Carl (Host): Welcome to Health Talk presented by the Valley Health System. I'm Carl Maronich, and joining me is Dr. Kevin Sharif from the Valley Health System. And today we'll be talking about endoscopic and robotic spine surgeries. We'll discuss how these innovative techniques are revolutionizing spine care by reducing recovery times, and enhancing patient outcomes.

Dr. Sharif, welcome to the podcast.

Kevin R. Sharif, MD: Thank you.

Carl (Host): Maybe we could start by talking and explaining just what is endoscopic spine surgery and how does it differ from traditional spine surgery?

Kevin R. Sharif, MD: Sure. you've probably heard, and people hear about minimally invasive spine surgery, so making smaller incisions and doing a surgery that can get someone better with a quicker recovery. But endoscopic spine surgery is different. Endoscopic spine surgery. Ultra minimally invasive surgery. I can make an eight millimeter incision. We're talking about an incision that's smaller than a dime, And then using a tube the size of a straw.

I can place a camera down into the spine. I can localize bone spurs or disc that may be pinching a nerve causing sciatica, and I can remove them without removing bone. Without cutting any major muscle and just leaving the anatomy intact. So it's like sneaking in, sneaking out, taking care of the problem.

when I talk about these, uh, surgeries to my patient's, kind of explain it as like Navy Seal, Sneaking in, to where the bad guys are taking out the target, no collateral damage. it's interesting, you know, when it comes to spine surgery, traditionally patient's think they're gonna have this big surgery with a lot of recovery.

but for problems that can be handled with the endoscope, that's just not the case. here's a good analogy for you. Imagine you locked your keys in your car. Traditional open surgery is like taking a break, smashing the window to get the keys out, The job gets done, but then you broke the window.

You gotta fix the window. You got a big mess. Endoscopic spine surgery, like a locksmith. Sneak in, pick the lock, get the keys out, take the pressure off the nerve, sneak out. Door's intact. Window is perfect. No mess.

Carl (Host): Very stealth, So that has to have a huge impact on recovery and ability following the procedures in terms of what patient's are able to do.

Kevin R. Sharif, MD: Absolutely. Absolutely. And that's, that's where it really shines. I mean, the reason I started doing this surgery is because, I had heard about it. this takes additional training. This is not something that you pick up during your fellowship training. At residency. spine surgeons that do this, and there's not many of us, across the nation that are doing it.

But the ones that have, seek additional training. And I happened to run into someone that was, he's a world-renowned surgeon. ran to him at a conference. He was talking about this. He was so enthusiastic about this type of approach to spine surgery. I started talking to him afterwards about it.

he's in California. he invited me to come Watch him do this surgery essentially. I was a little skeptical at first. but then being there and seeing how he was able to take care of these problems and very stuff like as you said, just getting in and getting down and getting the job done, I thought to myself, if I have a spine problem.

And it can be fixed with a endoscope. That's the kind of surgery that I want for myself. So I decided to do some extra training. I worked with him. I went to a bunch of labs. I learned how to do these techniques, now I've brought them back to the valley and I'm just glad I could be able to offer this type of high quality spine, care, uh, to my patient's.

Carl (Host): Yeah. Wonderful. And doctor, let's talk a little bit about endoscopic surgery and robotic surgery and how and where those, two things meet.

Kevin R. Sharif, MD: So I'm actually the surgeon that, really was a proponent of getting the robot here at Henderson Hospital. this was about five years ago. And one thing that I saw, I've been in practice almost 10 years. I actually, was one of the first spine surgeons to work at Henderson Hospital when it opened up 10 years ago.

And one thing I saw in the valley, just in general was a lack of the most cutting-edge spine technology. And I kind of made a priority in mind to work with the CEO that we could bring some of this high tech, spine technology. To the valley to better care for our patient's.

So about three or four years after I started, we started talking about it And we were talking about spine navigation and things like that. But then when I, got privy to the robot, I thought the robot would be, Best step for the hospital to take. So about five years ago, we were able to acquire the Medtronic Missouri X stealth edition.

one of the best robots in the market, the best in, in my opinion, on the market. And this robot doesn't actually do the surgery. You have to think about the robot as more like an assistant in the surgery. it makes the surgeon. Like Robocop, if you will, So, It helps us place the implants with precision and accuracy it's just about consistency and just, better patient safety.

and that's what it really helps and it benefits And also it helps with minimally invasive spine surgery using the robot. Because the robot shows us where the anatomy is on a computer screen. It's almost like using a, your GPS in your car, your navigation, so we can make smaller incisions and put these implants exactly where they need to be without exposing all the anatomy.

Carl (Host): so post-surgery, via these instruments endoscopic, the robotic, the mobility a patient will have and And the, And the, the activity they're able to participate in following the surgery. Is that impacted by this technology?

