Latest / Neck & Back Surgery Answers with Dr. Leonard Kibuule / Can a ROBOT Really Repair Your Spine? (Surgeon’s Stunning Finding)

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Can a ROBOT Really Repair Your Spine? (Surgeon’s Stunning Finding) · Neck & Back Surgery Answers with Dr. Leonard Kibuule

• 0:00
  SPEAKER_00: Robotic spine surgery sounds amazing, and some of it is.
• 0:02
  SPEAKER_00: And with the growth of AI, it can seem like robots are starting to take over everywhere, even in the operating room.
• 0:09
  SPEAKER_00: But that's not really how robotic spine surgery works.
• 0:11
  SPEAKER_00: I'm Dr.
• 0:12
  SPEAKER_00: Leonard Kabule, I'm an orthopedic spine surgeon, and before medicine, I trained as an electrical engineer.
• 0:17
  SPEAKER_00: I've also spent years working with robotics, navigation technology in the spine.
• 0:22
  SPEAKER_00: So in this video, I want to show you what the robot is actually doing during spine surgery, where I think this technology is genuinely useful, and the one thing it still can't do for you.
• 0:33
  SPEAKER_00: What does the robot actually do?
• 0:35
  SPEAKER_00: First, the robot is not standing over you performing surgery.
• 0:38
  SPEAKER_00: I still make the decision, expose the area we need to work on, and perform the operation.
• 0:43
  SPEAKER_00: Where robotics becomes useful is in helping me plan and guide certain parts of the procedure.
• 0:49
  SPEAKER_00: Let's say I'm doing a lumbar fusion.
• 0:51
  SPEAKER_00: I need to place the screws into the spine.
• 0:53
  SPEAKER_00: Before those screws go in, we can use imaging to create a detailed map of your anatomy.
• 0:58
  SPEAKER_00: I can plan exactly where those screws need to go and how they should follow that path, including the angle, the depth, and the position of the screws.
• 1:07
  SPEAKER_00: Then the robotic system can help position and guide me along that pathway in order to place those screws.
• 1:14
  SPEAKER_00: I still control the instruments and place the screws.
• 1:17
  SPEAKER_00: The robot is helping me stay on the trajectory that I've planned.
• 1:20
  SPEAKER_00: Think of it almost like GPS combined with a little bit of precise guidance.
• 1:25
  SPEAKER_00: It tells me where I am, where I want to go, and helps me place the instruments and the screws on the correct path.
• 1:31
  SPEAKER_00: And when you're working in the spine where nerves and other important structures may be only millimeters away, that kind of precision can be extremely useful.
• 1:40
  SPEAKER_00: But here's the part people don't always realize.
• 1:42
  SPEAKER_00: The robot can help me execute that plan.
• 1:45
  SPEAKER_00: It cannot tell me whether the plan is correct.
• 1:47
  SPEAKER_00: The robot can do the wrong operation very precisely.
• 1:51
  SPEAKER_00: That may sound strange, but this is probably the most important thing to understand about robotic surgery.
• 1:57
  SPEAKER_00: Imagine your MRI shows degeneration at two levels of your lower back.
• 2:00
  SPEAKER_00: A surgeon decides those levels need to be fused.
• 2:03
  SPEAKER_00: The robot may help place every screw exactly where it was intended to go.
• 2:08
  SPEAKER_00: Technically, the operation was beautiful.
• 2:10
  SPEAKER_00: But if those levels weren't actually causing you your symptoms, you still have a problem.
• 2:14
  SPEAKER_00: That is why the most important part of spine surgery happens before we ever turn the robot on.
• 2:21
  SPEAKER_00: I still need to understand where your symptoms are coming from, whether the examination matches the imaging, what your nerves are doing, and what specific problem the surgery is intended to correct.
• 2:31
  SPEAKER_00: Robotics can improve precision.
• 2:34
  SPEAKER_00: They cannot correct a bad diagnosis.
• 2:36
  SPEAKER_00: That is why I get a little cautious when people say robotics becomes the main reason why someone is being sold on an operation.
• 2:45
  SPEAKER_00: Advanced technology should improve the operation.
• 2:48
  SPEAKER_00: It should not become the reason for doing the operation.
• 2:51
  SPEAKER_00: And there's another reason the surgeon still matters.
• 2:54
  SPEAKER_00: What happens if the robot is wrong?
• 2:56
  SPEAKER_00: I compare robotics to a calculator.
• 2:59
  SPEAKER_00: A calculator can make you faster and more accurate, especially when the math gets complicated.
• 3:04
  SPEAKER_00: But if you put into the calculator an equation and it gives you an answer that clearly makes no sense, you need enough understanding to recognize that something is wrong.
• 3:14
  SPEAKER_00: You don't just accept the answer because the machine gave it to you.
• 3:17
  SPEAKER_00: Robotics is very similar.
• 3:19
  SPEAKER_00: The technology can give you very useful information, but I still need to understand the anatomy and know what I expect to see.
• 3:27
  SPEAKER_00: If something doesn't make sense or look right, I have to recognize it.
• 3:31
  SPEAKER_00: And I also need to know how to perform the operation if the technology is unavailable or isn't giving me the exact information that I expect.
