Becker's ASC Review

70 ORTHOPEDICS The next game changer in spine: 4 surgeon insights By Alan Condon F rom telemedicine to augmented reality and the advancement of single-position procedures, the technology that will have the most significant effect on the future of the field is discussed by four spine surgeons. Question: What technology do you see as the next true game changer in spine surgery? Alexander Vaccaro, MD, PhD. (Rothman Orthopaedic Institute (Philadelphia): Telemedicine is an inevitable game changer in spine surgery. As the field advances, the traditional doctor's visit is due for a much needed update. With the pandemic, the implementa- tion of telemedicine was kicked into overdrive, and its utilization will continue to reshape clinical practice. is will ultimately allow patients to receive the best care possible at their convenience, despite common boundaries such as busy work schedules, living in rural ar- eas or having functional limitations. Patients can now receive second opinions from world-class thought leaders at a fraction of the price, and a surgeon's office hours can now be mobile, exploiting downtime at medical meetings and between surgical cases if necessary. Brian Gantwerker, MD. Craniospinal Center of Los Angeles: I think it remains to be elucidated what is and is not a game changer in spine. We have seen so many pretenders to the throne. In truth, this is a marathon, not a race. As a whole, spine surgery is getting safer. When technology is used in conjunction with good judgment and not the ringing up of [relative value units] or maintaining a surgeon's lifestyle, we all get better at what we do. Shrewd selection of cases, application of the plethora of helpful technology, surgical experience and good outcome data applied in a thoughtful manner will lead to the continued progress and safe evolution of spine surgery. Alok Sharan, MD. NJ Spine and Wellness (East Brunswick, N.J.): I think the next big game changer in spine surgery will be the common use of virtual surgery tools, such as augmented reality glasses. ese glasses, along with the technologies that will allow other surgeons to proctor a surgeon in another state or country, will help improve the quality and efficiency of surgeons. As there is a greater emphasis on quality and outcomes, surgeons will have to ensure that they are able to produce reproducible results. is will require virtual coaching by other surgeons who can help a surgeon attain higher quality and efficiency in the OR. Currently, to learn a new technique, a surgeon has to travel to a weekend course. is becomes burdensome in terms of time off from your practice and personal obligations. With AR glasses, surgeons will be able to learn new techniques and also improve their current surgical techniques. Issada ongtrangan, MD. Microspine (Scottsdale, Ariz.): Endo- scopic spine surgery, including fusion, will be a game changer as it is gaining more acceptance in the U.S. e challenges are training, steep learning curve, cost of the equipment and reimbursement. Motion preservation, especially cervical disc replacement, will continue to gain more acceptance, as the data is undeniable. Single-position sur- gery, such as prone-transpsoas, will be a game changer as well. n Insurer sued for allegedly refusing to cover spinal stabilization device By Carly Behm A Florida woman is suing Anthem, alleging that the insurance company didn't cover a spine device that should have been covered under the Employee Retirement Income Security Act, which is designed to provide protections to as well as setting rules for employer-sponsored health insurance plans. The plaintiff, Brenda Honeycutt, works for a financial ser- vices company based in Alameda County in California. She had a spinal decompression procedure done with the Coflex interlaminar stabilization device to treat spon- dylolisthesis, according to the lawsuit, filed July 27 in the U.S. District Court for the Central District of California. Ms. Honeycutt, who was covered under an ERISA health plan, received a letter from Anthem on May 11 saying her claim for surgery with the device was denied. Anthem's letter said the denial was on the basis that the Coflex device was "experimental/investigational," the lawsuit said. The FDA considers Coflex a class 3 medical device, which "usually sustain or support life, are im- planted or prevent potential unreasonable risk of illness or injury," according to court documents. n Orthopedic surgeon base pay fell 13% in 2020-21 By Laura Dyrda T he base salary for orthopedic surgeons dropped 13 percent in the past year, according to the Merritt Hawkins 2021 Review of Physician and Advanced Practitioner Recruiting Incentives, released Aug. 9. The average salary for orthopedic surgeons dropped from $626,000 in 2019-20 to $546,000 in 2020-21. This year, orthopedic surgeons on the low end of the salary spectrum received $300,000, compared with $425,000 in 2019-20. On the high end, orthopedic surgeons did better in 2020-21 than the previous year. The high end of the pay spectrum extended to $1 million annual base sal- ary in the most recent year, compared with $850,000 in 2019-20. Orthopedic surgeons were the 13th most recruited specialist, including physicians and advanced practitio- ners. n

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