Becker's Spine Review

8 SPINE surgery could be a significant development because traditionally, spine surgery has been associated with the management of significant postoperative pain. Q: Artificial discs have had a real uphill battle in terms of getting payer coverage. Do you anticipate any kind of struggle like that with endoscopic spine? MG: I believe that part of the issue with disc replacement in the neck and lumbar spine arises from the fact that it involves an implant rather than a technique or technology. Because it's an implant, payers are oen reluctant to cover something that's expensive. Conversely, adopting these tools and performing procedures in this manner usually falls under the category of equipment, typically the responsibility of hospitals. us, hospitals endorsing the use of this endoscopic equipment for their surgeons would necessitate a capital investment. However, the advantage of having Arthrex driving this initiative is that they are already present in a majority of outpatient facilities today, which significantly reduces the facility's financial commitment. Q: Besides working on the fellowship program at Steadman, is there anything else exciting going on at the practice? MG: In the last 19 months, the Steadman Spine Program has seen significant expansion. We now have a surgical team consisting of myself, Dr. Sonny Gill, specializing in a wide range of complex cervical and minimally invasive procedures, and Dr. Stuart Kinsella, who also is a robotic spine user like me. As a result, we have developed a robust spine service line, incorporating all the latest technology. Our faculty is not only using this technology but also actively teaching others how to use it effectively. We are dedicated to upholding the principles set forth by Dr. Steadman, with the primary objective of getting people back to their athletic lives as swily as possible while minimizing tissue damage, and we apply these principles within the realm of spine surgery. Q: Is there anything else that you wanted to discuss? MG: It is essential that a major player like Arthrex has entered the endoscopic spine space because they have the capacity to provide effective surgeon training. When surgeons complete their training programs, they are well-equipped to apply the technology in their subsequent cases. n How 3 spine surgeons collaborate with other specialties By Carly Behm S pine surgery is not something a physician can always do alone. Oen spine surgeons will team up with physicians across specialties before, during and aer a case. ree spine surgeons share the collaborative opportunities they leverage. Editor's note: Responses were lightly edited for clarity and length. Question: What opportunities should spine surgeons take to collaborate with other specialties? Hansen Bow, MD, PhD. UCI Health (South Orange, Calif.): Collaboration is essential for a successful outcome in spine surgery. In addition to collaboration within members of the spine surgery team taking care of the patient, collaboration with other medical and surgical specialties are just as critical. Prior to an operation, consultation with an endocrinologist may be helpful to optimize bone strength in patients who are osteoporotic and in need of a fusion operation. Additionally, interventional pain can assist in helping to diagnose and treat causes of pain. During an operation, ENT, thoracic, general and vascular surgery could help in the approach for an anterior operation. For almost every patient with spinal oncology, a team is needed to coordinate care. e medical oncologist is frequently the primary medical contact for the patient and may have insights into whether a cancer has a better prognosis due to recent advancements in targeted therapy. Advancements in radiation oncology in the past two decades have enabled surgeries that are safer and require less recovery time (i.e. separation surgery) to be similarly effective to aggressive surgeries for metastatic cancer. Similarly, neurointerventional proceduralists may be able to embolize tumors resulting in less blood loss during surgery. NuVasive cervical disc implant backed by 5-year study By Carly Behm T he NuVasive Simplify cervical disc replacement implant was found to be superior to anterior cervical discectomy fusion after five years, Globus Medical said Oct. 24. The five-year study found that statistically significant postoperative improvements in neck disability index and visual analog scale after two years remained through five years compared ACDF, according to a news release. The average disc height and flexion/extension range of motion also increased postoperatively for Simplify disc patients and remained above preoperative levels throughout follow ups. No device failures have been reported in patients who received the Simplify disc. "Having clinically backed, long-term data for the Simplify Cervical Disc validates the promising clinical data we saw Simplify having at the two-year mark," Kyle Malone, senior vice president of scientific affairs at Globus Medical, said in the release. n

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