Becker's ASC Review

76 ORTHOPEDICS Wife of patient who died after receiving TB-infected allograft sues By Carly Behm T he wife of an Indiana man who died of tuberculosis after receiving Aziyo Biologics' recalled allograft is suing the company. Gregory Flinn, 73, had a spinal fusion on April 8, and the surgeon implanted Aziyo Biologics' FiberCel implant, according to a lawsuit filed in Marion Superior Court July 16. A few days after the surgery, Mr. Flinn started experi- encing symptoms including a fever, back pain, weakness and fatigue. He was admitted to the ICU May 14 as his condition worsened. He tested positive for tuberculosis May 19 and started treatment the same day. Mr. Flinn died from the infection May 23, according to court records. Mrs. Flinn's lawsuit alleges Aziyo Biologics and Medtron- ic, which distributed the allograft, failed to adequately obtain and review donor medical history, test the product for contamination, issue a timely recall and warn consum- ers of the risk of tuberculosis infection. Aziyo Biologics recalled a lot of its FiberCel implant June 2. Several lawsuits have been filed on behalf of patients who were sickened by the implant since then. The contaminated FiberCel products were used in 113 patients in 37 facilities across 20 states, WBIW reported July 26. Most of those cases have been in Delaware and Indiana. Aziyo Biologics declined to comment on the lawsuit. A Medtronic spokesperson said the company and Aziyo are working with the FDA and CDC to "ensure healthcare providers have the necessary guidance to manage the care and treatment of their patients." It is also working to create a patient support program with Aziyo and the CDC. n 'Half of what we do today will be history': Surgeons predict how spine surgery will look in 10 years By Alan Condon I n the next decade, spine surgeons will move further toward a multidisciplinary approach to care, with robotics becom- ing the standard of care for instrumentation placement, fewer fusions being performed and more total disc replacements. Here's what spine surgery in 2030 will look like, according to eight spine surgeons: Question: How will surgeons in 2030 look back at how spine care is performed today? Srdjan Mirkovic, MD. NorthShore Orthopaedic & Spine Institute (Chicago, Skokie, Ill.): I believe surgeons practicing at the start of the next decade will appreciate an enhanced multidisciplinary approach to treating spine pain. Between now and then, I see spine surgeons and pain specialists working in closer cooperation, referring more oen and increasing interactions through case discussions, perhaps through a multidisciplinary conference. Also, I anticipate more evidence-based, minimally invasive procedures that prove effective as technology evolves in the coming years. Lastly, I expect surgery will continue to evolve towards less invasive options. Vladimir Sinkov, MD. Sinkov Spine Center (Las Vegas): Given the amount of research and development currently devoted to improving spine surgery techniques and instrumentation, there are a lot of excit- ing developments that I look forward to in the field of spine surgery in the future. By 2030 I anticipate spine surgery to be a lot less invasive than current techniques. ere will likely be more regenerative options available to treat spine disease in earlier stages, before invasive fusion interventions are needed for degenerative spine disease. Most decompression procedures will likely be done endoscopically. Both endoscopic decompressions and all fusion surgeries will be done in a minimally invasive fashion with use of navigation and augmented reality. Robotic assisted surgery will be the standard of care for instrumentation placement, nerve decompression and disc space preparation. is will allow for more precise, predictable and safe surgery. I sincerely hope that more research will be devoted to determining the most effective and cost-conscious bone-gra- ing materials for fusion surgeries. ere will likely be improvement in implant quality and outcomes as well as expanded indications for motion preservation procedures, too. Issada ongtrangan, MD. Microspine (Scottsdale, Ariz.): My prediction is that in 2030, the majority of spine surgeries will be performed using minimally invasive techniques in outpatient settings. Endos- copy, navigation, virtual reality and artificial intelligence will be the standard of care. ere will be more advanced and accept- able solutions in biologics and stem cells for degenerative disc treatments. Half of what we do today will be history if not obsolete. Brian Gantwerker, MD. e Craniospinal Center of Los Angeles: We will solve many problems, such as facet replacement, three or more disc arthroplasty indications and a way to reliably select the right surgery for the right patients, in indifference to unrelated concerns such as [relative value unit] goalposts, de- partmental demands or medical school debt. Augmented reality with heads-up displays, real-time dynamic navigation with little to no radiation and near-bloodless surgery will be very prevalent. In short, things will be cooler, safer and better. ere are patients I see at times, who had a microdiscectomy or decompression 10-15 years ago, and the incisions look enormous. I am sure my prejudice and hubris would be

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