Issue link: https://beckershealthcare.uberflip.com/i/1425344
11 SPINE SURGEONS the world we're in because it takes out the need for huge robots — huge 3D imaging machines in limited spaces, particularly in an ASC where the ORs are obviously much smaller. Alexander Vaccaro, MD, PhD. Rothman Orthopaedic In- stitute (Philadelphia): Robotics will truly become the future of spine surgery when it is a practical and efficient option for both academic and community surgeons. Oen, healthcare systems market robotic surgery to patients who perceive it as technologically advanced, but the focus must shi toward robotic surgery as a safe, pragmatic alternative to traditional surgery for the bottom line. Infrastructure requirements and costs must be brought in line with a competitive marketplace. Technological advancements focused on workflow issues such as real-time intraoperative seamless imaging incorpo- rating preoperative MR advanced imaging with real-time neurovascular surveillance must be pursued to improve safe- ty and to expand the applications of further use. It is at this point that robotic surgery will have truly arrived in spine. Ernest Braxton, MD. Vail (Colo.) Summit Orthopaedics and Neurosurgery: Probably the most important feature of future spine robots is the concept of universality. ey must be able to perform a wide variety of procedures and ideally be agnostic to the manufacturer of the implant. To be com- monplace, they must be useful in all areas of spine surgery, not just pedicle screw placement. I think that they have a similar pathway that the operating microscope had in the 1980s and 1990s. For many facilities to have access to this technology, the cost must come down. Only when the spine robots are sold at a more reasonable price point (between $350,000-$500,000) and have applications for multiple types of procedures in- cluding decompression of neural elements (in the cervical, thoracic and lumbar spine) will they truly thrive in the prac- tice of spine surgery. e price is coming down as more com- petitors enter the marketplace, but today robots still have a limited role in spine surgery. Brian Gantwerker, MD. e Craniospinal Center of Los Angeles: Everyone is talking about the singularity of the age of the spine robot. In fact, we feel more like we are on an asymptotic approach, rather than exponential adoption. e function of robots needs to go beyond the function of a fancy electronic guide wire and evolve to reshaping, reconfiguring and predicting how well the decompression, interbody cage, or rod-screw constructs will look before your patient is off the table. David Essig, MD. Northwell Health (Great Neck, N.Y.): Spine robots will likely become an integral part of our prac- tice. However, in order to further improve patient outcomes and surgical throughput several changes will need to occur. Improvements in size and cost will need to happen for robots to efficiently participate in the outpatient surgical space. Ag- nostic soware that allows surgeons to utilize a variety of im- plants interchangeably with robotics will allow for preserved surgeon autonomy and assist with cost mitigation strategies. Finally, improvements in the "shared operative experience" between robots and surgeons are needed to allow for in- creased flexibility to adapt real-time changes in the operative plan based on intraoperative findings and complications. n Meet North American Spine Society's '20 Under 40' for 2021 By Carly Behm T he North American Spine Society released its "20 Un- der 40" list of spine care honorees under 40 years old Sept. 29. The 20 specialists are featured in the society's publication, SpineLine. Profiles of them are available here. The featured physicians are: 1. Chris Alcala, MD. Twin Cities Spine Center (Minneapolis) 2. Kaku Barkoh, MD. Orthopaedic Associates (Kingwood, Texas) 3. Aju Bosco, MBBS, MS. Madras Medical College in Chennai, India 4. Jose Canseco, MD, PhD. Rothman Orthopaedic Institute (Philadelphia) 5. Raymond Hah, MD, Keck Medicine of USC (Los Angeles) 6. Sandra Hobson, MD. Emory University School of Medicine (Atlanta) 7. Philip Louie, MD. Neuroscience Institute at Virginia Mason Franciscan Health (Seattle) 8. Simone Maybin, MD. Conway (S.C.) Medical Center 9. Michael McCarthy, MD. Indiana Spine Group (Carmel) 10. Jeffrey Mullin, MD. University of Buffalo (N.Y.) Neurosurgery 11. Aria Nouri, MD. Hôpitaux Universitaires de Genève (Swit- zerland) 12. Catherine Olinger, MD. University of Iowa Hospitals & Clinics (Iowa City) 13. Brenton Pennicooke, MD. Barnes-Jewish Hospital (St. Louis) 14. Aditya Raghunandan, MD. South Texas Spinal Clinic (San Antonio) 15. Lindsey Ross, MD. Cedars-Sinai (Los Angeles) 16. Alexander Satin, MD. Texas Back Institute (Frisco) 17. Gregory Schroeder, MD. Rothman Orthopaedic Institute (Philadelphia) 18. Eiman Shafa, MD. Twin Cities Spine Center (Minneapolis) 19. Koji Tamai, MD. Osaka (Japan) City University 20. Gene Tekmyster, DO. Keck School of Medicine (Los Ange- les) n