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12 ORTHOPEDICS Dr. Daniel Choi's 'golden goose' goal for endoscopic spine By Carly Behm Daniel Choi, MD, is oen looking for new ways to innovate in endoscopic spine surgery. He recently performed the first Barricaid annular closure implantation with Amplify Surgical's dualPortal system approach. Dr. Choi, of Spine Medicine & Surgery of Long Island in Ronkonkoma, N.Y., discussed the debut case and what he wants to do next with Becker's. Note: is conversation was lightly edited for clarity. Question: With your endoscopic case, how was the learning curve with combining it with the Barricaid device? Dr. Daniel Choi: I'm a recent incorporator of Barricaid. I had already been doing a lot of my discectomy laminated surgeries with dual portal endoscopy, so it was a natural fit to try to place the Barricaid with it. I didn't actually realize this was the world's first implantation, but that's what Intrinsic erapeutics told me. I definitely wished I had a little more room putting the implant in. Endoscopic incisions are typically one centimeter or less, and the Barricade implant was seven millimeters. So we were trying to fit this thing through a decent amount of so tissue, and had to get a little creative, but we were able to safely implant the Barricaid and make sure that the nerve root was protected. Q: Can you paint a bigger picture on the creativity involved with navigating that hurdle? DC: When you're putting this implant in, you don't want it to hit too many structures that can dislodge it from the implant holder. So tissue can potentially release the spring mechanism that's holding the implant. I had to do a little bit more so tissue dilation to make sure that my channel stayed patent to put the implant through. We used the X-ray to make sure I knew exactly where I was because I wasn't looking right down into the laminotomy site. I had a camera on it, and I was putting this implant in through the dual portal. Q: What do you think will be some next implants to be able to use endoscopic techniques with? DC: e kind of big golden goose I'm shooting for in my endoscopic career is to eventually do an endoscopic fusion with the DualPortal technique. Other surgeons have been able to do what we call endoTLIF where you do the complete discectomy and you place an expandable spacer into the interbody space using endoscopic techniques. I haven't gotten to the point where I'm comfortable doing that yet, but that definitely would be the next iteration of endoscopic surgery, to also incorporate fusion techniques into their repertoire. Another company that's doing endoscopic interbody fusions is using an allogra-based kind of planning and you actually don't have to remove the facet joint to do this. If you're not taking the facet down, it can be done through a very small incision and is also amenable for the ASC. at's an interesting technique that I would like to also explore and learn about. But I think, in general in endoscopic spine surgery, doing more implantation of interbody spacers is going to be the next exciting thing we're going to see. n Globus Medical names next CEO By Carly Behm Dan Scavilla stepped down as president and CEO of Globus Medical, and Keith Pfeil succeeded him, the company said July 21. Mr. Scavilla resigned to pursue a new opportunity effective July 18, according to a news release. Mr. Pfeil, who was Globus Medical's executive vice president, COO and CFO, stepped into the new role July 18. Kyle Kline, senior vice president of finance, was promoted to senior vice president and CFO. Mr. Pfeil joined Globus Medical in 2019 as senior vice president and CFO, and in 2024 he was named executive vice president, COO and CFO. The appointments come on the heels of a strong second quarter, Globus Medical said. Its preliminary financial results include an 18.4% increase in sales year over year. n How orthopedic surgeon pay has changed over 5 years By Carly Behm Orthopedic pay has climbed significantly since 2021, according to annual Medscape reports. Here are the average salaries for orthopedic physicians over five years: 2021: $511,000 2022: $557,000 2023: $573,000 2024: $558,000 2025: $564,000 n