The meteroric rise of endocscopic spine surgery
As medicine moves towards an ever increasing minimisation of bodily invasion the use of the endoscope in the treatment of a multitude of spinal discorders has mushroomed within the last five years, with the speciality now almost exclusively performed in the outpatient surgical setting , which is not only good for both patients and doctors but also the healthcare executives who financially benefit from this medical revolution.
The endoscopic approach to the spine has been around for almost two decades but has been handicapped in the US by professional jealousy, the excessive fear of litigation and an inability of surgeons to acquire the specific skills necessary to safely perform the procedures. This US inertia has enabled Korea, Germany and China to aggressively pursue their spinal endoscopic programs which have allowed them to position themselves at the front of the global field with the US lagging behind. This will have econmic consequences for the US as patients will seek more cost effective care overseas as the impact of the Affordable Health Act establishes itself.
The use of the spinsal endoscope is responsible the first limbar interbody fusion being being performed in 2005 in an outpatient setting in NJ, USA. This first ever operation revolutionised the field of spine surgery and demonstrated that complex spinal procedures could be safely and effectively performed in the outpatient setting.
The rest of the world has quickly recognisd the many advantages of the endoscopic approach and have devoted resources to training, education and research in this model of future spinecare.
The tragic irony that the US, once considered the stalwart of medical progress, has for forgone this privelagedue to the excessive medico-legal litigation that now plagues this country. The bright and innovative medical minds have been forced to find sanctuary on foreign shores where their skills and ingenuinity can proceed without the constant threat of litigation. The reversal in surgeon education, with US physicians now having to travel overseas to obtain the experience and exposure to conditions and procedures that they are unable to acquire back in the US, is an unexpected turn of academic events.
