Becker's ASC Review

23 ORTHOPEDICS Philip Schneider, MD. e Centers for Advanced Orthopaedics (Bethesda, Md.): Endoscopic spine surgery began in the 1990s and has evolved slowly since its inception. For endoscopic surgery to make a big jump in the next decade, we must incorporate artificial intelligence and robotic technology. AI is becoming increasingly popular across several industries, proving effective in medical practices. If we incorporate artificial intelligence in endoscopic spine surgery, I predict the practice will evolve exponentially. Nick Jain, MD. DISC Sports & Spine Center (Newport Beach, Calif.): I believe increasing adoption of this technology will lead to more patient demand for endoscopic procedures as patients will realize that minimally invasive alternatives are becoming more mainstream, similar to what has happened in Korea. Christian Zimmerman, MD. St. Alphonsus Medical Group and SAHS Neuroscience Institute (Boise, Idaho): Endoscopic spine surgery is performed with tubular retractors which reduce the need to cut through so tissues, effectively minimize blood loss and post-operative discomfort while promoting faster recovery and healing. However, endoscopy may not be appropriate for all spine surgery indications, as complex spinal diagnosis such as scoliosis, spinal instability, trauma or cancer may be better managed with a traditional open or minimally invasive spinal procedure. As the fund of knowledge, comfortability and surgeon experience grow, so will indications and recommendations to patients. Issada ongtrangan, MD. Spine Surgeon at Microspine (Scottsdale, Ariz.): I am positive that it will get more adopted by surgeons and patients. Patients are far more educated than ever before, especially through direct consumer social media platforms. e parties that will be against it are the payers, despite overwhelming evidence such as the level-one studies showing the safety and efficacy of endoscopic spine surgery in many aspects of spinal disorders, including endoscopically- assisted fusion or full endoscopic fusion. ere will be more development on how to incorporate this technology with navigation, robotics, AI, etc. I also think there will be evolving techniques where we can correct the segmental deformity or achieve sagittal balance by releasing all or even osteotomy using a combination of Navigation and endoscopic technology. Surgeons' education and training are essential as well as direct consumer education to patients. Brian Fiani, DO. Weill Cornell Medicine/ NewYork-Presbyterian Hospital (New York City): Endoscopic spine surgery will likely evolve to have more customized instruments and increased competition from medical device companies to supply the most user-friendly equipment. Additional advancements over the next decade will include 3D navigational components for endoscopic procedures and robotic-assistance in unison with the current technologies. An integrated approach to technology is the wave of the future with endoscopic spine procedures. Such developments will provide a more seamless workflow during surgery. Harel Deutsch, MD. Midwest Orthopaedics at Rush (Chicago): Endoscopic surgery has been around for a long time and hasn't progressed because current uses are not validated. To progress, there has to be a revolutionary change. Chester Donnally, MD. Texas Spine Consultants (Addison): Hopefully more literature will come out for the cervical spine, and this can be an alternative to ACDFs in certain cases. n How 6 MSOs grew in 2022 By Carly Behm O rthopedic management service organizations have expanded their footprints significantly in 2022. Here is what six of them did in 2022: United Musculoskeletal Partners: United Musculoskeletal Partners, which resulted from private equity investment in Atlanta-based Resurgens Orthopaedics, branded itself in March. UMP in July merged with another MSO, Novum Orthopedic Partners. The merger brought UMP's footprint to almost 190 physician partners across Colorado, Georgia and Texas. Healthcare Outcomes Performance Company: HopCo has had a busy year with hospital and practice partnerships. Its most recent partnership was with Memorial Healthcare System in Hollywood, Fla. Earlier this year, HopCo was also tapped by a group of orthopedic surgeons planning to launch a group in Wisconsin. HopCo also banded with Florida Blue to address healthcare affordability and partnered with Pardee UNC Health Care in Hendersonville, N.C. for an orthopedic and neurosurgery Center of Excellence. Spire Orthopedic Partners: Greenwich, Conn.-based Spire Orthopedic Partners bolstered its leadership naming Chris Fusco as its CEO and Patrick Seiler as CFO. The MSO added Peabody, Mass.-based Sports Medicine North and Orthopedic Surgical Center of the North Shore, Middletown, Conn.-based Middlesex Orthopedic Surgeons and Chelmsford, Mass.-based Orthopaedic Surgical Associates. OrthoAlliance: Cincinnati-based OrthoAlliance saw massive growth in 2022. Between June and October, the MSO inked five partnerships and added 50 physicians. OrthoAlliance began 2022 with a partnership adding eight physicians. In November it added Central Indiana Orthopedics in Muncie, a practice with 26 physicians, and in December it partnered with Granville, Ohio-based Orthopedic Specialists & Sports Medicine. U.S. Orthopaedic Partners: USOP began 2022 with six affiliate practices. It acquired its ninth practice in August and now supports 170 providers across 39 locations in Alabama and Mississippi. The MSO may expand into Georgia, signing a lease for space in Alpharetta. In April, USOP onboarded Kevin Navas as COO. Triumph Orthopedic Partners: Nashville, Tenn.-based Triumph Orthopedics is a new MSO that launched in April. Nate Bard is CEO of the MSO, and four orthopedic surgeons sit on the board of directors. In September, Triumph partnered with a 5-physician practice. n

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