Biggest Challenges in Spinal Surgery Today

Five spine surgeons discuss the biggest challenges in spine surgery today including Steven Lee, M.D., of Golden State Orthopedics & Spine.

Ask Spine Surgeons is a weekly series of questions posed to spine surgeons around the country about clinical, business and policy issues affecting spine care. We invite all spine surgeon and specialist responses.

Dr. Steven Lee’s take on biggest challenges in spine surgery

Curing the common problem of low back pain is the Holy Grail of our field. There are various accepted surgical treatments available to treat some of these patient based on their diagnosis. However, the majority of patients with low back pain do not have a clearly identified cause. Also, current treatment options have had variable outcomes.

A big interest has been trying to regenerate and restore injured or degenerated discs back to health. Techniques studied have involved gene therapy, biologic materials, and autologous cell treatments. None of these has been tested enough to prove their effectiveness and safety. It seems that within the next five years or so, I believe a breakthrough may come to help certain patients with low back pain. For example, a subset of patients with severe back pain that is believed to be due to annular tears may be able to be treated with biologic agents injected directly into or near the injured disc to promote healing of the tear. This may be able to prevent chronic back problems from developing.

A second challenge involves our aging population. People are living longer with expectations of maintaining an active lifestyle. More are unfortunately experiencing degeneration of their spine. The first priority in this population is identifying which patients will benefit from surgical treatment. Second, we need to reduce complication rates associated with surgery, such as infection or anesthesia-related events. Third, surgeons need to continue to improve techniques to improve recovery times and get patients back to activities.