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All right.

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Welcome to Live Well with UCI Health.

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Welcome to Live Well with UCI Health.

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I am Ryan Manno with

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KOST 103.5 and iHeart Radio.

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Thrilled to be joined today

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by doctor Don Young Park.

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I don't want to mess up

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your title,

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doctor. Director

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of the Advanced Endoscopic

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and Outpatient Spine Program

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here at UCI Health.

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Doctor, thank you so much.

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Well,

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thank you for having me.

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Thank you.

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I really appreciate you.

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Appreciate you.

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It's a pleasure to meet you.

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Tell us about you.

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I know

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I saw Stanford in there. Yes.

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I did my training at Stanford

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in my orthopedic

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surgery residency for spine

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surgery fellowship there.

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Yeah.

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And I know that

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you're one of the

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the leaders

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people call on

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you a lot to

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for your

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you're an opinion leader,

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as they say.

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Yeah. All right.

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Endoscopic spine surgery

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and minimally invasive

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spine surgery.

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So one of my other titles

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is I'm the director

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of the minimally invasive

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spine surgery at UCI Health.

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Yeah.

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How long have you

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been at this in the game?

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13 years now.

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Yeah.

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I graduated,

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fellowship in 2012.

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All right.

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Way to go. And thanks.

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And I know

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there's a couple things

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like you can live with, like,

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if your finger hurts that,

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you know, kind of ruins

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your day for a little bit.

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But like, when you have back

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pain,

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there are a few things

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in life

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that are more debilitating.

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When your back is

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whack like you,

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it throws off everything,

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right? That's correct.

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It really does affect

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everyone's activities.

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Their daily function.

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Yeah. Their enjoyment.

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Yeah.

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The quality of life,

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all of that's affected.

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And a lot of it's

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a lot of people are talking

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about health span.

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I think back

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pain has a lot

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to do with health span.

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Yeah.

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And so,

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if you have

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debilitating back problems,

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then I think that

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it's going

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to completely affect

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your life from,

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beginning to end. In your,

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in your practice,

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in your study,

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with what you do,

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do you find that there's,

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there's something,

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predominant that

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leads to back pain

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injuries.

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Yeah.

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That's one,

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but there's,

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it's, multifactorial.

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So you can have injuries,

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like a sports injury.

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You can have

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genetic predisposition.

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Some people are more

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prone to it.

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It runs

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in families sometimes.

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And then,

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you know,

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I think wear and tear,

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you know,

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what we do to our bodies.

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And so if we're really

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hard on our bodies,

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we put a lot of stress

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and strain

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into our spine and

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and our bodies,

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and it will

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be affected by it. Yeah.

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I've always heard that

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there are a couple things

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you shouldn't skimp out on.

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It's anything

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between you and the ground

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your shoes, your mattress

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and your tires on your car.

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And I bet a bad

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mattress and bad shoes

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if you're like a runner

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or if you're on your feet

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all day, that can,

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over time contribute to some

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some back stuff. Definitely.

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Yeah, definitely.

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One of the things

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I always recommend

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is having really good shoes.

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And I see a lot of

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these new shoes

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and new brands,

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and everyone's

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wearing them now

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because of that,

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you know,

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because it does

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a translate up,

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you know,

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from your feet to your legs

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and to your back. Yeah.

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So, okay,

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by the time someone

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comes to see you

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and they've exhausted all

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options, right.

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For, for treatment

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and surgery

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has been recommended.

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What is your guidance?

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Well, first

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look at the patient

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symptoms. Okay.

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I get good history.

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Understand what happens

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with the patient.

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What have they done?

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Non-surgically to treat it.

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Have they exhausted

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all non-surgical

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treatment options?

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That is reasonable.

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You know, for the patient.

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And many times

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patients have done rounds

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and round and rounds

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of non-surgical treatment

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and they're kind of like,

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this is the last resort,

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which is,

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I think,

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a very reasonable thing

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to think about.

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You know,

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many patients come to me

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and they say,

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you know,

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I wanted to avoid surgery

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like the plague. Sure. Right.

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I never wanted

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spine surgery, ever.

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Yes.

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And, you know,

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when they hear

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about what I do,

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then they're intrigued.

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They're like. Oh.

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And one of the things that

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the patients always tell me

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is that, well,

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I wanted that non

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non-invasive surgery. Yeah.

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I was like

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well that doesn't

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quite make sense.

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But I know what you're

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talking about.

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And what are they

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talking about.

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Yeah they're talking

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about endoscopic

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spine surgery.

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This ultra minimally invasive

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spine surgery that I do.

