Guest Column: The Future of Spine Surgery

Published October 8, 2014

As members of The Centers for Advanced Orthopaedics, I know we are all closely attuned to the future of orthopaedics. If we weren’t, we wouldn’t have proactively joined together to preserve our own private practices and the superior care our model offers to patients. While we have discussed this future in great detail from a business perspective, I think we agree that it is also critical to understand the major changes happening in medical techniques and patient care, even outside of our expertise, that will influence our divisions now and down the road. Collectively, we have an incredible wealth of knowledge amongst our physicians, and sharing of best practices and innovative procedures will benefit our patients while also providing us a distinct advantage over our peers in orthopaedics.

As a spine surgeon, I have focused my career on learning and developing minimally-invasive techniques, and the rapidly-growing demand for this type of surgery is changing patient demand and the entire patient experience. The older, more standard forms of surgery typically required large incisions in the spine, with difficult, long recoveries. More often than not, patients had many complications and different outcomes than we had hoped.

Minimally-invasive surgical techniques were developed after studying our colleagues’ work in knee and shoulder arthroscopy and the great benefits of that surgery. Over the course of my career, I have had the great opportunity to work with other leading spine surgeons to pioneer successful, minimally invasive surgery. When we first began this work some 25 years ago, most of the techniques we developed failed or were too inconsistent to use because we tried to copy arthroscopy too closely. However, over the last five to 10 years, we have begun to see a breakthrough with the development of much more successful techniques. Of course, it’s too soon to say whether this is better than traditional surgery, but early evidence shows that patients typically require much less pain medication after surgery, suffer less bleeding and muscle damage, and have quicker recovery periods.

The true advantage is that we can expand our offerings and care for patients better than we could in the past. Years ago, I wouldn’t do a spinal fusion on a sick or older patient if I thought it could be too dangerous and risk too much blood loss. I’m thrilled that with these new techniques, we have been able to expand the population of patients I can treat surgically and simply help more people return to active and pain-free lifestyles. Due to these benefits and the high patient demand, nearly every orthopaedic company in the United States is now offering a minimally invasive option for spine surgery – and if they aren’t, they are working to develop that option. If a company doesn’t have a minimally invasive option today, it puts them at a distinct competitive disadvantage.  

There are also several minimally invasive products now available in the U.S., some of which I have helped to develop, that we are always working to update and refine. These include surgical plating systems, inner body cages and a minimally invasive pedicle screw system, and the product market will continue to grow with new developments and technologies here. The early results from minimally invasive spine surgery have proven so successful that surgeons from across the United States and many different countries are frequently flying here to observe our surgeries and then offer these options to their own patients.

I’ve been privileged to be one of the early adopters, working alongside other surgeons to develop these techniques for years. And I can say that this is an incredibly exciting time in spinal care, especially as the shorter surgeries allow us to see a greater number of patients and treat a greater variety of conditions than were previously possible. I look forward to working with all of you to keep pushing for greater innovation with the unifying goal of delivering the highest-quality, compassionate orthopaedic care.

Philip Schneider, Montgomery Orthopaedics

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