'The field of spine surgery will be completely taken over by neurosurgery': What we heard from experts in October


Spine and orthopedic experts and leaders spoke with Becker's Spine Review on a range of topics in October, from awake spine surgery to hospital competition. 

Here are five viewpoints we heard:

Will neurosurgery take over spine surgery?

"The field of spine surgery will be completely taken over by neurosurgery [in the next decade]," said Sergio Mendoza-Lattes, MD, of Durham, N.C.-based Duke Spine Center, discussing how he predicts the spine market will look in 10 years.

"We are training an increasing number of neurosurgery residents to perform procedures that in the past were — and currently, in most of the world, still are — in the hands of orthopedic surgeons. This includes adult and even pediatric deformity surgery, trauma surgery and surgery for degenerative disorders."

'Patients will demand it': How awake spine surgery will develop in the next decade

"I really think that 10 years from now we're going to see awake spine surgery being done in the majority of cases," said Vijay Yanamadala, MD, of Hartford (Conn.) Healthcare Medical Group, discussing the outlook for awake spine surgery. "Patients will demand it. I think payers will also push in that direction, and we as surgeons will come to see its benefits, too — not only for our patients, but for our processes and ourselves. As it becomes more popular, the processes will be developed, and it will be smoother for broader adoption." 

Spine market is the biggest opportunity for growth, CEO says

"As large numbers of orthopedic practices consolidate under national health organizations, independent orthopedic practices may lose access to patients who will be directed to affiliated surgeons," said Kim Mikes, CEO of Irvine, Calif.-based Hoag Orthopedic Institute, discussing the most pressing issue facing independent practices.

"Practice overhead costs have also grown due to the COVID-19 pandemic. There is a shortage of healthcare workers, and those who are looking for employment are looking for a higher rate of pay."  

How hospitals will fight to remain competitive in spine surgery

"Hospitals have negotiated against surgery centers for decades, leading to a dramatic difference in hospital, hospital outpatient department and ASC reimbursement," said Adam Bruggeman, MD, of Texas Spine Care Center in San Antonio and CMO of MpowerHealth in Addison, Texas, discussing how hospitals can compete with ASCs.

"These practices and policies are driving a significant component of the outpatient migration, in addition to legislation that prevents new physician-owned hospitals from being developed de novo. Physicians will be the new drivers of healthcare for the next decade in terms of bundles and at-risk payments. Hospitals will need to find a way to bring their costs into bundles that make sense for the physicians who manage these arrangements."

What's the next game changer in orthopedics?

"The next game-changer in orthopedics will be artificial intelligence," said Jason Snibbe, MD, of Snibbe Orthopedics in Los Angeles.

"When a patient comes into the office, we will be able to use software with voice and face recognition. This will allow patients to have paperless and touchless access in the office. It will also allow us to create algorithms for treatment protocols. It will save time for the patients and physicians. Artificial intelligence will also help us in the operating room make decisions that are best for the patient. Every decision that we make in the operating room will be backed up by outcome data, which will help us make the right decision for every patient."

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