Robotic-assisted spinal fusion and emerging trends in outpatient spine surgeries: Q&A with Dr. Richard Chua

Alan Condon -  

Richard Chua, MD, is a board-certified neurosurgeon and fellow of the American College of Surgeons at Northwest NeuroSpecialists in Tucson, Ariz.

Dr. Chua is a founding member of the Society for Minimally Invasive Spine Surgery and an active member of several societies including the American Association of Neurological Surgeons, Congress of Neurological Surgeons and North American Spine Society.

Here, Dr. Chua shares his insight on artificial intelligence, robotic-assisted spinal fusion and the development of outpatient procedures in spine.

Question: How do you see artificial intelligence impacting spine surgery?

Dr. Richard Chua: Although AI in medicine is still in its infancy, I can certainly see how it may impact spine surgery in the future. If we can adopt machine learning and input data into our machines in a highly efficient, safe and effective way, then one can see the possibilities of having robotic-assistance perform not only placement of pedicle screws, but also perform the decompression, prepare interbody spaces for fusion, trial and implant interbody spacers and close wounds. My early experience with robotic-assisted lumbar fusion surgery has been phenomenal and I look forward to the advancement of not only the robotic techniques, but the machine learning and AI applications.

Q: How has your patient population changed over the past five years? How do you expect it to evolve in the future?

RC: The patient population where I practice in Tucson, Ariz., has become much more fit with more active lifestyles and is more prepared to discuss surgical and non-surgical treatments for their condition. With the access to information on the internet, including YouTube videos of surgical procedures and patient-centered blogs, many patients are prepared to ask questions, compare treatment options, and make an informed decision. I anticipate that this will continue in the future. 

Q: How do you see outpatient spine procedures developing in the future?

RC: With continued improvements in minimally invasive techniques, implant design/engineering, preoperative patient education, postoperative rehab and extended recovery after surgery pain management strategies, I see a continual evolution of spine surgeries into the outpatient world. I am now selecting certain patients for outpatient lumbar fusion in the hospital using an extended recovery phase for up to four hours, after their initial recovery room phase. With adequate pain control, early ambulation with physical therapy as well as appropriate patient education and home support, I am hoping to perform up to 25 percent of my single level lumbar fusions on an outpatient basis by the end of the year.

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