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Review
. 2022 Jun;8(2):254-265.
doi: 10.21037/jss-21-107.

Negotiating for new technologies: guidelines for the procurement of assistive technologies in spinal surgery: a narrative review

Vincent J Rossi  1   2   3 , Thomas A Wells-Quinn  1 , Gregory M Malham  1   4
Affiliations
Review

Negotiating for new technologies: guidelines for the procurement of assistive technologies in spinal surgery: a narrative review

Vincent J Rossi et al. J Spine Surg. 2022 Jun.

Abstract

Background and objective: This is a narrative review with the objective to discuss available assistive technologies for spinal surgery. Characteristics, costs, and compatibility of the different systems are summarized and recommendations made regarding acquiring these technologies. The availability of assistive technologies in spine surgery continues to evolve rapidly. The literature is lacking a collective summary of the available technologies and guidelines for acquisition. This is a narrative review which (I) presents an up-to-date summary of the currently available assistive technologies in spinal surgery; (II) makes comment on the utility of imaging, navigation, and robotics; (III) makes recommendations for the utility of the platform based on hospital size and (IV) discuss factors involved in negotiating for the purchase of these new technologies.

Methods: We assemble the most up-to-date collection of description, characteristics and pricing of assistive technologies in spinal surgery. We compare and contrast these technologies and make recommendations regarding acquisition.

Key content and findings: These technologies require a learning-curve for the surgeon and the operating room staff to understand how to use them efficiently. Surgeons need to be involved in the process of purchase decisions. Surgeons occupy a unique position in the health care infrastructure as their approach to care has significant ramifications on both the quality and cost of care. Surgeons should maintain conviction that their training and practice has allowed the use of these technologies to provide safer and more effective care for patients.

Conclusions: Assistive technologies and prostheses for spinal fusion are evolving rapidly. This article serves as an encompassing reference to the current technologies. These technologies will play a significant role in the delivery of spinal health care in the future. All stakeholders stand to benefit from the increased value these technologies bring to patient care.

Keywords: 3D fluoroscopy; imaging; navigation; robotics; spinal fusion.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jss.amegroups.com/article/view/10.21037/jss-21-107/coif). GMM serves as an unpaid editorial board member of Journal of Spine Surgery, and receives consulting fees from LifeHealthcare Australia and Globus Medical. TAWQ holds shares in SeaSpine and is a fulltime employee for an organization that promotes several pieces of the technology discussed in the manuscript. VJR has no conflicts of interest to declare.

Figures

Figure 1
Figure 1
3D fluoroscopy imaging systems. 3D, three-dimensional; FOV, field of view.
Figure 2
Figure 2
Mobile CT imaging systems. FOV, field of view; CT, computerized tomography.
Figure 3
Figure 3
Navigation platforms.
Figure 4
Figure 4
Navigation platforms cont. 3D, three-dimensional; CT, computerized tomography.
Figure 5
Figure 5
Robotics platforms.
Figure 6
Figure 6
Recommendations based on hospital size. 3D, three-dimensional; CT, computerized tomography.
See this image and copyright information in PMC

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