine Health Institute in Altamonte Springs and the North American Spine Society's section chair of robotics and navigation, a position he has held since it was created in 2012. n Former NuVasive CEO to exit board By Laura Dyrda G regory Lucier will retire from the company's board of direc- tors May 18. Mr. Lucier joined the board in 2013 and became chairman and CEO in 2015. He left his role as CEO in November 2018 after growing the company's net sales to more than $1 bil- lion. NuVasive also built a manufacturing facility in West Car- rollton, Ohio, during Mr. Lucier's tenure. The company be- gan developing the X360 system for lateral single-position spine surgery and the Pulse integrated surgical technologies platform under his leadership, as well. "I want to thank Greg for his leadership and guidance to NuVasive and the board of directors. His extensive medical device background and experience commercializing disruptive technology helped expand the company's key growth areas and build a strong foundation for our long-term strategy," said NuVasive CEO J. Christopher Barry. Mr. Lucier launched Corza Health, a San Diego-based life scienc- es and medical technology company, in 2019. Chicago-based private equity firm GTCR is a partner in the venture. n must travel great distances for care; those with responsi- bilities at work or home that make it difficult to take time away; and those for whom travel is difficult due to physical limitations. Certain routine postoperative visits and imag- ing follow-up appointments are also quite amenable to telemedicine. As we increasingly demonstrate the value of telemedicine through research publications, I am hopeful that payers and regulators will break down existing barriers to allow more widespread utilization. Rather than being limited by their local geography, patients should be able to seek the care of leaders in the field from the comfort of their homes. Brian Gantwerker, MD. Craniospinal Center of Los Angeles: Down the pipeline, spine care delivery will be increasingly hybridized with more motion preservation, augmented reality/virtual reality, robotics, endoscopy and telemedicine. We are seeing more spine care also being moved to the surgery center in an extended-stay modality. By 2026, I think we will see a very different payer landscape as well. Whether for better or worse, there might be a single payer and/or bundled payment system. I do not think this will necessarily be a good thing. e reason being, part of what makes spine surgery so important is the positive effect it has on patient lives. e impact of being without pain, or being much relieved, and being able to return to work and their family life is utterly undervalued by the payers. Unless something changes, and both physicians and patients push back, despite all the inno- vations and amazing technology, unless someone makes the payers actually pay for it, patients will not enjoy its benefits. Adam Bruggeman, MD. Texas Spine Care Center (San Antonio) and CMO of MpowerHealth (Addison, Texas): Spine care delivery will clearly shi toward the outpatient setting as payers see cost savings and providers have greater opportunity for ownership in surgery centers. Trends are shiing toward employment models and consolidation of practices as we see hospital systems, private equity and insurance companies continue to employ a greater percent- age of the workforce. Also pushing this trend is the growing attitude of physicians who prefer to avoid the ever-growing practice management requirements and increasing burden of preauthorization associated with payers. Christian Zimmerman, MD. Saint Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): e surgical expectation of early discharge is already the accepted norm for those who are capable following spinal surgery. e length-of-stay issue and patient education surrounding the pandemic has been an accepted shi of practice, resulting in temporary unit creation, focal physical and occupational consultation and early readiness for dis- charge. Diagnoses that are complex to treat such scoliosis, deformities, remote fractures, or intracanal tumors of the spine, coupled with systemic illness, will remain challenges even for the best health systems and providers. Issada ongtrangan, MD. Microspine (Scottsdale, Ariz.): I expect there will be more spine cases being done in outpatient settings. ere will be more adoption in motion preservation and endoscopic spine surgery on both sides, the surgeons and the insurers. I predict we will continue to see the growth in robotics, navigation and artificial intel- ligence. n

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