Enabling technologies are becoming more entrenched in and more widely adopted in spine surgery, but there is a concern that the next generation of surgeons may rely too heavily on new technology to help them through complex surgeries.
Robots and augmented reality continue to excite surgeons. These technologies are also being updated and refined as device companies develop the next iterations of their flagship surgical technologies.
"We're at a precipice now where technology is advanced to a point where it can actually become practical. We can actually implement some of these newer technologies in a practical sense in the operating room without as much effort," Mark Testaiuti, MD, of Mount Laurel, N.J.-based Coastal Spine, said during a panel at the 21st Annual Spine, Orthopedic & Pain Management-Driven ASC + The Future of Spine Conference in Chicago.
While the potential around navigation technologies such as robotics, AR and virtual reality is exciting, spine leaders insist that it is important to remind the next generation of surgeons that these innovations will not replace what highly trained surgeons do.
"We have to keep driving home to residents and fellows that this technology makes you more confident about what you already know, but it's not going to replace having been there first before this stuff became available to help you," Dr. Testaiuti said. "It might keep people out of trouble and I feel that is a positive, [but] it's gotten to the point now where it can be practically applied by those of us that are willing to adopt the technology."
Jeremy Steinberger, MD, director of the spine and neurosurgery department at New York City-based Mount Sinai Health System, reinforced the importance of the next generation knowing the anatomy inside and out and being trained in traditional surgical methods.
"One thing that cannot get lost in the discussions about technology is training the next generation and making sure that surgeons are capable of operating if their navigation machine dies or their robot isn't working or is not accurate," Dr. Steinberger said.
One way Dr. Steinberger combats this when using navigation during surgery is by instructing residents to pretend they are not using navigation, set themselves up and look at the trajectory of where they think the pedicle screw is going. Then look at the navigation.
"I tell the resident to pretend they don't have navigation," Dr. Steinberger said. "Then you are learning if your positioning is not accurate. Every single screw you do, you learn and you're getting the freehand technique solidified while using navigation to make it safer. "