Issue link: https://beckershealthcare.uberflip.com/i/796926
6 SPINE SURGEONS Spine Care in 2017: 4 Spine Surgeons Make Predictions By Anuja Vaidya Kevin Ju, MD. Spine Surgeon at Texas Back Institute (Plano): Spine surgery is an ev- er-changing landscape. roughout 2017, I expect that we will continue to see interest in motion-preserving procedures as an alternative to spinal fusion. As a field, we have seen the de- velopment and emphasis of several techniques and technologies over the years that are meant to effect neurological decompression while pre- serving spinal motion. Examples include lami- noplasty over laminectomy and fusion, cervical and lumbar total disc replacement over ACDF or lumbar fusion as well as various interlaminar spacers. Some of these have been very successful while others have been less so. In addition to new technical advancements, there will also be more research on when fusion surgery is ben- eficial. For example, in the last several months two papers were published in the New England Journal of Medicine that investigated the ben- efits and risks of spinal fusion in addition to decompression for degenerative spondylolis- thesis. roughout 2017, we will likely contin- ue to see an emphasis on trying to avoid spinal fusion surgery when it's appropriate. On a related note, something that I hope to see in the upcoming year is more attention on bone health and osteoporosis. As our popu- lation ages, this issue is becoming an increas- ingly prevalent problem. We need to team up with our medical colleagues and ask our pa- tients about recent bone density tests, history of fragility fractures and prior osteoporosis treatments. Not only can we help diagnose this problem, but if the patient ultimately requires surgery down the road, optimizing bone health preoperatively is ideal as we all know the perils and complications that plague instrumenting osteoporotic bone. Early detection and treat- ment of osteopenia and osteoporosis is key to improving these patients' lives. Brian R. Gantwerker, MD. Founder of the Craniospinal Center of Los Angeles: I am most keyed in on endoscopic spine. I had the opportunity to meet a colleague from South Korea where they are doing some amazing things through a scope. I expect it to become pretty hot in the coming year as we focus on outpatient surgery. Also, we will likely see more instrumentation being done on an outpatient basis, especially with cervical ar- throplasty and interspinous stabilization. Last- ly, deformity correction is becoming more and more important in the inpatient setting. I think the focus will be on faster and safer surgeries, possibly with robotic assistance. Richard Kube, MD. Founder and CEO, Prairie Spine & Pain Institute (Peoria, Ill.): With the election and the nomi- nation of former orthopedic surgeon, Congressman Tom Price, to secretary of HHS hopefully we will see the slowing if not an actual rollback on regula- tions. is is one of the most time consum- ing and least rewarding aspects of practicing medicine and management of the business. Only time will tell, but I am currently more optimistic than I have been in a while. Vladimir Sinkov, MD. Spine Surgeon at New Hampshire Orthopaedic Center (Nashua): Robot-as- sisted spine surgery will be the most exciting devel- opment of 2017. Further improvements in programming, instrumen- tation, navigation and expanded indications will make the robots more versatile and ca- pable of assisting spine surgeons with more complex cases, while allowing for minimal so tissue disruption. n Jury: Concurrent Spine Surgeries Did Not Cause Patient's Paralysis By Megan Wood O n Jan. 30, 2017, a Boston jury determined a Mas- sachusetts General Hospital spine surgeon's con- current surgery schedule in 2012 did not result in a patient's quadriplegia, The Boston Globe reported. While a surgeon at Massachusetts General Hospital, Kirkham Wood, MD, performed an 11-hour surgery con- currently with another surgery. The patient was paralyzed during the 11-hour surgery, and later sued. The case was recently brought in front of a jury to decide whether the concurrent surgery schedule caused the patient's paralysis. Here are five key points: 1. The Suffolk Superior Court jury found that Dr. Wood vio- lated informed consent by not telling the patient he would be performing two surgeries during the same time period. 2. The jury did not find a connection between Dr. Wood's split time and the patient's paralysis, however. Thus, the jury did not award the patient any financial damages. 3. Dr. Wood's case sheds light on the controversial practice of concurrent surgeries. In December 2016, the Senate Fi- nance Committee released a new report, recommending hospitals ban surgeons from performing concurrent sur- geries. 4. Dr. Wood has since joined Stanford (Calif.) Medicine. 5. A board-certified orthopedic spine surgeon, Dr. Wood completed his fellowship at University of Minnesota/Twin Cities Scoliosis Spine Center. n