Los Cabos: An Expansive Spine Meeting
BY JOHN MCCORMICK, JULY 9, 2007
The week prior to the 4th, we attended the Spine Technology Education Group meeting in Los Cabos, Mexico, which addressed numerous topics on innovative techniques in spine surgery. Kudos to Drs. Phillips, Albert and Vaccaro for organizing a meeting that fills badly needed white space in a crowded universe of spine meetings. This meeting was more expansive in scope than the usual discussions on devices and technologies. Numerous additional topics were covered such as reimbursement, stem cells, soft tissue technologies and the like. Another aspect of the meeting we liked was the unstructured nature of some of the talks, which included extended Q&A and open debates on hot topics.
Notable presentations included Robin Young's panel on reimbursement, which was of particular interest to the surgeons in light of the recent CMS proposal not to cover lumbar disc arthroplasty for medicare patients and the CMS proposal to increase diagnostic codes and co-morbidities in the spinal fusion area. This, combined with the culture of evidence-based medicine at CMS and the constant threat to surgeons' income, made this panel one of the highlights of the Los Cabos meeting. Some takeaways here include Former U.S. Senator David Durenberger's historical overview of Medicare and view that cost containment is inevitable, Diana Bogard's insight that bringing technology to market means all stakeholders must be considered and clinical/economic analyses must take this into account and Barb Peterson's strategic view that that payors should be engaged during the product development process not after.
Technologywise, this was a rich conference because we weren't just talking about hardware, discs, rods and screws. There were quite a view visionary moments. Among them was Todd Albert's paper on stem cell regeneration of the nucleus, which maintains that we live in an area where molecular medicine has reached a stage that allows stem cells to offer real possibilities in spine and even tissue regeneration. Most of the other technologies reviewed included the various motion preservation technologies slowly making their way to market, among them artificial discs, posterior dynamic stabilization, interspinous process devices, nucleus, annulus and facet joint repair.
