How the spine field could change in the next few years: Q&A with Dr. Kee Kim of UC Davis

Laura Dyrda -   Print  |

Kee Kim, MD, is chief of spinal neurosurgery at Sacramento-based UC Davis School of Medicine and co-director of the UC Davis Spine Center.

Here, Dr. Kim outlines the key trends on the forefront of spinal technology and how he sees clinical trials evolving in the future.

Note: Responses were edited for style and clarity.

Question: What emerging technology are you most interested in today and why?

Dr. Kee Kim: There is a dizzying array of innovation in our field so it's very hard to pinpoint just one technology. For example, there is a new polymer that may be a suitable bone graft substitute and a novel alloy implant with advantages over what we use currently. Also, the role of robotics in spine surgery will be more versatile. Right now, it is utilized primarily for accurate screw placement, but it should be adapted to help with surgical access, tumor resection and decompression including osteotomy.

Q: How do you think your practice will change in the next three years? What are you doing today to prepare?

KK: For a variety of spinal disorders, there are more treatment options. Lower back pain is one example. I expect that stem cell injection to treat discogenic back pain will be available based upon FDA-approved clinical trials. [Orthopedic clinicians] must be constant learners to keep up with both surgical and nonsurgical options to help our patients make the best choices. We should be willing to change our practice based upon the evidence. In this context and as an educator, this is a huge challenge due to the rapid pace innovation takes, often with very poor or incomplete data. I try to openly and critically look at the available data and share not only my success but my failures, too, to better equip our residents and fellows.

Q: What is the most dangerous trend in healthcare, spine or orthopedics today and why?

KK: Losing control of our practice due to external forces that compromise the quality of care for our patients is the most dangerous trend in healthcare.

While I would not call it dangerous, I am concerned about the overemphasis around global spinal alignment. We have made many mistakes in the past because we were not aware of its importance, but I feel that the current trend may be going to another extreme. There is a trend of overemphasis on an 'ideal' radiographic outcome. As a result, I am concerned that some patients, especially older patients, may end up with a major deformity correction surgery associated with increased risks when more limited surgery may suffice.

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