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15 SPINE SURGEONS in quality of life. ey also have more frequent complications that increase costs. ere are risk stratification models being utilized to identify a more appropriate surgical treatment of individual patients in order to minimize risk. is brings us to one of the biggest trends in spine surgery and that is reimbursement. ere is no doubt that reimbursement is going to change. is will affect hospitals, surgeons, vendors patients, pay- ers and employers as well as government. ere are many interests involved so where it leads will be difficult to predict. Fee for service medical care will decrease and some sort of managed care with a fixed total payout will be more likely. Presently, bundled payment models are being developed and implemented with mixed results. If a single payer government system evolves, then rationing will be the main characteristic of the medical system and we can forget about almost everything previously discussed. It is an exciting time to be a spine specialist with many new and ef- fective treatments to offer more patients. Patients need not suffer in pain as in the past. People can recover quicker and return to an active lifestyle not seen in the past. e scientific and technological progress is moving ahead very well. e main challenge is financial, and I have confidence in the free market for solutions. n The 3 aspects of spine surgery expected to gain ground from Dr. D. Greg Anderson By Laura Dyrda P hiladelphia-based Rothman Institute spine surgeon D. Greg Anderson, MD, is the clinical director of the spine section of the Orthopaedic Research Laboratory at Thomas Jefferson University in Philadelphia. Here he offers insight into the biggest spine technology trends for 2018 and beyond. Dr. Anderson is the president of the Society of Min- imally Invasive Spine Surgery and active in several other organizations, including the North American Spine Society. Question: What is the biggest spine technology trend for 2018? Dr. D. Greg Anderson: There is a continued trend to- ward cost containment and complication prevention in the field. Technologies that support this are slated to win out over traditional techniques. Therefore, minimally in- vasive approaches, pre-packaged sterile products and disease-based procedural solutions are expected to gain ground in 2018. Q: Where do you see the biggest innovations in im- plant material? GA: Biologically active materials are a hot topic these days. Several competing approaches including na- no-coatings and bioactive polymers have been launched that offer the potential of enhanced interbody implant incorporation. More clinical outcome data is needed to compare the efficacy of these competing technologies in improving clinical outcomes in patients. Q: Where do you see biologics and stem cells in spine headed for 2018 and beyond? GA: Selective use of bone morphogenetic protein-2 continues to be seen in the market, although the amount of off-label usage has fallen. Cell-based products seem to enjoy pockets of popularity. A wide array of less-ex- pensive, lower efficacy products continue to be used with limited clinical data to support their usage. Compa- nies will likely have to provide stronger supportive data to support biologic products in the future in order to gain reimbursement acceptance. n Dr. Odette Harris becomes 1st female African-American neurosurgery professor at Stanford: 5 insights By Mackenzie Garrity S tanford (Calif.) University School of Medicine appoint- ed Odette Harris, MD, as a neurosurgery professor, according to the Stanford Daily. Here are five insights. 1. Dr. Harris is the second African-American neurosurgery professor in the U.S. and first at Stanford. She joins Dr. Lu Chen as the second female in Stanford's neurosurgery de- partment. 2. She has served as director of brain injury in Palo Alto (Ca- lif.) Veterans Administration Health Care System's neurosur- gery department and as associate chief of staff of polytrau- ma and rehabilitation since 2009. 3. A Clayman Institute Faculty Research fellow, Dr. Harris earned the William P. Van Wagenen Fellowship Award from the American Association of Neurological Surgeons. 4. Board certified in neurosurgery, Dr. Harris underwent dual fellowship training at Louisiana State University in New Orleans and Kingston, Jamaica-based University of the West Indies. 5. She earned her medical degree and completed her resi- dency at Stanford. n