David L. Skaggs, MD, Co-Director of Cedars-Sinai Spine
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This is Carly Beam with the Becker's Spine and Orthopedics Podcast. And today I'm thrilled to be joined by Dr. David Skaggs, co-director of Cedars-Sinai Spine. Dr. Skaggs, thank you so much for being here today.
Hello. Thanks for having me. Love Becker's. Love keeping up with what's new in spine.
Thank you. I'm glad to hear it. And before we dive into our questions, can you introduce yourself and tell us a bit about your background?
Sure, absolutely. I'm now the co-director of spine at Cedars-Sinai, along with Dr. Alex Tuchman, who's the neurosurgical co-director. We probably have about 30 spine surgeons here. We run seven or eight spine rooms a day and believe very deeply that a combination of neurosurgeons and orthopedic surgeons working together deliver the best spine care. I was here for five years. Before that, I was at Children's Hospital Los Angeles for 25 years. It's been very invigorating and eye-opening to come to an adult spine center and honestly learn about some of what we're going to talk about today, new technology and how we could make spine care better for children with new technology.
Absolutely. I know you have a lot of expertise in pediatric spine area as well. Can you go through some of the biggest innovations that you've seen develop in the last few years?
What is Dr. David Skaggs' background in spine care?
Yeah, so one of the biggest is just happening right now. It is getting a synthetic CT from an MRI. And it's probably most important in children because children are most susceptible to radiation. And what it is, it's one of the few things I've seen in medicine where AI actually makes a difference, you know, in practical terms. And now what happens is when we get an MRI, a CT comes out. In addition, really just doing one quick sequence might take a few minutes longer, and you can get an amazing quality CT that's accurate to within one millimeter, including three-dimensional reconstructions. So for pediatrics, what this does is save children from unnecessary radiation. But if we think bigger picture in adult spine, what it could also do is save people from getting two studies.
So instead of someone being sent for an MRI and at a separate time being sent for a CT, it could all be done at once.
So it sounds like it's a real win-win both for children and adults as well. Yeah.
And if you don't mind, there's even more to this one. One of the biggest advances, you know, in the past decade or so in spine surgery has been using navigation intraoperatively and robotics intraoperatively. And up until now, that has required a CT scan. And now we can use this synthetic CT, the proprietary name right now is called bone MRI. We can load that up into navigation and or robotics. And all of a sudden we don't radiate the patient at any point for navigation or robotic usage, which is a complete game changer.
Yeah. And I'm wondering, you know, when working with pediatric patients are obviously smaller patients that are also still growing. What kind of developments are you excited about in terms of just having tools or navigation technologies that are tailored to them?
Yes. Great question. So, you know, I have to admit, I never even saw a robot until I came to Cedars. And next thing you know, I'm really just trying to meet my colleagues and go into the rooms and seeing, wow, they're doing incredible surgery through tiny incisions. And one of my partners, Dr. Corey Walker, who was trained at Barrow Institute with Juan Uribe, taught me how to use a robot. And in Young athletes and I'll say kids in college and high school, they frequently have something called spondylolisis, which basically means it's a fracture most commonly of L5. In the old days to fix this, you had to open them up and put in screws and rods and hooks. Now with the use of a robot, we could literally make a two centimeter incision or even less and put a screw or screws perfectly across the fracture site.
And I never, you know, back in my days at Children's Hospital, imagine I'd be doing outpatient pediatric spine surgery, but the use of robotics and navigation have really changed what we can do.
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