Robotics is among several factors that will be crucial to the future of endoscopic spine surgery.
Three spine surgeons discussed their outlooks on the next steps for endoscopic techniques with Becker's.
Sohail Syed, MD. OSF Health (Bloomington, Ill.): I think that right now the biggest indications for endoscopic spine surgery is in minimizing the degree of destruction, and it's pretty much applied for degenerative disease. But I think as the instruments that are available improve, it's going to be applied to a wider variety of diseases. We're really hoping that it'll eventually be used in cases like trauma or even oncology cases. Especially with the latter, it's really important to try to minimize your incision because these patients tend to be immunocompromised. They are going to require chemo and radiation post-op. So smaller incisions mean quicker time to chemo, radiation and less likelihood of complications from that.
Max Kahn, MD. OSF Health (Bloomington, Ill.): I think over time I think it's probably going to get combined with robotics for planning optimal trajectories. And truthfully, the way I see it, neurosurgery as a whole is sort of behind general surgery and orthopedic surgery. In general surgery or orthopedic surgery, endoscopic or arthroscopic technology gets the first pass. Right now that's not really the case in spine or in neurosurgery. My prediction is that probably within the next 10 and 20 years, that's where it's going to go. It's going to be first pass endoscopic to almost any pathology at the larger open stuff is going to be a salvage.
Corey Walker, MD. Cedars Sinai (Los Angeles): I think we're starting to see a critical mass and company interest. The thing that is astounding to me is the granularity and resolution. I can even see blood flowing through the little, teeny capillaries on the top of the nerve. I can see in areas that I couldn't see before. I can look under the nerves with critical, vivid pictures. The cameras and screens are in 4K now, and they allow you to see tissue and pathology better than ever before.
I think that the tools are going to continue to develop and improve. The drills are getting better. They're getting faster and safer. The different tools on which we use to remove bone and dissect are improving, and people are coming up with better tools to use through the endoscope, which I think is going to make the procedure easier.