The evolution of spinal fusion and neuronavigation in spine: Q&A with Dr. Mark Liker

Alan Condon -   Print  |

Mark Liker, MD, is an assistant clinical professor of neurological surgery at Los Angeles-based Keck School of Medicine at USC and founder and CEO of the California Neurological Institute. 

Here, Dr. Liker discusses cost-effectiveness in spinal fusion and emerging trends in the field.

Note: Responses were edited for style and clarity.

Question: What do you see as the most effective way to make spinal fusions more cost-effective without sacrificing quality?

Dr. Mark Liker: There are three overall factors that will reduce the cost of spinal fusions: implant cost, the second surgical expediency and the increased use of outpatient facilities. Of the three, the use of outpatient facilities is the most impactful in the near-term. Increased comfort with outpatient fusions for the right patient population will be advantageous to cost both in terms of the overall lower cost of surgical centers and the better pricing leverage in surgeon owned facilities.

Q: How do you see 3D printing developing in spinal fusion? Are there any 3D printed devices you see as particular innovative?

ML: At this time, I don't see 3D printing as a significant development for spine surgeons until the 3D printing can occur in the OR for the particular patient's anatomic needs.

Q: What is the most challenging aspect of a spinal fusion for a spine surgeon in training?

ML: For neurosurgery spine training, the most challenging aspect is the significantly higher complexity of the surgeries seen at most academic centers relative to the complexity of fusions performed at a community hospital. 

Q: How do you see endoscopic spine surgery developing in spine?

ML: I don't see endoscopic spine surgery becoming particularly important for fusions until a more effective fusion matrix is developed and the techniques are developed to perform a wide and aggressive discectomy via endoscope.

Q: In your opinion, what is the next big trend on the horizon in spine?

ML: I believe the next big trend will be the increasing use of neuronavigation and lower radiation techniques in spine surgery.

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