A Rapidly Evolving Field: Spine Surgeons Weigh In on Important Clinical Developments

Question: What is the most important clinical development in spine surgery?

Ara Deukmedjian, MD, CEO, Medical Director, Deuk Spine Institute, Melbourne, Fla.: The most important recent clinical development in spine surgery is minimally invasive surgical techniques including endoscopic and laser spine surgery. Minimally invasive approaches to the spine allow surgery to be performed in the outpatient setting with less pain, shorter recovery and even fewer complications.

One of the best examples of how advanced surgical techniques have improved spine care is the Deuk Laser Disc Repair. Patients suffering with symptomatic disc disease such as herniation and stenosis have traditionally been recommended for open surgical decompression and fusion or even more recently artificial discs. These procedures are highly invasive and there is substantial "collateral damage" to the spine and surrounding soft tissues done during the surgery. Minimally invasive endoscopic spine surgery allows the surgeon to selectively repair only the diseased part of the spine through a 4mm or 7mm long incision. Each incision allows up to 2 spinal disc herniations to be repaired using a holmium YAG medical laser. Patients go home within one hour of the surgery and can return to work as soon as the next day.

Minimally invasive spine surgery will continue to grow in popularity as long as the outcomes remain good. We are seeing a migration of spine cases to the outpatient setting including spinal fusions. Deuk Spine Institute has been performing both outpatient lumbar and outpatient cervical spinal fusions for several years with no major complications. As more spine surgeons become familiar with the minimally invasive techniques we will see shorter recovery times, and eventually major spinal reconstructions will find their way to the outpatient arena.

Richard A. Kube II, MD, CEO, Founder, Prairie Spine & Pain Institute, Peoria, Ill.: The most important current clinical developments use minimally invasive techniques. These options have completely changed the way we are able to handle multiple disease processes. We have much less collateral damage from the procedures we perform leading to quicker recovery and fewer complications.  

We have the ability to use ambulatory settings, which have lower infection rates and higher patient satisfaction rates. Options once too invasive for some of the elderly are now possible to improve quality of life. On the horizon, stem cell and other biologics including nano-technologies are evolving, and I believe they will encompass the next wave of advancement in the field.

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