For years, the spine world operated in silos. Surgeons handled the operating room; interventional pain physicians handled the fluoroscopy suite. Referral patterns were linear, turf battles were real, and the patient often got caught in between. That era is ending.
At the 2026 Becker's Spine Conference, a striking consensus emerged among industry leaders: the word defining this year is "integration." The most forward-thinking practices are breaking down walls between surgical and interventional disciplines, creating unified care pathways that start with the least invasive option and escalate only when clinically justified.
Why this matters for pain physicians
This convergence isn't a threat to interventional pain — it's a massive opportunity. As evidence mounts that conservative and minimally invasive approaches produce comparable outcomes for many spine conditions, the interventional pain physician becomes the quarterback of the care team, not the backup.
We're also seeing this play out in ASC development. Pain management procedures are increasingly moving to outpatient settings where we control the environment, the patient experience, and the economics. With real-time imaging advances and augmented reality tools now available for percutaneous pedicle screw placement, the technical capabilities in interventional suites are approaching what was once exclusively surgical territory.
What I'm watching
The practices that will thrive are the ones building multidisciplinary teams now — PM&R physicians, interventional pain specialists, orthopedic spine surgeons, physical therapists, and behavioral health providers all under one coordinated umbrella. At Clearway, we've seen firsthand how this model improves outcomes, reduces costs, and drives patient satisfaction.
The question for every pain physician in 2026 is simple: are you building bridges, or are you still guarding your silo?