Kevin R. Sharif, MD: that's what it's all about. It's about the outcomes, It's about how the patient does after surgery and with endoscopic spine surgery. I'll talk about that. first. Then we get into robotics, endoscopic. These patient's leave the hospital the same-day. my first case that I did endoscopically and I called the patient the next day.

I'm very into each and every outcome for my patient. So I happened to call this gentleman the next day. I wanna know how he did. It's my first one that I had done. I trained to do it. I knew I could do it, but he was my first patient and I told him that before the surgery.

and I called him the next day And the first thing he said to me was, This is weird. This is, I really didn't expect this. And I'm thinking like, okay, what's wrong? And he says, Guess what? I don't have any pain. Is that normal? I mean, my leg pain's gone, but I don't really even feel like I have had any back surgery.

My back feels a little tighter, but there's no pain. Especially with endoscopic spine surgery, most patient's do not have much pain after surgery at all. they don't take opioids, so they're not taking Percocet or hydrocodone and all those things that you would think a spine patient's, may take after surgery.

Sometimes they take a little Tylenol and that's really all they need, and most of 'em are back at work the following week.

Carl (Host): Amazing. are all patient's candidates for these kinds of surgeries or, they better suited to some patient's, over other's?

Kevin R. Sharif, MD: Yeah, it's all dictated by the problem, Some problems respond very well to endoscopic spine surgery. Other problems may respond better to other types of surgery. For me, I am a minimally invasive surgeon, so I offer minimally invasive options to my patient's. Sometimes that's endoscopic spine surgery, sometimes that's robotic surgery where we do fusions and use implants to help the patient get better.

But even with robotics, what I've seen is patient's get better faster. We're using smaller incisions, less impact on the patient and greater precision. So, a lot of patient's with a traditional fusion that's not done minimally invasive, they'll be in the hospital for three or four days while the majority of my patient's are discharged within 23 hours.

Carl (Host): Wow, amazing. motion preservation. That's, something that, as you said a little bit earlier, it's all about, the outcomes. you addressed pain, but in terms of, motion, following surgery, getting back to activities people enjoy, talk a little bit about that.

Kevin R. Sharif, MD: Yeah, so That is something else that endoscopic spine surgery allows us to do. There are certain problems that actually need a fusion. The spine needs to be stabilized, it needs that type of support, but there's other problems where the spine doesn't actually need to be fused. But the reason we have to fuse it is because we have to remove so much bone and just.

Change the anatomy so much that it would destabilize a spine and cause a further problem down the road. But with some problems and some pathology, what we call it, we can do an endoscopic surgery instead of doing a fusion. So a patient that may have required, a fusion, which would've decreased their range of motion and could lead to other problems down the road, we can do an endoscopic spine surgery and preserve their motion.

And they don't need a fusion anymore.

Carl (Host): talk a little bit about the pathway that patient's may go through to end up with you. I mean, if I'm feeling, I have some back pain, my first thought isn't to go to a surgeon, probably maybe my primary care provider, but talk a little bit about those who are suffering from back pain or some issues.

What, the pathway is to, getting cured.

Kevin R. Sharif, MD: most of my patient's are referred by a primary care doctor or a pain management doctor. So typically a patient will have a problem, they'll see their primary care doctor, they'll probably be sent to physical therapy. It depends. Just, based on the problem and, and maybe sometimes the x-rays or MRIs, after physical therapy, if that doesn't work, they may be sent to pain management or they could be sent to me.

Most of my patient's see me before pain management physicians sees them and try some injections, but some get injections before they come and see me. And then when I evaluate them, my goal is to help. Each and every patient avoid surgery if they can. I'm a surgeon, but if you can get better without surgery, that's definitely the way to go.

So we try non-surgical things. sometimes that's, anti-inflammatory medicines. Sometimes it's physical therapy, other times it may be injections. And then if nothing's working And the problem is, correctable with surgery, then surgery is offered.

Carl (Host): Are there different conditions that may impact the spine that, would require surgical or, or some other intervention, as opposed to trauma? Are there other conditions that could cause a patient to need some spine care?

Kevin R. Sharif, MD: Sure. those conditions are typically degenerative in nature. they could be congenital, or it could be deformity like, scoliosis. So Those are all conditions that I treat. I really treat all aspects of spine care. my training is a little bit different than most spine surgeons. so there's two schools of, spine surgery.

You could think of it that way. Like two teams. You have the neurosurgeons And then you have the orthopedic spine surgeons. I'm my orthopedic spine surgeon. However, my training was not just with orthopedic spine surgeons, it was with neurosurgeons as well. I trained at the Leatherman Spine Institute. it's one of the oldest spine fellowships in the country.

And during that fellowship, you not only work with orthopedic spine surgeons, you work with neurosurgeons as well. It's about 50 50. So I really feel like in my training I was able to get the best of both worlds, And this dual training allows me to see the full picture for my patient's, understanding the biomechanics of the spine And also the neurology and how the nerves affect pain.

