Spine surgeons Ryan Farmer, MD, and Lawrence Haber, MD, are pioneers in their state.
The two performed a spine surgery using the ExcelsiusGPS robot at New Orleans-based Ochsner Children’s Hospital in August, a first for the state.
Additional pediatric patients have been treated with the robot for routine and complex cases since the initial surgery, Dr. Farmer said.
Robot-assisted spine surgery has been in place for adult patients at Ochsner, Dr. Haber said. When adopting robotic spine surgery in younger patients, one major consideration was top of mind.
“The biggest issue for us is always making sure that we’re minimizing the radiation patients recieve,” Dr. Haber said. “We’re always making sure that we’re using the lowest radiation settings possible. That’s important for anybody, but it’s most important for children that have the rest of their lives to live. We’re still working on improving our workflow, just like with any new technology. We certainly are beneficiaries of people who’ve done the work before us within our system to make a smooth transition into the pediatric world.”
Dr. Haber said radiation settings have been the most significant workflow challenge. When working with pediatric patients, spinal deformities often occur on multiple planes compared to adults, which Dr. Haber said pushes the demands of the robots.
But the future is bright for spine robots, especially as artificial intelligence becomes more integrated.
“Having a real time understanding of correction and what it is that we’re able to do to improve the balance and to improve the deformity in our patients is going to be huge,” Dr. Farmer said. We take some fluoroscopy images in the operating room, and from that we’re able to hypothesize what these folks are going to look like when they’re actually standing up or sitting. So having an AI involved in really high fidelity imaging within the operating room that can provide us with real time assessments of their overall balance is going to be a huge advantage. Moving forward we’ll be able to really dial in and fine tune the correction that we’re able to obtain in our patients.”
Along with robotics, Dr. Farmer and Dr. Haber take care of all aspects of spine care from complex fusions, nonsurgical care and vertebral body tethering.
“We’re the only center in the multi-state regions that perform vertebral body tethering,” Dr. Haber said.
Another strength is in patient safety outcomes. For example, surgical site rates have been low with Dr. Haber’s initiatives in perioperative antibiotics care, Dr. Farmer said. And with the robot, pedicle screw placement has been done in a more precise manner.
“We’ve been able to push forward better patient safety and a better overall gestalt on what it is that we’re doing in the operating room to allow for better patient safety and better outcomes,” Dr. Farmer said. “We’re continuing that trend and being able to embrace new technologies as they come, to be able to trial them. It’s definitely a testament to the Ochsner system that they not only allow, but encourage it so that we can continue to provide the highest level of patient care in the region.”
