Evidence map›Paper›PMID 41412801›Full record

ArticleInternational journal of spine surgery2025

Regenerative and Wellness Medicine: A Boon or Barrier to Surgical Innovation in Degenerative Spine Care?

Álvaro Dowling, Kai-Uwe Lewandrowski, Morgan P Lorio, Óscar L Alves, Rossano Kepler Alvim Fiorelli, Sergio Luis Schmidt, Hansen A Yuan, Alexander R Vaccaro

Abstract read
In one paragraph

Article in International journal of spine surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Álvaro DowlingDepartment of Orthopedic Surgery, USP, Ribeirão Preto, Brazil.ORCID http://orcid.org/0000-0001-9963-4131
Kai-Uwe LewandrowskiDepartment of Orthopedics, Fundación Universitaria Sanitas, Bogotá, Colombia business@tucsonspine.com.ORCID http://orcid.org/0000-0001-7842-2914
Morgan P LorioOrlando College of Osteopathic Medicine, Winter Garden, FL, USA.ORCID http://orcid.org/0000-0003-1623-2095
Óscar L AlvesCentro Hospitalar entre Douro e Vouga, Porto, Portugal.ORCID http://orcid.org/0000-0003-4111-9270
Rossano Kepler Alvim FiorelliDepartment of General and Specialized Surgery, Gaffrée e Guinle University Hospital, Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.ORCID http://orcid.org/0000-0001-5236-0903
Sergio Luis SchmidtUniversity Hospital - Tijuca, Rio de Janeiro, Brazil.ORCID http://orcid.org/0000-0001-7654-5507
Hansen A YuanState University of New York Upstate Medical University, Syracuse, NY, USA.
Alexander R VaccaroDepartment of Orthopedic Surgery, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA, USA.ORCID http://orcid.org/0000-0002-8073-0796

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRegenerative and wellness medicine is rapidly reshaping health care, particularly in the management of degenerative spine conditions. Noninvasive or minimally invasive options such as stem cell therapy, platelet-rich plasma (PRP) injections, and holistic wellness programs are increasingly selected by patients who wish to avoid the risks, costs, and prolonged recovery associated with elective spine surgery. PURPOSE: This perspective article examines whether regenerative and wellness approaches function primarily as a boon or a barrier to innovation in spine surgery and explores their impact on traditional, insurance-based surgical care models.

methodsUsing a narrative, opinion-based framework, this article synthesizes current trends in regenerative and wellness treatments, their economic growth relative to conventional spine care, and their penetration into nonsurgical spine markets. It further considers how these trends intersect with policy, reimbursement, and professional society initiatives.

resultsThe rapid expansion of regenerative and wellness interventions has created a powerful economic sector that, in some areas of nonsurgical spine care, is projected to surpass traditional medicine. Many of these therapies lack robust clinical evidence, yet the absence of data does not equate to inefficacy. These resulting strategic challenges will likely have a greater effect on spine surgeons who aredependent primarily on insurance-based reimbursement. At the same time, integrating validated regenerative options can broaden the surgical practice portfolio and better match patient preferences for personalized, minimally invasive care. Policy changes expanding coverage for evidence-based regenerative treatments may further accelerate this shift.

conclusionsTo remain relevant in an increasingly patient-driven health care environment, spine surgeons and organizations such as the International Society for the Advancement of Spine Surgery must proactively adapt to the growth of regenerative and wellness medicine. Failure to engage may relegate spine surgery largely to trauma, tumor, and infection, while regenerative and wellness strategies could dominate the management of painful degenerative spine disorders. CLINICAL RELEVANCE: Regenerative and wellness medicine is rapidly reshaping how patients with degenerative spine conditions seek care, forcing spine surgeons to decide whether to integrate these modalities or risk losing a growing segment of nonsurgical spine patients. LEVEL OF EVIDENCE: 5:

Indexed as

degenerative spine conditionshealth care policyholistic treatmentinsurance coverageminimally invasive treatmentsnonsurgical spine carepatient-driven health carepersonalized careplatelet-rich plasma (PRP)regenerative medicinespine surgerystem cell therapywellness medicine

Identifiers

PMID41412801
PMCPMC12800657

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.