Carl (Host): we talked about the faster recovery times and all the benefits, but are there risks associated with these surgical methods that patient's should be aware of?

Kevin R. Sharif, MD: Absolutely. I think that anything you do in life there's always risks and there's definitely risk for surgery And we do not take those risks lightly. however, with robotics. With AI planning that we are able to do, we can develop a blueprint for surgery. We go into surgery like building a custom home.

We're, we're trying to get the patient right, but we, we have a plan going in because we can use AI planning in the robot. So, you wouldn't just start, building a home by just hammering without a blueprint. Right? So the ai, technology that we use with the robot allows us to plan the entire surgery on the computer before I even enter the operating room.

So I know exactly where the implant's gonna be, but not only that, the AI has a predictive quality as well, where we can predict, how much we can correct the deformity, correct the alignment, decompress the nerves to really try to give patient's a predictable outcome. So I think spine surgery is actually getting safer.

Spine surgery in 2026 is safer than it's ever been before.

Carl (Host): prior to a procedure, what kind of education does a patient go through to make sure you their expectations are set and they know what's gonna be happening?

Kevin R. Sharif, MD: So, I see patient's multiple times, before surgery, unless it's some kind of emergency condition, right? if they broke their back and they're in, the trauma hospital, uh, things are a little bit different. but typically, especially with degenerative conditions, I see 'em in, in my office several times And that first appointment is kind of getting to know them.

I wanna know what's going on. I, I wanna know, how This is affecting your, your life. go over the MRI with them. I, I tell them exactly what's going on. I point out the findings on the MRI and walk them through it. And then if surgery is the direction that we're headed in, I explain that surgery in detail, the risks, the benefits, possible complications, And then their prognosis.

will there be any effects down the road because I have this surgery, that's really important to me as well. And then we have to send 'em for testing. We wanna make sure that our patient's are healthy enough for surgery. so we send 'em for, testing with, their primary care doctor or any specialist they may see.

And then what's very important to me, and I have every patient come back and see me about two weeks before surgery. I wanna know if their symptoms have changed. I wanna be able to answer any questions that they have to make sure we're on the same page going into surgery.

Carl (Host): Doctor, you mentioned In 2026 spine surgery's safer than it's ever been. do you see in the future for spine surgery?

Kevin R. Sharif, MD: It's a great question. I'm really excited about the direction spine surgery is headed. we're using robotics. We're using ai. I think that's going to continue to grow. I think we're gonna see, some big breakthroughs in the next five to 10 years. Augmented reality is something that's being used now and I think we'll be using it more.

it's kind of like, a fighter pilot with a heads up display in their helmet. And these ar glasses can help you look directly into the patient and see a digital overlay of their spine and nerves so you can see where everything is. It's like giving the surgeon x-ray vision.

Then there's, uh, patient specific implants. So right now we use implants and there's, there's several sizes of different implants that we can use, but the concept is that we can use 3D printing to make our implants. Tailor made so they're not just off the shelf. So instead of, buying a suit off the rack, you got one that's tailor made for you based on your anatomy and maybe even based on the quality of your bone.

So the implant matches the bone better, for a better outcome. And I think the AI's gonna help us as well.

Carl (Host): you mentioned earlier that the robot doesn't do the surgery. You do, but you're aided by that and all the things you just mentioned. I think probably fall in that same category they're not gonna be doing these things, but there are tools that you're gonna be able to use to make all this better for the patient.

Kevin R. Sharif, MD: Sure. Absolutely. Absolutely. one more thing that, I'm really excited about in spine surgery outside of actual doing surgery on patient's, I really feel that biologics and regenerative medicine is really gonna explode. Over the next 10 years, we're learning so much about stem cells and biologics that we can use to maybe heal a disc or maybe regrow healthy tissue.

So maybe at some points for some of these conditions, we don't have to operate at all, and that's the future we're really striving for.

Carl (Host): that's exciting stuff. Dr. Kevin Sharif, orthopedic Spine Surgeon, a lot of great information today about spine surgery. We really appreciate your time.

Kevin R. Sharif, MD: Thank you so much.

Carl (Host): For more information, visit Valley health system lv.com. If you enjoyed this podcast, please share it on your social channels and check out our entire podcast library. For topics of interest, I'm Carl Moroni and This is Health Talk presented by the Valley Health System. Thanks for listening.

uhsv020_Carl_Disclaimer: Physicians

are independent practitioners who are not employees or agents of the Valley Health System. The system shall not be liable for actions or treatments provided by physicians.

uhsv020 retrack: Individual results may vary. There are risks with any surgical procedure. Talk with your doctor about these risks to find out if minimally invasive or robotic surgery is right for you.