Becker's Spine Review

12 SPINE SURGEONS gery are leading to increased ability to exe- cute outpatient spine reconstruction surgery." 14. In December 2017, Jocelyn Idema, DO, discussed the future of MIS spine sur- gery technology with Becker's Spine Review. Dr. Idema practices at Washington, Pa.-based Advanced Orthopaedics and Rehabilitation. "Innovative technologies, such as improved navigation systems, robotics and the various implant techniques, will continue to positive- ly impact the spine industry in the future. It is important to note that although these tech- nologies continue to change and improve, the spine industry must also balance the cost-ef- fectiveness and value of these technologies, always striving for the best patient outcome and experience for the patient." 15. Tucson, Ariz.-based Northwest NeuroSpe- cialists spine surgeon Richard Chua, MD, em- phasized robotic image guidance is the next "big thing" in spine surgery during a Decem- ber 2017 interview with Becker's Spine Review. "I believe there will be continued growth in the application of minimally invasive spine surgical techniques, including improvements in implant technology, biologics, instrumen- tation and biomechanical considerations…I believe that the integration of image guid- ance and robotics will be the next big thing in spine surgery over the next five to 10 years. e ability to improve accuracy of instru- mentation placement, reduce X-ray exposure to the patient, surgeon and staff as well as the ability to more efficiently correct deformities will result as the robotics, engineering and surgeon adoption become more feasible." n Spinal biologics — Will evidence support it? Key thoughts from Drs. D. Greg Anderson, Scott Blumenthal & William Tally By Laura Dyrda T hree spine surgeons from across the U.S. discuss where they see the biggest opportunities in spinal biologics and disc generation. Question: Where are stem cells and biologics headed in spine? D. Greg Anderson, MD. Rothman Institute (Philadelphia): Selective use of bone morphogenetic protein-2 continues to be seen in the market, al- though the amount of off-label usage has fallen. Cell-based products seem to enjoy pockets of popularity. A wide array of less-expensive, lower effica- cy products continue to be used with limited clinical data to support their usage. Companies will likely have to provide stronger supportive data to support biologic products in the future in order to gain reimbursement acceptance. Scott Blumenthal, MD. Texas Back Institute (Plano): Mesoblast just com- pleted enrollment for its study, which was truly blinded; the physicians administering the injections didn't know who got the Mesoblast and who didn't. That will be really interesting to see. We are six months away from that data. There is another company in San Diego, Vivex, which has started a clinical trial with allograft material. They are another company to keep an eye on; we've met with dozens of these companies and Vivex is the first one that said they would put money into a study of their products. William Tally, MD. Athens (Ga.) Orthopedic Clinic: More companies are starting to include some form of a cellular component with their products. We started three years ago with a bone graft material that had a cellular component and were one of two in the market. Now there are more, and I think there will be more studies on the regenerative use of stem cells. Clin- ically, they aren't really viable yet, but there will be more studies on disc regeneration. n Orthopedic spine vs. neurospine surgeons: Which do patients prefer? By Laura Dyrda A new study published in Clin- ical Spine Surgery examines the criteria in patient selection of orthopedic spine and neurospine surgeons. Researchers administered an anon- ymous 26-question questionnaire to 644 patients seeking treatment from a neurosurgeon or orthopedic spine surgeon at a single institution. Six questions asked the patient to rate specific spine surgeon selection and six were multiple choice asking pa- tients about their preferences. Study authors found: 1. Both patients who selected ortho- pedic spine and those who selected neurosurgeons felt these three factors were the most important: • Board certification • In-network provider status • Bedside manner 2. Almost all — 82.74 percent — of the neurosurgery patients and 48.81 percent of the orthopedic surgery patients said they pre- ferred a surgeon trained in neuro- surgery. 3. Patient autonomy is growing in the healthcare system, and surgeons may find it helpful to identify preferences in physician selection. "Board certifi- cation, in-network status and bedside manner may be the most influential factors for patients in spine surgeon selective irrespective of specialty," concluded the study authors. 4. The study can provide a framework to improve patient recruitment and selection. n

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