2 Hospital for Special Surgery leaders on the most 'exciting and opportune' area of spine

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Biologics holds numerous possibilities for the future of spine surgery, and leaders with New York City-based Hospital for Special Surgery are exploring ways it can be leveraged.

Andrew Sama, MD, co-chief of HSS Spine, and Sheeraz Qureshi, MD, MBA, co-chief of HSS Spine and chief medical officer of HSS Florida, discussed their outlook on biologics in the specialty.

Note: This conversation was lightly edited for clarity.

Question: Where do you see spine biologics growing in five to 10 years?

Dr. Andrew Sama: Biologics is the most exciting and most opportune area in spine surgery. We have an understanding of the metal and the mechanics of how we operate on the spine, and we can certainly improve on that. But from a societal standpoint, it would be much more powerful if there was a way to understand the underlying biological reasons for some of the things we treat, and then figuring out a way to intervene before they become mechanical issues that require decompression or fusion instrumentation. I think that's the future. With artificial intelligence and some of the other modes we have of understanding these processes on a larger scale, I think we can make some meaningful assessments and then act on those things in a more accurate and successful way.

Dr. Sheeraz Qureshi: I think about biologics in two big buckets. I think about the biologics that we use for fusion which we're using every day. There is a huge opportunity there because they're often significant cost drivers to care. One of the things we've been doing in our service is trying to better define how much biologics something like infusion we should be using for particular types of surgeries. 

Then there's the other aspect of biologics around stem cells and things like that that are really hot topics for patients. But we don't have a significant understanding of where the value is in those. One of the things that our service has been doing is working through the regenerative medicine program that's led by Scott Rodeo, MD. Our spine service has involvement in trying to really develop protocols and understand better what the value is of those types of biological treatments.

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