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With most spinal surgeons generally specializing in one procedure or the other, Dr. Gallizzi has joined a small and elite group of specialists who have performed 100 or more of both the robotic and endoscopic cases.
The difference in the robotic and endoscopic procedures helps to explain why many surgeons focus on one over the other.
“They are actually diametrically opposite procedures,” explained Dr. Gallizzi. “The robotic surgery is really instrumental in doing minimally invasive spinal fusions. We are able to place hardware with 99-plus percent accuracy and avoid neural structures, as well as adjacent level joints so we don't disturb any of the other parts of the anatomy.
“The endoscopic procedure is typically reserved for decompressions and disc surgery. I also often do a procedure for low back pain. That is called a medial branch transection that eliminates a nerve that causes back pain from back arthritis.”
While the procedures are quite different, Dr. Gallizzi feels equally adept in performing both and explains some of the reasons why one is more prevalent than the other.
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he movement of spine cases to outpatient settings will help drive this change, because [endoscopic spine surgery] is significantly less disruptive. I think quite honestly, once people know it's available, consumers are going to start demanding it. We also need industry support. We need major players in the industry and medical device companies to really step up and start large training programs to get more people interested and get them the skill set. A surgeon doesn’t want to introduce the technology without the right training behind it.
As much as it pains me to say this, continuing education is real, and you have to take time out of your life outside of work and continue to train. What I do is I take personal time away to go learn or train with other surgeons. Surgeons come to visit me and I visit other surgeons. I think really being open-minded and trying to look for different ways to maximize patient outcomes is really important. If you've been doing spine surgery the same way for the last 10 years, I don't think in the future that's going to cut it.
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Also, consider the way you sleep—are you a back sleeper? If so, look for a low-profile pillow (10 centimeters is the optimal loft for back sleepers, Michael Gallizzi, MD, MS, FAAOS, a spine surgeon with OrthoOne at Sky Ridge Medical Center, previously told SELF). Side sleepers should look for a high loft pillow and something that's a little bit more firm.