Why future spine surgeons will shake their head about care today


The prevalence of spinal fusions is something in spine surgery that physicians will likely be disappointed about years from now. 

"I believe spine surgeons will look back at the current state of the field and shake their head at the number of fusions performed instead of disc replacements," said Todd Lanman, MD, of ADR Spinal Restoration Center in Beverly Hills, Calif. "The same thing happened in 1958 when John Charley invented the artificial hip. Most surgeons at the time laughed at him and said his device would not work. That hip replacement was a fad. Instead, knee and hip fusion were standard of care." 

Disc replacement debuted in the U.S. in 2000, and the technology has expanded since then. Prominent devices including Prodisc L, M6-C and Simplify hit the market, and multiple disc replacement trials are underway.

And cervical disc replacements are likely to take the spotlight. Cervical disc replacement cases rose from 2011 and 2021 while anterior cervical discectomy and fusion plateaued, according to The Spine Journal

"In 10 years the field will have shifted dramatically to motion preservation surgery — artificial disc replacement, facet joint replacement — to the point that we may see the ability to partially correct 20 degree to 25 degree scoliosis curves with motion sparing devices," Dr. Lanman said. "Just like arthroplasty is now commonplace for hip and knee and fusion is rare, the same will be true of spine devices; cervical and lumbar artificial discs will be the mainstay of treatment and spinal fusion will be the rare exception."

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