By: 8 June 2023
Dr Vivek Babaria discusses his recent research looking at the risk vs benefits of continuing anticoagulation and antiplatelet medication during spine surgery

Dr Vivek Babaria, a board-certified and fellowship-trained physician with substantial experience in interventional spine care, sports and regenerative medicine, has co-authored a research article in Interventional Pain Medicine. He answers questions about his findings to Spinal Surgery News 


SSN: Looking at your recent research article, it explores the purported risks to patients on anticoagulant and antiplatelet agents when undergoing cervical medial branch blocks (CMBBs) for cervical spine joint pain. Could you give more detail about the possible risks involved to patients? 

VB:  This article was published because there has been an accepted consensus from various organizations that stopping anticoagulation and antiplatelet agents was a safety necessity to perform spine procedures. The theoretical risk of a bleed and management of the bleeding is why the guidelines of stopping the agents existed. An uncontrollable bleed could have theoretical catastrophic outcomes. 


SSN: Could you tell us more about undertaking your research and what you discovered? 

VB:  As a member of the Spine Intervention Society, I was selected onto the Patient Safety Committee. This committee has been publishing guidelines and articles entitled FactFinders to debunk and/or shed light on controversial topics related to spine interventions, including this recently published paper. Essentially, from the data we gathered of the risks and benefits involved with stopping or continuing the agents mentioned above, it is our understanding that there is more risk involved with stopping the above-mentioned agents than there is a risk of complications while they are on these agents. 


SSN: What could your early findings mean to the spinal industry and the patient experience? 

VB:  Given the data that we have reviewed, this can result in a paradigm shift in the understanding of risk/harm vs. benefit of continuing anticoagulation medication. The data suggests that patients are placed on these agents for specific medical reasons. By stopping or holding the agents, those conditions tend to cause more complications for the patient than doing the spine procedure itself. 


SSN: What’s next? Are you currently working on any new research articles, or developing work with emerging technologies? 

VB:  As research and technology continue to evolve in our space, I feel compelled to push the envelope for safety, efficacy and standards of care. I am fortunate and humbled to have been trained by some of the pioneers of my field.  As new technologies emerge, the lens of prudence and outcomes is necessary. If there are ways to improve evidence-based delivery of care, I try to get involved in those types of projects. Currently, I am very interested in orthobiologics and its use in treating low back pain.  


SSN: Please can you tell us more about the research and what it could mean to patient outcomes? 

VB:  The research involved in finding better ways to identify sources of low back pain is a passion of mine. To fix the “spine of a person” has a literal and figurative meaning to me. Since low back pain is one of the most common reasons people go visit a doctor in general, any way to fine tune our diagnostics and treatment algorithms can really change how we practice. 


SSN: Are you planning to attend any orthopaedic or spinal events this year? 

VB:  Yes, I sit on several different committees for different national and international societies. I will be presenting at Becker’s 20th Annual Spine, Orthopedic & Pain Management-Driven ASC Conference in June and both the SIS Annual Meeting and PSPS Annual Conference in September. 


SSN: How do you think the future looks in the field of spinal surgery? 

VB:  The patient population that I see is asking to be more functional and independent in the later decades of their lives. This is forcing me to be more cognizant of what treatment options I offer and the long-term consequences they may have. I believe spine surgery will continue to evolve by offering more minimally invasive procedures that are more precise and motion preserving. I am so amazed by the human spirit, and it brings me great joy when my 80+ year-old golfers want to be at peak performance.  


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