Just 10 years ago, even what might be called simple back, or spinal, surgery came with significant post-operative care and lengthy recovery times, and patients were often almost-guaranteed a repeat visit somewhere down the line. But in the last five years, the field of spinal surgery has undergone a major renaissance in terms of treatment options, recovery times, and patient outcomes. As advances in medical technology rapidly evolve, spinal fusion, in particular, is poised to benefit from groundbreaking innovations that improve outcomes by addressing challenges in healthcare delivery and patient care from the start. With spinal orders affecting millions worldwide and the healthcare system striving to reduce costs while enhancing patient satisfaction, the future of spinal fusion surgery is happening now.
Minimally-invasive techniques are increasing positive outcomes and reducing risk
During a spinal fusion surgery— a procedure for the stabilization and reduction of pain in the spine and extremities, a bone or other bonelike material is placed in between two spinal bones, and supported by metal rods, screws, or plates, which fuse to the bones during the healing process. In traditional spinal fusion, a large incision is paired with the retraction of the muscle and tissue to open space for the procedure. This typically requires a hospital stay of one-to-four nights, narcotic pain medications, and total recovery times exceeding six months. New minimally invasive spinal surgery (MISS) uses smaller incisions closer to the entry point as well as specialized tools. This reduces time under anesthesia, leaves muscles and tissues intact, and reduces the potential for complications. In fact, most patients go home within one-to-two days and are back to normal activities within six weeks. While minimally invasive procedures have changed spinal fusion forever, they’re even more successful when paired with new therapies.
Biologics and stem cell therapy encourage natural bone growth and increase success
There has been explosive growth and expansion of the use of stem cells and biologics in all areas of healthcare over the past two decades. And the success of these therapies in spinal fusion has been nothing short of remarkable. As early as 2017, researchers from the University of California Davis Medical Center found that while autograft— transplanting a patient’s own bone from one location to another— has a 59.8% success rate, stem cell-based grafts have a fusion success rate of 73.7%. By 2021, clinical studies were reaching between 85% and 100% success with both autologous and allogenic stem cell procedures. Biologics— substances that stimulate fusion— have been found to increase success rates by up to 92 percent. Essentially, the field has gone from a generally accepted 60% success rate to 100%. This is nearly unheard of elsewhere in medicine, and reduces the need for follow-up surgeries, and it’s only getting better as healthcare gets smarter.
AI and personalized care are making healthcare work for every patient
One of the biggest drawbacks of not only spinal fusion surgery, but every type of medical care, has been that for decades healthcare isn’t one-size-fits-all. Not every patient has the exact same needs or will respond to treatment in the same way. In the past five years, and with increasing speed, artificial intelligence (AI) has been helping surgeons to personalize care to meet the needs of individual patients. Hundreds of articles have already been published on the positive role AI can play in spinal fusion surgery. It can be used to analyze patient data and empower physicians and surgeons to make personalized treatment recommendations— see: surgery isn’t for everyone. It can also help surgeons learn more about their patients prior to and during surgical procedures. A new system called Holo is already being used by surgeons to combine AI and augmented reality (AR) to map and carry out a more precise surgery. This all necessarily leads to better precise surgeries, and ultimately better patient outcomes.
These are not the only advances happening in spinal fusion surgery right now. Every part of the spinal fusion surgery process— from designing customized implants and rehabilitation plans to providing more affordable treatment options for both patients and payers— is changing rapidly. What we know today may very well be different tomorrow, but one thing is for certain. These changes are all incredible leaps forward in providing the most effective and meaningful care to patients. And there is nothing more important than that.
Dr. Larry Davidson
Larry Davidson, MD, FAANS, is a Board-certified neurosurgeon with over 28 years of experience treating a wide range of spinal conditions, including disc degeneration, herniated discs, spinal stenosis, spinal tumors, fractures, and more. He earned his medical degree from East Carolina University and completed his neurosurgery residency at the Medical University of South Carolina. Dr. Davidson also completed a fellowship in complex spinal surgery at the University of Tennessee in Memphis. Additionally, Dr. Davidson is a member of the American Association of Neurological Surgeons and other key medical organizations. He currently practices at Carolina Pines Medical Group Orthopaedics & Spine, where he provides comprehensive care to help patients recover their mobility and improve their quality of life.
