Mark J. Lambrechts1, Jin Ye Yeo2
1Department of Orthopaedic Surgery, Division of Spine Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; 2ASJ Editorial Office, AME Publishing Company
Correspondence to: Jin Ye Yeo. ASJ Editorial Office, AME Publishing Company. Email: asj@amegroups.com
This interview can be cited as: Lambrechts MJ, Yeo JY. Meeting the Editorial Board Member of ASJ: Dr. Mark J. Lambrechts. AME Surg J. 2024. https://asj.amegroups.org/post/view/meeting-the-editorial-board-member-of-asj-dr-mark-j-lambrechts.
Expert introduction
Dr. Mark J. Lambrechts (Figure 1) is an assistant professor of Orthopaedic Surgery at Washington University in St. Louis. He earned his medical degree from Tulane University, in New Orleans, LA and he completed his residency training in orthopaedic surgery at the University of Missouri, in Columbia, MO. Dr. Lambrechts completed a 2-year fellowship in orthopaedic spine surgery at the Rothman Orthopaedic Institute, in Philadelphia, PA, the only fellowship in the country that offers the dual fellowship.
Dr. Lambrechts has more than 100 peer-reviewed publications, most of which are related to optimizing outcomes in degenerative spine surgery or spinal trauma surgery. He has received multiple awards, including the Best Resident/Fellow Research award at the North American Spine Society and the Cervical Spine Research Society (CSRS). He has also received additional awards for his basic science research and clinical research at CSRS and the Global Spine Congress.
Figure 1 Dr. Mark J. Lambrechts
Interview
ASJ: What drove you into the field of orthopedic spine surgery?
Dr. Lambrechts: I started my orthopedics residency with an open mind. While I was initially drawn to the field due to sports related injuries, I was drawn to the complexity and substantial improvements spine patients could realize. There are endless areas for continuing to expand our knowledge and outcomes in spine surgery. The room for improvement and ability to substantially improve a patient's quality of life drew me to a career in academic spine surgery.
ASJ: Could you provide an overview of the current landscape of publications in orthopedic spine surgery? Are there any hot topics or trends that emerged in recent years?
Dr. Lambrechts: The field of spine surgery is rapidly evolving. Our understanding of spinal alignment and its effects on osteoarthritis development in neighboring joints including the sacroiliac joints, hips (hip-spine syndrome), and knees has become a hot topic in both spine and joint reconstruction surgeons. In the same vein, we are rapidly gathering more data and gaining a better appreciation for the reciprocal change in spinal alignment with sagittal correction of a patient’s deformity. As surgical software pre-planning has evolved and enhanced our ability to predict postoperative patient alignment, it should allow us to improve outcomes and minimize reoperation rates as surgeons are able to “dial in” the amount of spinal correction they wish to receive.
The technology in spine continues to evolve with endoscopic or “ultra minimally invasive” surgeries becoming more popular. This may allow for more rapid recovery and minimal narcotic requirements as our tools continue to expand.
ASJ: How has the treatment for degenerative spine disease evolved over the years? What significant technological advancements have been made in spine surgery for this condition?
Dr. Lambrechts: There has been considerable advancement in motion preserving technology. The rate of cervical disc replacement utilization has continued to grow as surgeons gain a better understanding of which patients are candidates for this procedure. In appropriate candidates, this surgery likely minimizes the likelihood of future re-operations by minimizing stress and shear on the adjacent intervertebral discs. In the lumbar spine, there is growing research on facet replacement surgery, which could minimize the need for a spinal fusion. Time will tell if this surgery can improve outcomes by maintaining lumbar spinal motion. While there is early promising data on this technology, there is insufficient data at this time for widespread adoption.
ASJ: What specific areas of degenerative spine disease are you focusing on in your current research? What research gaps do you hope to address?
Dr. Lambrechts: I continue to be interested in optimizing outcomes in cervical spine research. This includes identifying which patients should have a cervical fusion, disc replacement or hybrid procedure (a combination of fusions and disc replacements). Recently, I have become particularly interested in spinal anesthesia and analgesia. Much research has been focused on enhanced recovery protocols, but little is known regarding how anesthesia affects short- and long-term neurocognitive function and whether we are prescribing the optimal postoperative analgesics to minimize the patient's pain, complication rates, all while improving patient outcomes. I recently published on opioids and their detrimental effect on spinal fusion rates in a translation animal research model (1). I hope to continue to push forward our understanding of how opioids affect patients following spinal fusion procedures and ways to minimize narcotic usage, while still providing patients with a good surgical experience.
ASJ: Robotic-assisted surgery is an increasingly popular option for spinal fusion procedures. In your research comparing surgical outcomes of robotic and nonrobotic spinal surgery, pitfalls such as longer operative time and limited clinical differences remain to exist (2). Despite these challenges, do you believe there is still a role for robotic-assisted surgery for spinal fusion procedures?
Dr. Lambrechts: Robotic spine surgery is becoming very popular due to its improved accuracy in placing pedicle screws compared to freehand technique, but it is not a panacea. As indirect decompression (disc space distraction places tension on ligamentous structures allowing for greater central canal and neuroforaminal cross sectional area) allows for minimally invasive surgical options, indications for robotic assisted surgeries will continue to grow. This is perhaps the best current indication for this surgery. However, robotic-assisted surgery often requires increased radiation exposure to the patient (they receive a computed tomography [CT] scan to merge with intraoperative radiographs) without significantly improving re-operation rates. Operative times are also significantly longer in patients who require an open direct decompression of the neural elements. As robotic technology continues to advance, its indications will likely continue to grow and operative times will likely continue to decrease.
ASJ: What advice would you give to doctors and researchers aspiring to specialize in orthopedic spine surgery?
Dr. Lambrechts: The road to becoming an orthopedic spine surgeon is long and arduous. Aspiring spine surgeons will need to be willing to adopt a mindset of lifelong learning as the field is rapidly growing. There is probably no field in orthopedics that requires more advancements than spine surgery. Given the continued growth that I expect over the next couple decades, the overall competitiveness of orthopedic surgery residency and spine fellowship will continue to advance as well. Spending a year (or more) dedicated to spine research will make you a better applicant and give you an appreciation of whether the field is the right fit for you.
ASJ: As an Editorial Board Member, what are your expectations for ASJ?
Dr. Lambrechts: I expect ASJ will continue to rapidly grow over the next couple years. It will be a go-to resource for obtaining the most up-to-date knowledge in orthopedic surgery and spine surgery. I look forward to continuing to collaborate with and provide insights on advancements in spine surgery from spine experts across the world.
Reference
- Lambrechts MJ, D'Antonio ND, Heard JC, et al. The Inhibitory Effect of NSAIDs and Opioids on Spinal Fusion: An Animal Model. Spine (Phila Pa 1976). 2024;49(12):821-828. doi:10.1097/BRS.0000000000004959
- Heard JC, Lee YA, D'Antonio ND, et al. The impact of robotic assistance for lumbar fusion surgery on 90-day surgical outcomes and 1-year revisions. J Craniovertebr Junction Spine. 2024;15(1):15-20. doi:10.4103/jcvjs.jcvjs_145_23