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Yeah.

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So how does that

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how does that work?

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I mean,

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how minimally are we talking.

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These are millimeters.

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So millimeters

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Ultra minimally invasive

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is the kind of like

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the the next evolution

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of spine surgery.

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So, we've gone

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through this phase.

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When I was in residency

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and fellowship,

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it was minimally invasive,

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was kind of the,

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you know, the big thing.

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Yeah.

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And that's,

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you know,

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incisions of centimeters.

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Sure.

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So maybe 2 or 3cm incision.

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And, you know, it

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does wonders.

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A lot of patients

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do really well from that.

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Yeah.

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But now

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we're talking

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about millimeters okay.

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And so several

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millimeter incision.

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So these are really truly

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small incisions where

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sometimes I can't

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even see the incisions

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on their back.

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Like where did I do surgery?

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And I'm

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embarrassed to say it,

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but they'll

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call me a magician

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because I feel like,

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you know, I'm doing magic,

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but I'm really not.

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I feel like I'm

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sitting with a magician

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right now learning this.

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That's what.

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That's where

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they're calling me.

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And I'm like, no,

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no, I'm not a magician.

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I'm actually doing

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real surgery.

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It's just that

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the technique allows me to do

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the the things that I need

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to do

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to treat the patient

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and undo the pathology

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that's been growing

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for years. Yeah.

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Inside their spine,

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inside their bodies,

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with these tiny incisions.

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So on a very literal level,

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put this in terms for people

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that that aren't in the O.R.

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with you

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and aren't seeing

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what you're doing

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when you make these

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small incisions, then what?

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Like, are you what

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what are you using?

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What are you doing?

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So I put in camera.

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So it's a very now

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we have, like, 4K,

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you know,

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high definition,

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you know,

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TVs everywhere, right?

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Yes.

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And I can put

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in 4K cameras into the spine

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and with an endoscope, it's

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a, you know,

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the one that I use

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is about four millimeters

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in diameter.

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And so then I put

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that into the,

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into the spine.

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And then I'm able

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to visualize the anatomy.

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I can see everything in 4K

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okay. And it's underwater.

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And it's very similar to

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You’re blowing my mind right now.

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You do surgery underwater.

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Yeah. Underwater. All right.

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Sometimes myself,

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with all the water

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that spills on me.

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But then,

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literally underwater

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in the spine.

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You know,

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and it's very similar

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to arthroscopy. So if you do,

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knee surgery or

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shoulder surgery,

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you know, even now,

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hip, hands. Orthopedics is now,

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large part arthroscopic.

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Wow.

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That means you're in the

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in the joints.

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Yeah.

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You're putting a camera

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in the joints.

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Endoscopic

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is putting a camera

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in the body somewhere.

00:06:09:06 - 00:06:09:23
It could be,

00:06:09:23 - 00:06:11:10
you know, in your gut,

00:06:11:10 - 00:06:12:05
but here I'm

00:06:12:05 - 00:06:13:11
doing it in the spine.

00:06:13:11 - 00:06:14:07
And so I put

00:06:14:07 - 00:06:15:19
the camera in the spine,

00:06:15:19 - 00:06:16:10
and then I'm able

00:06:16:10 - 00:06:19:10
to visualize with extreme,

00:06:20:03 - 00:06:22:05
visualization, I can see

00:06:22:05 - 00:06:23:11
really well,

00:06:23:11 - 00:06:24:05
the anatomy,

00:06:24:05 - 00:06:25:14
I can see the nerves.

00:06:25:14 - 00:06:26:04
So it makes me

00:06:26:04 - 00:06:27:11
a safer surgeon.

00:06:27:11 - 00:06:30:11
So I know with, you know,

00:06:30:14 - 00:06:33:14
200 times

00:06:33:17 - 00:06:34:17
magnification.

00:06:34:17 - 00:06:35:04
Yeah.

00:06:35:04 - 00:06:36:07
That,

00:06:36:07 - 00:06:36:13
you know,

00:06:36:13 - 00:06:37:21
that structure

00:06:37:21 - 00:06:39:05
is not to be touched.

00:06:39:05 - 00:06:40:17
I need to be preserving that,

00:06:40:17 - 00:06:41:08
and I can.

00:06:41:08 - 00:06:41:20
It's safe

00:06:41:20 - 00:06:43:18
to do the surgery that I do

00:06:43:18 - 00:06:45:07
to really kind of

00:06:45:07 - 00:06:47:10
decompress or

00:06:47:10 - 00:06:49:09
fix the problems that the

00:06:49:09 - 00:06:50:00
that the spine

00:06:50:00 - 00:06:51:03
is going through. Yeah.

