Fri. Dec 1st, 2023
    New Skills and Technologies: Evolving Practices in Spine Surgery

    Spine surgery has witnessed significant advancements in recent years, particularly in the areas of spine navigation and robotics-assisted procedures. However, as these technologies continue to evolve, concerns arise about the next generation of surgeons becoming overly dependent on them. While experienced surgeons are exploring the essential robotics skills to integrate into their practices, it is crucial to strike a balance between innovation and traditional freehand techniques.

    One crucial skill that all spine surgeons in training should possess is the ability to perform freehand pedicle screw insertion. This skill remains fundamental, regardless of the difficulty of the insertion. Additionally, surgeons should familiarize themselves with basic robotic and navigation skills, which can be invaluable for less invasive spine surgery and complex cases. Furthermore, it is essential for surgeons to be well-versed in working around epidural scars, as these are commonly encountered in surgical procedures.

    When it comes to robotics, the use of robotic-assisted spinal instrumentation has shown advantages in accuracy for implant placement and deformity correction. Surgeons performing complex deformity and tumor cases should be familiar with this technology. However, it is crucial not to lose sight of the importance of traditional freehand skills. Anatomy remains the foundation of surgical practice, and surgeons must be able to accurately place instruments using surface anatomy, even in scenarios where technology may fail.

    Another critical skill emerging in the field is the use of navigation techniques. Surgeons must have a comprehensive understanding of how intraoperative computer navigation works to maintain accuracy and address any loss of it. Navigation not only enhances safety in challenging cases but also reduces radiation exposure for both surgeons and patients. However, it is important for surgeons to rely on their own judgment and determine the accuracy and feasibility of navigation systems before blindly relying on them.

    In conclusion, spine surgeons must embrace the evolving technologies and skills in their field. While robotics and navigation offer significant benefits, it is essential to maintain proficiency in traditional freehand techniques and prioritize a deep understanding of anatomy. By striking a balance between innovation and traditional practice, surgeons can ensure the best outcomes for their patients.


    Q: What are the key skills that spine surgeons in training should possess?
    A: Spine surgeons in training should have proficiency in freehand pedicle screw insertion, basic robotic and navigation skills, and the ability to work around epidural scars.

    Q: Why is it important for surgeons to maintain traditional freehand skills?
    A: Traditional freehand skills are crucial because technology may sometimes fail, and surgeons need to be able to perform surgeries safely and effectively in such scenarios.

    Q: What is the role of navigation techniques in spine surgery?
    A: Navigation techniques enhance safety, particularly in challenging cases, and reduce radiation exposure. They also ensure accurate placement of difficult screws and can make surgeries more efficient.

    Q: How can surgeons strike a balance between new technologies and traditional techniques?
    A: Surgeons should embrace evolving technologies while maintaining proficiency in traditional techniques. This involves staying updated with the latest advancements while prioritizing a deep understanding of anatomy.