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>> So robotic-assisted surgery
in medicine is really an evolving art.
So there have been robots now
that help us take gall bladders out,
help surgeons take prostates out.
Now in spine surgery we have the ability to use a robot
where we can actually plan a surgery,
plan where want screws to go, plan where we want
to do a decompression, and with the aid of robot,
have that trajectory and have that plan affected
with sub-millimeter accuracy.
So the robot is going to help elevate the art
of what we do in surgery.
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I think almost anybody that needs screws placed
in the spine is a potential candidate for robotic surgery.
There are some cases where the robot may not make sense
and in some cervical cases
or in some routine degenerative cases,
but certainly in most cases and especially those
where anatomy is complex,
the adjunct of the robot will help us improve our outcomes,
help us do what we do on a daily basis
with a higher degree of accuracy,
hopefully collapsing the time of surgery,
which also improves outcomes.
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Everything in medicine is an evolution and along the way
what we are trying to do is improve upon
what we have been doing for the past 20 or 30 years.
So image guidance, for instance, gave us the ability
to see in real time where we were in the spine.
The addition of robotics now elevates that
to the next level, so while we are accurate now,
we can automate that accuracy, we can take the accuracy
that we've gotten with image guidance surgery
and parlay that into automation
where we can plan multiple trajectories
and then, with robot assistance,
have those trajectories affected one after the other
after the other in a fairly predictable fashion.
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Having good outcomes following surgery,
essentially are related to multiple factors
and those factors begin with the first meeting
of the patient, taking a very thorough history,
looking at all the imaging, talking with the patient,
and deciding upon whether or not, first of all,
is surgery indicated at all and then,
when we decide upon surgery, tailoring that surgery
for the particular patient, picking an operation
to ensure a good outcome.
And every step of the way managing expectations,
explaining to the patient what they're going
to be going through, what pain is like after surgery,
and then ultimately, how do we get to the end of the road,
the end of the yellow brick road, that rehabilitation state
where patients can get back to life,
get back to doing things that they were unable
to do prior to surgery.
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>> Sure, the rehabilitation really is everything
and in most cases and in almost every case,
it begins with walking.
I tell all my patients ultimately that the goal
after any spinal surgery is to walk one hour a day.
The power and benefits of walking
an hour a day are innumerous.
In addition to that, we talk about,
potentially, physical therapy, core strengthening,
conditioning, and then ultimately,
the rehabilitation depends on what the patient wants to do.
So if the patient is a golfer for instance,
we have certain physical therapy for those
who want to return to golf.
We tailor the entire rehabilitative aspect of spinal surgery
to trying to get that patient back to doing things
that they want to do.
In some cases, need to do, like drive, walk, etc.
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