• 3:39
  SPEAKER_00: That's why I consider robotics an adjunct.
• 3:42
  SPEAKER_00: It can help me do the procedure, but it can't replace the judgment and experience required to perform it well.
• 3:48
  SPEAKER_00: Does robotics mean minimally invasive?
• 3:50
  SPEAKER_00: Not necessarily.
• 3:51
  SPEAKER_00: Those terms get grouped together a lot.
• 3:54
  SPEAKER_00: Robotic surgery, small incision, faster recovery, minimally invasive.
• 3:59
  SPEAKER_00: Sometimes they overlap, but they are not the same thing.
• 4:02
  SPEAKER_00: A robot does not decide how large the operation needs to be.
• 4:06
  SPEAKER_00: Your spinal problem does.
• 4:08
  SPEAKER_00: If the problem can be solved through a smaller approach, robotics and navigation may help us perform that operation very precisely.
• 4:15
  SPEAKER_00: If the spine has significant instability or another problem that requires a larger reconstruction, adding a robot does not suddenly make the operation smaller.
• 4:24
  SPEAKER_00: This is why I don't define mentally invasive spine surgery by the size of the scar.
• 4:29
  SPEAKER_00: If you've been told you need spine surgery and you're trying to figure out what procedure actually makes sense for you, there's a link below this video where you can get in touch with my office.
• 4:38
  SPEAKER_00: We can look at what's going on, review your options, and help you understand whether surgery is appropriate and what type of procedure would actually address the problem.
• 4:47
  SPEAKER_00: Because whether somebody is talking about robotics, mental invasive surgery, or a traditional operation, the first question should still be the same.
• 4:55
  SPEAKER_00: What exactly are we trying to fix?
• 4:58
  SPEAKER_00: If somebody has recommended robotic spine surgery to you, then you do not need to walk into the room with a list of technical questions.
• 5:04
  SPEAKER_00: But before you leave, you should understand what they are seeing.
• 5:08
  SPEAKER_00: I would want the surgeon to actually show me the MRI, not just read the report to you.
• 5:13
  SPEAKER_00: Show you the level that they are concerned about, show you where the nerves are being compressed, where the spine would be unstable, or whatever problem they believe is causing your symptoms.
• 5:24
  SPEAKER_00: The important part is connecting that picture to what you are actually experiencing.
• 5:30
  SPEAKER_00: If the MRI shows a problem on the right side, but all of your symptoms are on the left side, I would want somebody to explain that.
• 5:37
  SPEAKER_00: If several levels look worn out, I would want to know why one of those levels matters more than the others.
• 5:43
  SPEAKER_00: And if they are recommending a fusion, I would want to understand what needs to be stabilized and why a smaller procedure would not be enough.
• 5:50
  SPEAKER_00: You do not need to understand every word on the MRI report.
• 5:54
  SPEAKER_00: You just want to be able to leave the room saying, I understand where the problem is, I understand why they believe it is causing my symptoms, and I understand what the operation is supposed to fix.
• 6:05
  SPEAKER_00: Then you can ask where the robot fits into the plan.
• 6:09
  SPEAKER_00: Maybe it's helping guide the screw placement.
• 6:11
  SPEAKER_00: Maybe it's helping with general navigation.
• 6:14
  SPEAKER_00: Maybe it allows the surgeon to perform part of the operation more precisely or through a less disruptive approach.
• 6:20
  SPEAKER_00: But if all you know when you leave is they use a robot, you still do not know enough about the operation.
• 6:27
  SPEAKER_00: I don't want to leave you with the impression that I'm skeptical of robotics.
• 6:30
  SPEAKER_00: I'm not.
• 6:31
  SPEAKER_00: I have an engineering background.
• 6:32
  SPEAKER_00: I spent many years involved with navigation and robotics, and I think this technology is going to keep getting better.
• 6:39
  SPEAKER_00: We can plan surgery with more information, navigate anatomy more precisely, and in the right cases, combine those tools with minimally invasive single position techniques to make the surgery more efficient and less disruptive to the tissue.
• 6:54
  SPEAKER_00: And as AI develops, I expect more information to be available to surgeons in the operating room to become even more sophisticated with what they do.
• 7:03
  SPEAKER_00: I don't think the exciting future is a robot replacing the surgeon.
• 7:07
  SPEAKER_00: I think it's a good surgeon having better tools.
• 7:10
  SPEAKER_00: So can a robot really repair your spine?
• 7:12
  SPEAKER_00: It can help us plan and perform certain parts of spine surgery with remarkable precision, including helping us navigate anatomy and stay on a trajectory where we have already decided that trajectory is appropriate.
• 7:25
  SPEAKER_00: What it can't do is diagnose you, decide whether you need surgery or turn the wrong operation into the right one.
• 7:32
  SPEAKER_00: If you're considering robotic surgery, don't focus on how advanced the technology is.
• 7:37
  SPEAKER_00: Make sure you understand what problem is being fixed, why the operation is necessary, and what the robot is actually helping the surgeon do.
• 7:45
  SPEAKER_00: And if you're still trying to figure out whether spine surgery makes sense for you in the first place, watch my video on herniated discs and sciatica, where I'll walk you through the signs that tell me when it still makes sense to wait and when surgery starts becoming the better option.