Becker's ASC Review

20 ORTHOPEDICS Spine surgeons' 'fiduciary' responsibilities: Q&A with Dr. Kai-Uwe Lewandrowski By Carly Behm I n a healthcare system that's becoming highly focused on resource management, it's more important than ever for spine surgeons to collaborate on changes in care delivery and patient outcomes, Kai-Uwe Lewandrowski, MD, told Becker's. Dr. Lewandrowski, who's on the board of the International Society for the Advancement of Spine Surgery-Asia Pacific, spoke with Becker's about the spine research he's prioritizing. Note: is conversation was lightly edited. Q: What are some of the other advocacy efforts you've been doing on the global or U.S. stage? Dr. Kai-Uwe Lewandrowski: Beyond our work on policy and coding, we've published several papers on the clinical applications of spine surgery in outpatient settings. For example, one study looked at what drives a surgeon's preference for a TLIF procedure. Interestingly, it's oen not the patient-related factors people assume — it's things like ownership structure, equipment availability in the surgery center, and the team's ability to handle stressful intraoperative situations. ose practical factors tend to influence surgical decision-making more than case complexity. We also conducted a study using Rasch analysis to evaluate the relative value of endoscopic spine surgery compared to traditional Spine tech surgeons say will be obsolete by 2035 By Carly Behm Fluoroscopy and standalone imaging are among technologies that are most likely to be outdated in the next 10 years, spine surgeons say. ree surgeons discuss what's headed out the door and the innovations that will take prominence. Note: Responses were lightly edited. Question: What's a spine technique or technology that will be obsolete by 2035? Why? William Taylor, MD. University of California San Diego: Fluoroscopy will be completely outdated by 2035. It's only available now as a holdover and as systems become simpler or faster, easier and less expensive, it will be used for every part of spine surgery. ere is simply no reason to use fluoroscopy if navigation can be achieved, even with the simplest of procedures. Lali Sekhon, MD, PhD. Spine Surgeon at Reno (Nev.) Orthopedic Center: I think given time, everything will be obsolete. Biologics we have not even discovered are ahead of us. Regeneration may be a reality one day. Prevention of degeneration may also become reality. e genetics of spinal disease may be better understood and prevented. Self maintenance should peak. We've had pedicle screws for about 40 years and cages for about 30 years. at's an eye blink of time. Everything will become obsolete as we know it today. In hindsight, we are dinosaurs and patients in 2035 will scoff at cortisone, pedicle screws and most likely, implants. Philip Louie, MD. Virginia Mason Franciscan Health, (Seattle): Using standalone X-rays for surgical planning and correction. Pre-op planning is rapidly moving toward 3D imaging, AI-driven modeling, and "digital twins." Improved CT/MRI imaging with lower radiation, automated measurement tools, and AR/VR planning platforms that integrate biomechanics are rapidly changing how we prepare and execute our plans. n Campbell Clinic launches endoscopic spine fellowship By Carly Behm Memphis, Tenn.-based Campbell Clinic is launching a first- of-its-kind endoscopic spine fellowship in the U.S. Chad Campion, MD, is leading the program which will offer high-intensity, hands-on experience over up to three months, according to an Oct. 9 news release shared with Becker's. It is designed for post-fellowship or practicing orthopedic spine surgeons and neurosurgeons. The fellowship will include training in uniportal and biportal endoscopic spine surgery with an emphasis on outpatient surgical techniques. The program's first fellow graduated in August and completed more than 60 endoscopic spine surgeries in three months. The fellowship was created to meet growing demand for motion-preserving and minimally invasive spine care. "No other program in the country offers this volume, focus, or flexibility," Dr. Campion said in the release. "Our goal is to empower surgeons with the tools and experience they need to bring high-quality, less invasive spine surgery to their communities, thereby improving patient outcomes." n

• Cover