Gowriharan Thaiyananthan, MD, founder and head neurosurgeon of BASIC Spine in Orange, Calif., discusses the most important innovations in spine surgery over the next several years. Q: What are the emerging technologies that you are most excited about going forward?
Dr. Gowriharan Thaiyananthan: There are two main categories of devices that we use for spine surgery developing right now. The technology that is emerging really revolves around maintaining normal function of the spine and using less rigid fusion technologies than we have in the past. I think the other category is biologics and stem cell use. Surgeons and scientists are looking to potentially regenerate disease in spine. Moving forward, the future of spine surgery will revolve around motion preservation and regenerative medicine.
Q: How are new technologies changing spine surgical technique?
GT: For motion preservation, the artificial disc has always been around, but now physicians are looking for new ways to implant them through a minimally invasive technique. Being able to put in an artificial disc through a lateral procedure, which could take 30 minutes and use an incision less than an inch, is an amazing leap forward. Using biomechanical material to recreate the biomechanics of the disc and polymers to inject into the spine is now being explored by physicians as well.
Q: What difference will these developments make on the field of spine healthcare?
GT: The difference is they potentially could lower costs by decreasing the length of stay in hospitals. They are converting surgeries that require patients to be in the hospital for several days or weeks to outpatient procedures. The improvement in outcome is that the inpatients have a shorter time to recover and costs are lower because patients are staying in the hospital for a shorter period of time.
Q: There are clear advantages to these surgical techniques, so what roadblocks are keeping them from becoming the standard care today?
GT: The biggest hurdle is pushing technological development through the FDA. The second is showing efficacy and the third is cost effectiveness. Especially in today's environment, you have to show surgery works and is cost effective. You can always upgrade technology, but now you have to do it in a cost-effective way.
It also takes time to change the traditional dogma. Some of the other challenges are getting surgeons to look at the technology and accept it. The next challenge is training surgeons and trying to get them to adopt it in their process. Surgeons are getting savvy to the fact that they need to change their practice and figure out ways to lower their costs. The healthcare climate will demand that.
Q: Where is there the biggest opportunity for growth and development over the next 20 years and beyond?
GT: I really think that spine surgery will be focused on regenerative medicine in the future. We will be looking into stem cells to fix problems that typically require big surgeries. I think that spine surgeons in the future will do more procedures through a needle instead of using the scalpel.
Dr. G. "Ty" Thaiyananthan is founder of BASIC Spine. BASIC specializes in complex and minimally-invasive spine surgery and is at the forefront of pioneering new surgical techniques using stem cells and minimally invasive surgery to treat chronic neck and back pain.
Dr. Ty earned his medical degree from UCSF, did a general surgery internship and neurosurgery residency at Yale and completed a surgery fellowship at Cedars-Sinai Medical Center. Follow Dr. Ty on Google+.
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