Innovation, strictly defined, is any change that has significant impact on the way things are done. The majority of papers in this Scoliosis Research Society Focus Issue describe innovations and innovative technologies in use today. Other innovations included are on the cusp of clinical use, and some are only being tested in a basic laboratory setting. These may not be ready for clinical use for at least 5 to 10 years.
The goal of the innovations introduced here is to improve the lives of our patients through less invasive surgical techniques, lower morbidity interventions, lessening blood loss, retaining motion, improving neural recovery, improving cosmesis, overall improvement in health outcomes, and extending lifespan in severe juvenile/infantile deformities. However, all these lofty goals still need to be balanced against the morbidity of the intervention, added time, cost, and resources required for the intervention, and the outcomes compared to the present gold standard. The authors have done an excellent job communicating this balance and fairly representing the results.
The issue is divided into four sections. The initial section focuses on regenerative technologies and disc preserving/repairing innovations. The next grouping includes those technologies that correct deformity while avoiding or delaying fusion. Those that are used today make a huge impact toward allowing growth in the very young patient and saving the lives of those with chest wall abnormalities seen in thoracic insufficiency syndrome. The third section covers two papers presenting novel biomaterials for use in spinal surgery. Finally, a group of four papers evaluates novel techniques being used to enhance traditional deformity surgery: either through decreasing the morbidity of blood loss and bone graft harvest or in attempts to lessen the fusion length and posterior dissection.
I congratulate and thank all of the authors for their well-written, balanced, and responsible approaches to the introduction of these innovative changes in spinal surgery.