Becker's Spine Review

13 SPINE SURGEONS 866-948-7673 • nationalASCbilling.com THE ASC REVENUE CYCLE. It's all we do. It's all we think about. And it shows. UNPARALLELED EXPERTISE | PROPRIETARY PROCESSES | INTELLIGENT ANALYTICS | STRATEGIC VISION | EXCEPTIONAL RESULTS | THE BUSINESS OF Powering Profitability artificial disc replacement has also been pick- ing up steam. "The newest generation disc implants have pliable cores that allow vertical com- pression and some lateral shear (twisting) movement, as we see with natural discs," said Todd Lanman, MD, of Beverly Hills, Calif.-based Lanman Spinal Neurosurgery. "The new generation implants give patients even greater stability while also providing natural multidirectional flex as it preserves range of motion." 8. Stem cells. Stem cell-based therapies have shown prom- ise for the treatment of degenerative spine conditions, and use in augmenting spinal fusion has already proven effective. But the overarching feeling by most surgeons is that more research must be conducted. "As clinicians, we must be cautious in the way we communicate about it with our pa- tients," according to Vladimir Sinkov, MD, of Las Vegas-based Sinkov Spine Center. "Our opinions and treatment decisions must be based on sound scientific judgement and available high-quality research, which is still very scant." 9. Robotics. Robotics have made significant strides in spine over the past decade, but still lag be- hind robotics in other specialties, such as general surgery, urology and OB/GYN. Ro- bots have impressed with their improved precision in the placement of pedicle screws and limiting radiation exposure in the OR, but their high cost and learning curve have somewhat curbed adoption. However, they are expected to continue to advance and ex- pand beyond assisting surgeons with screws in the future. "In order to gain wider adoption, robots need to be less expensive and cumbersome, and improve efficiencies and outcomes for all sur- geons, including those with the greatest expe- rience and outcomes," said Ali H. Mesiwala, MD, of DISC Sports & Spine Center in New- port Beach, Calif. "Similarly, when the cost of robotic surgery decreases to an amount that can be absorbed by private practice facilities and ASCs, and insurance/Medicare provide payment or incentives for its adoption, wide- spread adoption will follow." 10. Endoscopic spine surgery. Endoscopic spine surgery is steadily picking up steam among surgeons, particularly in the outpatient setting, and has been demonstrat- ed to lower complication risks, reduce blood loss and lead to quicker recovery times for patients. "One of the cool things about endoscopic procedures is it's allowed me to do decom- pressions on many different patients who would have traditionally obtained a fusion," said Peter Derman, MD, of Texas Back Insti- tute in Plano. "You can sometimes decom- press 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 with- out destabilizing improves, we're going to see more and more of a trend away from fusion as a treatment paradigm." n

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