Dale Horne, MD, a Cincinnati-based neurosurgeon, began using spinal robotic technology in 2007 and hasn't looked back.
Here, he discusses how robotics has evolved and the potential threats for the spine field in the future.
Question: What emerging technology are you most interested in today and why?
Dr. Dale Horne: Two emerging technologies that we will certainly be seeing more of will impact both general neurosurgery and spine. Exoscopes, particularly 3D robotically controlled scopes will eventually dominate and replace conventional intraoperative microscopes. As the availability, cost, and integration of ultra-high definition sensors grows, the current footprint and size of intraoperative microscopes will transition to unobtrusive, high-resolution 3D optical exoscopes that will automatically focus, zoom, and move to maintain the field of interest in view. These scopes also provide ease of involvement of other surgeons and operating room staff to be engaged in the surgery. This will benefit all aspects of neurosurgery.
Spinal robotics, which began with the Mazor SpineAssist in 2004, has passed multiple reiterations and improvements in planning, intraoperative registration, and integration into the surgeon's natural workflow. Currently, multiple systems are on the market and in development by a variety of major spine vendors. The ability of the spinal robot to assist the surgeon in accurately and reproducibly placing spinal implants while decreasing the radiation exposure to the patient and operative staff, ultimately providing for improved outcomes, is the force that will continue to drive this technology. I began using spinal robotics in 2007 and at that time, it was clear to me, that they would ultimately become a standard in operative spine care.
Q: How do you think your practice will change in the next three years? What are you doing today to prepare?
DH: The best method for preparing for the future is to become familiar with these technologies and gain and maintain facility with applying these tools to neurosurgery. Patients learn about new technology and ask about it. Where appropriate to the patient's condition, we should be able to skillfully use our new tools to further improve patient outcomes.
Q: What is the most dangerous trend in healthcare, spine or orthopedics today and why?
DH: Complacency and cutting corners by surgeons, physicians and staff, often due to the increased regulations and time demands, is dangerous. Practice and hospital administrations must respect that quality care requires time with patients. Furthermore, unless a surgical emergency exists, patients should be given the option of conservative measures and stable conditions should be followed. Just because we have the technology to perform a surgery does not mean we should.
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