Robotic technology in spine and orthopedics is growing its foothold among early-career spine surgeons and seasoned physicians.
Navigation robots can help increase precision, efficiency and bolster patient outcomes for a variety of procedures. But there's a big learning curve that comes with robotics, along with some concerns that surgeons could become overly reliant on it.
Some early-career spine and orthopedic surgeons have taken extra care to make sure their training covers the full gamut of techniques available to them. Rachel Bratescu, MD, who joined George Washington University in Washington, D.C. after a fellowship at New York City-based Weill Cornell, said she took a progressive approach to learning spine techniques.
"Number one: You have to have a very good handle on spinal anatomy no matter what," she said." 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."
Daniel Buchalter, MD, an orthopedic surgeon joined Carmel, N.Y.-based Somers Orthopaedic Surgery & Sports Medicine Group following his fellowship at New York City-based Hospital for Special Surgery this year. He said he saw his peers wanting to gain mastery in both robotic and traditional joint replacement procedures.
"For my generation, I think that is smart because right now we are still trying to figure out which technique leads to the best outcomes for our patients, which technological platform is the most cost-efficient, and what system is the least burdensome for the healthcare system as a whole," he said. "Additionally, knowing how to do joint replacements manually and with technology is critical as many graduates don't necessarily know where they are going to work and what platforms will be available to them."
Dr. Buchalter also said he expects that one day robotics will be the primary way surgeons learn how to operate.
"I think the future of it all is similar to the way that everybody used to know how to ride a horse, and then when cars came out, people said, 'What happens if your car breaks down and you don't know how to ride a horse?'" he said. "Well, I don't know very many people in New York City or elsewhere who know how to ride a horse, and they get around just fine. My point is that technology advances to such a stage that saying, 'You need to know how to do something because what if,' becomes irrelevant. I feel lucky that I graduated residency from a program where I got a lot of both, and was fortunate enough to train at a fellowship program that also offered both."