Melanie Cole, MS (Host): Welcome to UAB Med Cast. I'm Melanie Cole. Joining me today is Dr. Jacob Godzik. He's a neurosurgeon and an assistant professor at UAB Medicine, and he's here to highlight the future of spine surgery robotics. And minimally invasive surgery. Dr. Godzik, it's a pleasure to have you join us today. I'd like you to start by telling us a little bit about robotics and how the utilization of robotics has changed the landscape of medicine, in your opinion, and specifically spine surgery.

Dr. Jakub Godzik: Well, thank you Melanie. Thank you for having me. I appreciate the time to chat with you about this a little bit. It's a bit of my passion, so I'm happy to share. I can't say too much about how robotics has changed the whole landscape of medicine. It's been around for a really long time. But in terms of spine surgery, I think it's a really exciting time right now as it's just starting to creep into our field. And I think it's passing that threshold where it's gone from a little bit of a experiments and a marketing gimmick to something that's a little bit more tangible.

And so I think what is really exciting about it is that it's becoming more and more adopted widely. And it's really, I think, changing the way that we can provide care. It's making us more efficient as providers. I think it's gonna reduce the, variability of surgeries and I think it's really gonna change spine surgery into the future in a really, really exciting way.

Melanie Cole, MS: Well then speak about the variability of surgeries. What are some of the more common uses for it, and what type of surgical interventions do you perform with them?

Dr. Jakub Godzik: That's a great question. So, spine surgery, has a lot of different. procedures that are done, a lot of different surgeries. And one of the things that we perform very commonly for a variety of conditions, but back pain or for our fractures or for other, more complex diseases, is that we fuse segments. And so we have to immobilize the segment. And the way that we do that is through a process called fusion.

And in order to really make that happen is we have to place what are called pedicle screws or we have to place a screw into the bone so that we can provide that kind of stability. And that's been performed for decades now. But the target that we're trying to hit is fairly small. And right now where robotics comes into play is that it helps us leverage the technology of navigation, so we can use a CT scan for instance, to image someone's boney anatomy in someone's spine and then deliver this screw through the skin and with a very, very small, almost percutaneous incision without having to pull the muscle off of the spine.

It really allows us to combine these really two related, aspects of this profession, which is robotics and, minimally invasive surgery. So it allows us to do the same thing, but with a smaller incision, which translates to less pain, you know, potentially less complications, less blood loss. Quicker recovery and return to work or the activities that you want to do and it actually might be a little faster and more efficient for the medical system.

Melanie Cole, MS: What an exciting time in your field, Dr. Godzik. As we're speaking to other providers, and this is relatively new in the world of spine surgery, tell us a little bit about the learning curve involved and technical considerations for other providers. How much does the experience of the surgeon matter for these advanced techniques?

Dr. Jakub Godzik: That's a great question. I think that, The learning curve is quite steep. and I always tell people that, when we just started using robotics, at least in my training program, and we're using a new system after our 30 cases, we put a scientific seminar and a talk together, and my title was, how to increase the stress of an operation and increase the surgical time by about two hours, for the price of a million dollar robot. But that's changed with the experience we've gotten a lot better.

And so I think that, using robotic techniques doesn't revolutionize what we do, but what it allows us to do, especially an experienced surgeon or experienced team, it can really make surgery just much more consistent. It can help, do more complex surgeries with smaller, potential errors or complications. So it's a very, very powerful tool both in community practice, whether it's a community hospital or whether it's an academic teaching institution.

Of course, surgeon skill and experience, are very, very important. This doesn't eliminate that or doesn't eliminate the need for quality decision making and good judgment, but I think it really does take us and elevate us into another level of performance, and I think that's something that's gonna be here to stay. And I think robotics are only gonna get more and more powerful as we move forward in time.

Melanie Cole, MS: Is there any specific patient selection? I mean, is this for everybody or only a select group of patients that will help to achieve better outcomes when you're using these robotic technology?

Dr. Jakub Godzik: I think that it's pretty wide across the procedures that we do, but it does really, right now what the spine robot, what it allows us to do is really right now just place pedicle screw. So it's really patients who have a need for fusion. So whether it's back pain or, whether it's a fracture, for instance, something like that, that's very amenable to that. It's particularly useful for patients that are a little bit more heavyset because it allows us to really b e very accurate and make smaller incisions, which decreases the, rate of infection. but it's useful across the board for all spine pathologies which is great, for degenerative conditions. It's not so much right now useful for decompressive procedures or anything else like that. It's mainly for the fusion and for the placement of the pedicle screw.

Melanie Cole, MS: So then where do you see it going in the future as it's pretty limited right now for fusion surgery? Where do you see it going or where do you hope it will go so that you can use it more widely in your practice?

Dr. Jakub Godzik: I think the reason that I'm really interested in this and am excited about it, is I think that especially as everything changes, as AI technology becomes more commonplace, as we collect more experience with these more simpler, robotic platforms. I think the future is very much on par with, something out of a movie. Out of like Prometheus where you enter the surgical pod. I mean, that's within the realm of reality, decades and decades from now.

But I think within, my career and within, our lifespan, I think we'll see these robots becoming slightly more, maybe a little bit more autonomous. Maybe it'll encompass a lot more techniques rather than just placing a screw, it might expand the things that we're able to do. Because I think it's all doable and the anatomy is fairly reliable in that regard. I think it'll never eliminate the need for a trained surgeon to be there. At least not within, I think our lifespan. But I think the growth will be very, very rapid in the next coming decades.

And I'm excited to be part of it and I'm excited to see, what we're able to achieve and really more importantly, what we're able to really provide our patients. Maybe again, more reliably and, having more reduced variability of outcomes and even smaller and smaller incisions and more minimally invasive operations. I think all of that is very, close in terms of timing.

Melanie Cole, MS: How exciting. That's really cool information. Dr. Godzik, I hope you'll join us again and update us as things continue to advance. It's such an exciting world of technology in spine surgery and robotics, so please join us again, and thank you so much for being with us today. And that concludes this episode of UAB Med Cast. For updates on the latest medical advancements, breakthroughs, and research, follow us on your social channels. And for more information, you can visit our website at uabmedicine.org/physician. I'm Melanie Cole.