John Berry-Candelario, MD, is director of spine and spine oncology at UMass Memorial Medical Center in Worcester and medical director of the hospital's spine center.
Here, he discusses advancements in augmented reality and artificial intelligence as well as innovations in spinal oncology.
Question: What do you see as the next big breakthrough in minimally invasive spine surgery?
Dr. John Berry-Candelario: Patients, hospitals and other stakeholders are asking spine surgeons and the industry as a whole, what's next? We have all witnessed the impact of robotics and endoscopy on minimally invasive spine surgery. I believe virtual augmented tools and AI are also seeing breakthroughs in the field. The future is now.
Q: How do you see spinal fusions progressing in the next 10 years?
JBC: I think all spine surgeons have witnessed the rebound from excess as it relates to spinal fusion. Like most things in life, it's moderation and patient selection. In the age of personalized medicine and value-based medicine, I believe we will be forced to constantly evaluate value-added and not just our productivity.
Q: Where do you see the biggest need for advancement in spinal oncology?
JBC: This is a very exciting time for spinal oncology with the advancement in the field of molecular-targeted therapies. The era of surgery and radiosurgery will remain, but we will have to adapt to incorporate this growing treatment paradigm.
Q: What research are you currently engaging in? Is there anything you see as becoming particularly innovative in spine?
JBC: I have a number of research projects that excite me. First, with the advent of immunotherapy, I have been interested in learning more about tumor microenvironments in the spine tumor patient after radiation treatment. The innovation here is in changing our paradigms for surveillance and treatment for patients with spine tumors.
Second, I am spearheading a project that evaluates the gut microbiome and its relationship to different spine pathologies. We have already learned that the microbiome has significant impact in both inflammatory and pain syndromes. The innovation would be to correlate differences in the microbiome and its impact on severity of spine pathology and on validated patient-reported outcomes.