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21 JUNE 2017 CONFERENCE PREVIEW How Spinal Deformity Surgery is Becoming Less Invasive — And Lowering Costs as a Result: Q&A With Dr. Todd Lansford By Laura Dyrda T odd J. Lansford, MD, is a spine surgeon at South Carolina Sports Medicine & Orthopaedic Center in N. Charleston, S.C., discusses minimally invasive spine surgery and the biggest opportunities for surgeons to lower the cost of care. Question: How is spinal deformity surgery becoming less invasive? Dr. Todd Lansford: Of all realms of spinal surgery, it is deformity surgery which I believe to be the most impacted by minimally invasive technology. is has allowed surgeons to correct both sagittal and coronal plane deformity without using large osteotomies. What this means [for] the patient is less blood loss, less recovery time and less returns to the OR. Furthermore, in many situations you can get more correction using lateral-based surgery like XLIF. As more MIS deformity surgery is completed, the exciting news will be the decrease in adjacent segment disease. Eliminating [proximal junc- tional kyphosis] has been the holy grail to many a deformity surgeon, trying a multitude of techniques including flexible rods, cemented su- perior levels and even hook/laminar wire constructs. With the limited exposure of MIS, it is quite likely we can maintain the posterior tension band, decreasing the stress that those adjacent levels and hopefully sig- nificantly decrease the need for future surgery at those levels. Q: Where do you see the biggest opportunities for spine surgeons to lower the cost of care? TL: Many benefits of minimally invasive deformity surgery carry over to the degenerative surgery practice and those benefits are all cost containers. When you think of decreasing OR time, faster recovery and less revision surgery, they are all sources of cost. Furthermore, the ability to do more surgery in the ASC setting, which MIS techniques allow, greatly reduce the cost. e integration of these techniques is physician driven, not always reinforced by hospitals or insurance companies. With that in mind, it appears that physicians themselves have the most power to lower the cost of care. Q: What is the next frontier in minimally invasive spine sur- gery? TL: e next frontier of minimally invasive spinal surgery is two-fold. In one respect, it is increasing the adoption of MIS techniques we currently have. Technology now is quite advanced, as more surgeons use them and research their benefits, adoption will only increase. is is already seen in cervical disc replacement. Single levels have been approved for many years, but two levels were impossible to get through insurance. Just recently, the increase use of [total disc replacement] allowed for more research to be focused on two levels. is research illustrated the benefits and the insurance companies listened. ey are now approving this and the patients are reaping the benefits. As adoption increases, we will see the second aspect. We will refine the technology, improving the power of these techniques. is will likely involve improved navigation systems that will increase not only the safety of the case but the speed too. Instrumentation will be evolved to be less disruptive to the anatomy, allowing even faster recoveries and decreased adjacent segment disease. e peak technology of course is preserving the anatomy before pathol- ogy leads to surgery. While stem cells have come a long way, there is a considerable way to go. I hope in my lifetime this becomes the standard of care. n Dr. Todd Lansford will be speaking on "What's Next in Sports Medicine" at the conference Friday, June 23 at 10:40 a.m. 141 PHYSICIANS SPEAKING, PRIMARILY SPINE SURGEONS 235+ SPEAKERS TOTAL REGISTER HERE www.beckersasc.com/june-conference Registration@BeckersHealthcare.com OR 800.417.2035. 15TH ANNUAL SPINE, ORTHOPEDIC AND PAIN MANAGEMENT-DRIVEN ASC CONFERENCE + THE FUTURE OF SPINE JUNE 22-24, 2017 | SWISSÔTEL | CHICAGO, ILLINOIS BECKER'S ASC REVIEW Marcus Allen Former NFL Running Back, Los Angeles Raiders and the Kansas City Chiefs and Analyst, CBS Lou Dobbs Business and Financial News Legend and Host, Fox Business News' Lou Dobbs Tonight Andrew Hayek Chairman and Chief Executive Of ficer, Surgical Care Af filiates Michael A. Kasper Chief Executive Of ficer, DuPage Medical Group KEYNOTES BY