Five Questions With: Dr. John K. Czerwein Jr.

In April, University Orthopedics spine surgeon Dr. John K. Czerwein Jr., who specializes in minimally invasive spine surgery, used a new type of technology as an assistant in the operating room.

Czerwein discusses the ExcelsiusGPS, a robot that provides clear imaging of patients’ anatomies during procedures and helps surgeons with precise placement of spine implants.

PBN: What was the operation that you performed using the ExcelsiusGPS, and how did it differ from how the procedure has been traditionally done?

CZERWEIN: The first procedure that I performed using the ExcelsiusGPS was a lateral lumbar interbody fusion with percutaneous posterior instrumentation. What does that mean in layman terms? I entered the body through the side, fusing two disc spaces and then from the back the robot was utilized to place the screws and rods.

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As I had successfully performed this procedure many times in the past, I felt the patient was a good candidate for use of the robot. I was able to utilize the technology that assists in accurately placing the hardware in the correct position in the spine. One advantage to the robot is the planning we do before the surgery. The patient has a CAT scan before the surgery, which I use to plan the exact hardware that will be used during the surgery.

This planning allows me to plan within millimeters of what will best suit the patient. I always use the analogy that it’s like having a rear-view camera in the car that helps you back up instead of just having a rear-view camera. The additional information leads to more accurate overall surgery.

PBN: What does the use of technology like this mean for patients who need spine surgery?

CZERWEIN: As a doctor that already focuses on minimally invasive spine surgery, this is another tool at my disposal to expand on the types of procedures I perform. Patients love to hear the word robot. The most important thing is that minimally invasive surgery helps them recover quicker and usually in the comfort of their own home, as most go home the same day.

Current patients that have had minimally invasive surgery do very well. This technology allows me to further perfect my craft while expanding the portfolio of cases that can be performed with minimal soft tissue dissection.

PBN: Is the use of this machine limited to spine surgery, and how do you determine which patients that it is appropriate for?

CZERWEIN: Currently the ExcelsiusGPS is designed specifically for spine patients. However, there are other technologies being built for additional specialties. The right patient is determined by their symptoms, overall health and procedure that is required.

PBN: How much training did you need to complete before being able to use the ExcelsiusGPS?

CZERWEIN: Globus, the developer of the ExcelsiusGPS, requires physicians to take a certification training course, taught by a certified teacher. Also, a surgeon already using the technology proctored me for my first few cases in the operating room.

PBN: Do you have your eye on any other technology that promises to streamline minimally invasive surgery even further?

CZERWEIN: Not at this time, but as technology evolves, it’s important to look at the benefits of every option. In spine surgery, it’s so important to provide patients with options that meet the needs of their symptoms, help them alleviate those symptoms and recover safely and quickly. This will allow them to get back to normal and live their best life.

Elizabeth Graham is a PBN contributing writer.