Becker's ASC Review

77 ORTHOPEDICS Orthopedic groups in Reno, Carson City merge to form Nevada's largest musculoskeletal platform By Alan Condon R eno-based Spine Nevada and Tahoe Fracture & Orthopedic Medical Clinic in Carson City, Nev., merged to create a 60-provider group, which is the largest musculoskeletal care platform in the state. The combined practice will continue to operate under its existing brands, which include Tahoe Fracture, Spine Nevada, Swift Urgent Clinic and Vein Nevada. Tahoe Fracture will join Spine Nevada under Phoenix- based Healthcare Outcomes Performance Co.'s Nevada care network. It will have access to HOPCo's clinical and quality infrastructure, IT tools and claims analytics to part- ner with health systems, provider groups and payers. The partnership aligns with HOPCo's mission to team with musculoskeletal practices, health systems and payers to develop value-based care programs — such as bundled payments, shared savings and population health — that improve quality and reduce the cost of care. "The addition of Tahoe Fracture to HOPCo's platform in Nevada is a big step forward in creating a high-perform- ing clinically integrated network in the Reno, Carson City and Lake Tahoe markets," said Wael Barsoum, MD, chair- man of HOPCo Nevada's board of directors, said in a June 30 news release. "Tahoe Fracture's commitment to excep- tional outcomes and patient-first model makes them an ideal partner to continue to transform the musculoskeletal care market in Nevada." n different if I were that surgeon 10-15 years prior and be very proud of using a "small" incision. Ten years hence, I hope our suc- cessors will look on us kindly and with an understanding heart. Todd Lanman, MD. Lanman Spinal Neuro- surgery and ADR Advanced Disc Replace- ment Spinal Restoration Center (Beverly Hills, Calif.): In the next nine years, I think that spine surgeons will look back at the number of fusions that were performed and how debilitating and oen restrictive this type of surgery was for a patient's health. As artificial disc replacements and motion preservation surgery continue to develop, these will become the mainstays of treatment in the future. Fusions will become very limited in their usage, mostly reserved for severely arthritic degenerative or scoliotic spines, but not for the general cases of patients that need spine care. Most of these patients can be treated using artificial disc replacements. As we are finding out now, the indications for artificial disc replacements are being expanded greatly. For example, patients that are believed to have arthritic joints once required a fusion, but this is indeed not true, particularly in the cervical spine where most patients who have somewhat arthritic facet joints in the can undergo artificial disc replacements with certain discs that help unload or offload the facet joints, lessen facet pain and keep mobility and function. Jeremy Smith, MD. Hoag Orthopedic Institute (Irvine, Calif.): I believe we will look back and think that our surgeries were too invasive, and over performed. Over the next 10 years, spine surgery will become less invasive, more motion preserving and more reliant on image guided technology. It will be performed more regularly in the ASC on an outpatient basis and recovery will be more expeditious. Artificial intel- ligence will help build evidence based treat- ment algorithms tailored to the individual patient. ese pathways will make the surgical outcome more predictable and help drive down revision rates. Ali H. Mesiwala, MD. DISC Sports & Spine Center (Newport Beach, Calif.): e years 2020 and 2021 will likely be viewed as a turning point when spine surgery became more acceptable and available in the outpa- tient setting. For the decade or two prior to this, limited centers existed which special- ized in spine surgery, and many surgeons and medical device companies did not feel comfortable performing these operations in the outpatient setting. With the COVID-19 pandemic, hospitals were overrun with patients who truly needed inpatient care, and elective cases were pushed to the side or delayed indefinitely. For surgeons working in the outpatient setting with established outpatient spine practices, the pandemic proved to be an op- portunity to showcase what could be done. As more facilities and surgeons recognized the safety, efficiency and convenience of outpatient surgery, it became more accepted and, in fact, requested by patients. In 2030, most elective spine surgeries will be performed in the outpatient setting, and only those complex cases or medically risky patients will be taken to traditional hospitals and medical centers. Rojeh Melikian, MD. DISC Sports & Spine Center (Newport Beach, Calif.): Similar to how we might look back on 2010's surgical landscape today, I imagine we will wonder how we did some surgeries without the newer technologies that came out in 2025 or 2030. n "Over the next 10 years, spine surgery will become less invasive, more motion preserving and more reliant on image-guided technology." - Dr. Jeremy Smith

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