The Case for Single-Use Spine Instruments

Unique demands of a growing outpatient specialty are driving a migration away from reusables.

I use single-use spine instruments daily in my work as a board-certified orthopedic spine surgeon. While not without challenges, these instruments have increased our efficiency and are particularly useful for customized surgery and patient-specific implants.

Streamlined workflows, reduced infection risk

I’m not the only spine surgeon who takes this approach. As more outpatient surgery centers become destinations for spine procedures, the role of single-use or disposable instruments has become more significant. These prepackaged sterile instruments streamline workflows and reduce patient infection risk.

A spine line that relies heavily on single-use instruments also lowers overhead associated with cleaning and reprocessing. Minimally invasive techniques and improved anesthesia protocols have made many spine procedures feasible outside the hospital, and single-use instruments align well with the needs of ASCs, where reprocessing resources may be more limited. A same-day facility with fewer instruments to process can finish more cases daily. Single-use instruments ease the burden on reprocessing staff and lower the risk of cross-contamination.

The growth in acceptance of single-use spine instruments reflects broader changes already occurring in orthopedics. Joint replacement specialists increasingly rely on disposable devices for hip and knee replacement procedures, while sports medicine has seen a surge in single-use arthroscopes, shavers and drills.

The fact that these prepackaged, sterile tools eliminate the possibility of using improperly disinfected instruments is critical in spine surgery, where postoperative infections can be devastating. Their use also leads to quicker OR turnovers, which are essential at busy ASCs. When instruments don’t need to be sterilized between cases, clinicians can move swiftly from one surgery to the next.

While single-use instruments may seem more expensive per unit, the savings from reduced sterilization, faster OR turnover and minimized infection risk can offset initial costs if managed correctly.

Momentum toward single-use

The attributes that are driving the shift to disposable spine instruments — enhanced efficiency, convenience and infection control — are precisely why interest in single-use instruments is escalating. With more procedures in ASCs, the impetus to simplify processes only intensifies.

Several companies specializing in spine instruments are driving momentum toward single-use. For instance, there are systems designed explicitly for anterior cervical discectomy and fusion (ACDF) procedures, with the vendor claiming to eliminate the need for reprocessing and accelerate turnover times. Its technology is often singled out for its hermetically sealed, disposable designs that reduce postoperative infections. Other companies produce and package sterile kits in-house that reduce reliance on external suppliers and streamline verification and validation testing.

Those are just two examples of how vendors are adapting manufacturing and logistical processes to accommodate single-use demands. Offering single-use instruments requires careful research and development, especially in material science. Companies must ensure that injection-molded plastics or composite polymers can withstand gamma or X-ray sterilization without degrading. Engineers design specialized molds for unique shapes and functionalities — such as a drill handle or a retractor — knowing each piece is destined for a single surgical use.

Shelf-life testing is also crucial with single-use instruments. Sterile packaging must remain intact for approximately five years, forcing manufacturers to conduct accelerated aging tests and real-time studies.

The complexity of this testing combined with potential supply chain disruptions requires companies to maintain robust planning and quality control to avoid stockouts or subpar batches.

Supply strains and other concerns

A central issue with disposable spine instruments is waste. By nature, single-use devices generate more material discards than reusables. The environmental impact of plastic wrappers and polymer instrument casings can’t be ignored.

Some companies are exploring compostable or recyclable materials, though this technology is still very much in its infancy. While it’s not the primary focus of most single-use manufacturers today, sustainability could shape disposable instruments’ future — especially as some healthcare organizations prioritize greener practices.

Cost is always top-of-mind for facility administrators. On paper, single-use items have a higher unit price. However, when you factor in overhead related to sterilization, time lost waiting for instrument reprocessing and potential infection expenses, single-use can hold its own — and even result in savings over time.

Having fewer instruments to process at a same-day facility means higher throughput and lower infection rates. In many cases, that might offset or even exceed initial procurement costs.

Keep in mind that the past few years have placed unprecedented strain on supply chains, from raw materials to final distribution. Single-use instruments are no exception.

Creating a stable pipeline for these sterile devices means establishing dependable supplier partnerships. Many facilities, especially smaller ASCs, may not store extensive inventories, making just-in-time deliveries crucial. A single delay could disrupt an entire day’s surgical schedule. It’s essential to align with vendors that offer reliable service and a consistent inventory.

Positioning for success

Those concerns may be easily overcome if the service and supply chain are maintained. Administrators must weigh the possible infection control benefits and OR efficiencies against the cost of implementing single-use instruments on a larger scale. For those considering the leap, pilot programs or phased rollouts can provide valuable data on cost-effectiveness and patient outcomes. Despite the drawbacks, the benefits of disposable instruments are increasingly attractive. Single-use instruments streamline processes and position same-day spine centers for success in an increasingly competitive environment.

Speedy turnovers allow more procedures to be completed daily, boosting revenue and patient satisfaction. Meanwhile, lowering infection risks fosters a stronger reputation and compliance with accreditation standards.

Patients often appreciate the sense of safety that single-use items evoke. There’s less chance of encountering a reused instrument that might harbor microscopic debris. Surgeons benefit from consistently sharp or precise tools — imagine a new scalpel or reamer every time — which leads to more predictable outcomes.

Facility owners, meanwhile, see the potential for cost savings through fewer reprocessing overheads and less staff time devoted to sterilization.

The unique demands of spine surgery — a service line that encompasses a variety of procedures from decompressions to fusions that are increasingly performed in the ASC setting — mean single-use tech must provide advanced capabilities.

Companies are developing disposable retractor systems, drill bits and nerve monitoring accessories that align with the intricacies of spinal anatomy. As these innovations proliferate and spur competition, facilities will gain access to a broader range of advanced disposable solutions at potentially more competitive prices.

Have a backup plan

Given the momentum behind outpatient spine surgery, single-use instruments appear poised for continued growth. However, adoption isn’t as simple as placing a bulk order.

Surgical facility leaders must map out the cost implications, assess supply chain reliability and consider environmental responsibilities. Meanwhile, surgeons will need training to seamlessly transition from reusable to disposable sets, notably if the instruments feature unique designs or slightly different ergonomics.

Even as single-use technology matures, facilities should have a backup plan for emergencies or unexpected supply disruptions. Nothing is worse than canceling a procedure because the single-use kit didn’t arrive.

“Single-use spine instruments are a logical step in outpatient care, provided we address cost and supply chain issues.”

This is especially relevant in an era still grappling with the aftermath of global supply chain shocks. Maintaining open communication with vendors — and retaining a minimal set of reusable instruments — can serve as a safety net. Single-use spine instruments are a logical step in outpatient care, provided we address cost and supply chain issues. The benefits of infection control and efficiency are substantial, and with careful management, the concerns about cost and backups can be mitigated.

Challenges remain with disposable instruments, but the industry is adapting quickly. It is developing advanced materials, forging stronger partnerships, and creating specialized tools that cater to the evolving demands of spine surgery.

The rise of single-use spine instruments represents a broader shift in health care: a willingness to innovate, streamline and reimagine how care is delivered. With thoughtful planning and collaboration among surgeons, administrators and suppliers, the promise of safer, faster and more patient-friendly spine procedures can become a reality, one disposable set at a time. OSM