Sino-German Video Conference: Some Future Trends in Spinal Surgery

On May 27th, the Luoyang Orthopedic-Traumatological Hospital of Henan Province, together with Prof. Mayer, the Founding President of German Spine Society and Former President of EUROSPINE., successfully held a Sino-German Video Conference on Spine Surgery. Cao Xiangyang, Vice President of the Luoyang Orthopedic-Traumatological Hospital of Henan Province, attended the meeting and gave a welcome speech. Zhou Yingjie, Director of the Spine Center, presided over the meeting. Chen Hailong, Director of Spine Surgery III of Zhenzhou Hospital District, and Han Zhi, Diagnosis Team Leader of Spine Surgery VI of Luoyang Hospital district, shared some challenging cases for discussion. With more than 30 spine specialists attending, the conference set two venues in Luoyang and Zhengzhou hospital districts. Experts from two countries exchanged ideas and knowledge on the recent development of spine surgery, the status quo of clinical and scientific research and some future trends in spinal surgery.

Cao Xiangyang, Vice President of the Luoyang Orthopedic-Traumatological Hospital of Henan Province, attended the meeting and delivered a welcome speech. He firstly extended his warmest welcome to Prof. Mayer and all the attendees, and then introduced the history of the Luoyang Orthopedic-Traumatological Hospital of Henan Province, the current status of its spine center and its efforts made in the development of (minimally invasive) spine surgery.

Prof. Mayer, while sharing his new lecture about some future trends in spinal surgery, noted that spine surgery is a continuously growing medical specialty. In the future, the number of patients needed for spine surgery will be unlimited, whereas there is still a few spine specialists worldwide. For hospitals, spine surgery may be an attractive specialty for further development. As a new specialty, it has wide fields for research in the future as well. He also shared with us that in Western countries, many hospitals are currently facing great cost and quality pressure in spinal surgery, and also there is a lack of quality data for either surgical procedures or conservative treatment, and that negative public perceptions about spinal surgery, and the wide discussion about unnecessary operations have discouraged the development of spinal surgery.

The call for quality control is getting very big, as the insurance companies, as well as the hospitals and the polities are asking for patient reported outcome measurements(PROMs). For example, we will do the routine measurements to get the outcome data from our patients, including VAS, ODI, EQ-5D and 6-, 12- and 24-month postoperative follow-ups, ect. And his hospital would also collect some specific scores, such as BASD, BASFI, from patients. The data collected can be applied not only for scientific research but also for evaluating the clinical outcomes of patients. Patients’ expectation management will also be a future trend in spinal surgery.

One big trend in the implants materials for spinal surgery is 3D printing technologies. The 3D printing implant for spine is pure titanium cage, with advantages such as rough surface with high primary stability, elasticity modulus close to cancellous bone, and implant design that ensures a maximum endplate contact. What’s more, it also has a porosity of up to 80%, which provides mechanical support for new bone formation and blood vessels.

Prof. Mayer later introduced the development/trend of spinal surgery techniques from 1980 to 2030, talking about the invention and application of pedicle screws, the development of minimally invasive spine surgery, the application of alone fusion techniques, the promotion of various LIF techniques and their advantages and disadvantages, and some future trends of surgical robotics, navigation technology and augmented reality (AR) in spinal surgery as well as their advantages and disadvantages.

UBE/BESS in spinal surgery is also a hot trend in the next decade. UBE/BESS means on one side surgeons go in with the endoscopy, and the other side go in with instruments through a small or second small approach. The idea behind that is the two small approaches are less invasive than the one bigger approach. And the UBE/BESS gives more possibilities as it is so called the 'triangular' principle for surgery. Nowadays, the UBE/BESS techniques can be used in TLIF. It is interesting to consider whether the laparoscopic or retroperitoneal spine surgeries, which were introduced thirty years ago will be revived after the biportal endoscopic technique is widely used now.

During the case discussion, Chen Hailong, Director of Spine Surgery III of Zhenzhou Hospital District, and Han Zhi, Diagnosis Team Leader of Spine Surgery VI of Luoyang Hospital district, shared some challenging cases for discussion. The Chinese experts and Prof. Mayer actively shared their ideas and discussed the treatment options for the patients. The atmosphere was warm and rewarding, two sides all learned a lot from each other. The Chinese colleagues all hoped that they will have an opportunity to hold another video conference with Prof. Mayer to discuss OLIF technique in the future.

Director Zhou Yingjie gave a conclusion speech at the end of the meeting, saying although the COVID-19 imposed great difficulties and challenges on us, but academic exchanges will never stop. We believe we will become stronger and stronger after going through the pandemic. We will also strengthen cooperation with our sister units to build up a Healthy Henan Province and to make more contributions to better health conditions for all human kinds.