The advent of new spinal technologies makes spine surgeon Rachel Bratescu, MD, eager about the specialty's future.
Dr. Bratescu is the first female spine surgeon accepted into New York City-based Weill Cornell's neurosurgery spine fellowship, and she has orthopedic spine fellowship training from NYU Langone Health.
Now, she is an assistant attending at Weill Cornell, and she plans to move to George Washington University in Washington, D.C. in August to continue her work, she told Becker's.
She discussed her outlook on spine navigation and robotics and how other early-career spine surgeons should approach them.
Note: This conversation was edited for clarity and length.
Question: As an early career spine surgeon, are you feeling more excited or nervous about the future of the specialty?
Dr. Rachel Bratescu: My overall feeling is excitement. I'm excited about all the new technology, in particular the integration of navigation and robotics. There is a whole lot of discussion about how artificial intelligence will play into all this. That is probably one of the most exciting aspects of spine surgery. That's also why spine surgery lends itself to a career of lifelong learning, because there's this huge research aspect to it. I'm excited to see where the field goes as technology continues to develop. So I think from that standpoint, that's what I'm most excited about.
Q: Can you expand more about your experience learning to master these technologies while also at the same time mastering just the basics of spine surgery?
RB: The progression of your education is important. Number one, you have to have a very good handle on spinal anatomy no matter what. Number two, it's so important to learn how to do everything freehand. Once you're comfortable from that standpoint, then you can start integrating.
For example in a revision case you have the luxury of utilizing the navigation to help assist with your bony landmarks when they may not be as clear. Then once you're comfortable placing pedicle screws, you can integrate the navigation to place those screws exactly where you want or need them. Using robotic techniques is really the last step. The benefit of both of the fellowships that I did is I had the benefit of having that progression.
I've really been able to get very facile with minimally invasive spinal techniques and the use of navigation, which is one of Dr. Roger Härtl's primary areas of expertise. Progression is incredibly important. From a patient safety standpoint, if you don't understand the anatomy and if you don't understand how to do the surgery in a traditional way without any of this technology, it's not safe because you don't know when to trust it and when not to trust it. You want to be in a position where you can use it as a tool and that you're not reliant on it.
Q: What advice would you give to more experienced spine surgeons as someone early in your career?
RB: If you constantly keep up your desire to learn and to advance, and you keep that fire beneath you, then you're always going to improve. You're going to do better for your patients. That's who I think are the best spine surgeons — the people that don't become complacent. I think that's one of the most important things no matter where you are in your career, I found that some people learn techniques. They become married to them, to how they first learned it, and they don't really consider what may be better for their practice or their patience or their efficiency. Being open minded is also part of that as well.