"Less Metal and More “Mind!”

Where is Spine Innovation heading?

I have a huge interest in the Economics of Enabling Tech and how they impact Education and Ergonomics — beyond the absolute necessity of advancing patient care!
( 😎 my 4 E’s: Ergonomics, Education, Enabling Tech, Economics…)

Having taken some time to evaluate various “innovations” in spine care recently, I find myself thinking how spine care will grow outside of the traditional brick and mortar hardware that had driven innovation in the past decade.

Between cases and clinic, I’ve started jotting down some more non-traditional innovations that I am seeing and hope to see in the near future. And broadly applicable across multiple areas of medicine.
"❗LESS METAL AND MORE MIND ❗ "

🏥 Cross-Stakeholder Value Index Tools (ok this is a shameless plug to start)
- Here is a recent systematic review that I recently authored that introduces the Enabling Tech Value Index (ETVI) that we are working on! https://lnkd.in/gt5hy2nD
- Digital platforms will allow hospitals, surgeons, and payers to collaboratively assess enabling technologies using shared outcome and cost benchmarks from the ETVI. (Think Consumer Reports or Kelley Blue Book)

📱 Remote Patient Monitoring & “Digital Twins”
- Wearables and home-based sensors will track movement, compliance, and pain (somehow) in real-time—creating "digital twins" of patients to guide recovery and flag complications early. This will help us understand the relative recovery of similar patients in the future.

👁️ Augmented Reality for Education and Workflow Integration
- Beyond the current screw placement applications, AR will be used to teach, simulate, and streamline preoperative planning and intraoperative decision-making.

💡 Preauthorization AI Assistants
- AI tools may hopefully augment payer approval processes by generating evidence-based justifications for surgery or advanced diagnostics, reducing peer-to-peer burdens. (Indications still matter!)

🔁 Learning Health Systems & Feedback Loops
- Large Hospitals and Health Systems will adopt systems that continuously learn from each spine case, iteratively updating care pathways, implant selection, and tech adoption based on value delivered. Yes, we still need to figure out to define that “value”

🩻 Smarter Imaging: Reducing Radiation, Achieving 3D Imaging, Without New Large Equipment
- Innovations in intraoperative imaging are enabling high-resolution, low-radiation 3D visualization using equipment already present in many ORs.
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⭐ In spine care, the spotlight has long been on implants—bigger, stronger, more customizable. But the real revolution may come not from what we put into the spine, but from how we think about the entire episode of care.

Our training has traditionally been focusing on mastering techniques and hardware.

But, the future will need to include “mastering” the data, the ecosystem, and the “economics” of our care.