00:06:51:03 - 00:06:51:19
And let's talk

00:06:51:19 - 00:06:52:12
about those problems.

00:06:52:12 - 00:06:53:15
What, what,

00:06:53:15 - 00:06:54:00
you know,

00:06:54:00 - 00:06:54:08
I don't know

00:06:54:08 - 00:06:55:01
about most common,

00:06:55:01 - 00:06:56:16
but what specific?

00:06:56:16 - 00:06:57:10
You know,

00:06:57:10 - 00:06:58:10
spine conditions

00:06:58:10 - 00:06:59:10
can, can be treated

00:06:59:10 - 00:07:00:00
with what you're doing.

00:07:00:00 - 00:07:00:05
Right.

00:07:00:05 - 00:07:01:07
So common things like lumbar

00:07:01:07 - 00:07:02:13
disc herniations. Okay.

00:07:02:13 - 00:07:03:07
Now these are things

00:07:03:07 - 00:07:04:19
that happen to young people.

00:07:04:19 - 00:07:05:11
People, you know,

00:07:05:11 - 00:07:05:19
like,

00:07:05:19 - 00:07:07:11
you know, weightlifters,

00:07:07:11 - 00:07:08:01
football

00:07:08:01 - 00:07:09:12
High School players who,

00:07:09:12 - 00:07:09:18
you know,

00:07:09:18 - 00:07:10:18
are deadlifting and,

00:07:10:18 - 00:07:12:03
and they tweak their back

00:07:12:03 - 00:07:13:13
and get a disc herniation 

00:07:13:13 - 00:07:14:09
These are patients

00:07:14:09 - 00:07:15:16
I see all the time. Yeah.

00:07:15:16 - 00:07:16:15
And then older

00:07:16:15 - 00:07:17:10
patients as well.

00:07:17:10 - 00:07:19:07
So as people age,

00:07:19:07 - 00:07:20:17
their discs degenerate.

00:07:20:17 - 00:07:21:18
The degeneration

00:07:21:18 - 00:07:22:17
causes arthritis.

00:07:22:17 - 00:07:23:21
That arthritis can then lead

00:07:23:21 - 00:07:26:00
to compression of the nerves

00:07:26:00 - 00:07:26:15
and what's called

00:07:26:15 - 00:07:28:00
lumbar stenosis.

00:07:28:00 - 00:07:29:13
That lumbar stenosis can

00:07:29:13 - 00:07:32:11
then lead to symptoms like

00:07:32:11 - 00:07:33:07
pain in their legs,

00:07:33:07 - 00:07:34:14
like sciatica. Yeah.

00:07:34:14 - 00:07:35:05
And that kind

00:07:35:05 - 00:07:36:22
of sciatica pain

00:07:36:22 - 00:07:37:16
can be treated

00:07:37:16 - 00:07:38:20
with this as well.

00:07:38:20 - 00:07:39:11
Other things that I

00:07:39:11 - 00:07:40:07
can treat is

00:07:41:12 - 00:07:42:19
common things like

00:07:42:19 - 00:07:44:07
slippage of the spine

00:07:44:07 - 00:07:46:15
where the spine is unstable

00:07:46:15 - 00:07:48:16
and it slips back and forth

00:07:48:16 - 00:07:50:01
abnormally, abnormally.

00:07:50:01 - 00:07:50:13
And so that's

00:07:50:13 - 00:07:51:19
something that I think,

00:07:51:19 - 00:07:53:07
can be treated as well.

00:07:53:07 - 00:07:54:20
Endoscopically. 

00:07:54:20 - 00:07:55:16
I can even do,

00:07:55:16 - 00:07:56:01
what's called

00:07:56:01 - 00:07:57:22
an endoscopic fusion.

00:07:57:22 - 00:07:59:00
Now,

00:07:59:00 - 00:07:59:15
a lot of people

00:07:59:15 - 00:08:01:01
have this, like, notion

00:08:01:01 - 00:08:02:11
that fusion is all bad.

00:08:02:11 - 00:08:02:22
Yes.

00:08:02:22 - 00:08:03:14
And actually,

00:08:03:14 - 00:08:05:08
if you look at the studies,

00:08:05:08 - 00:08:05:20
the randomized

00:08:05:20 - 00:08:06:14
clinical trials,

00:08:06:14 - 00:08:07:21
the evidence out there,

00:08:07:21 - 00:08:08:13
the best evidence

00:08:08:13 - 00:08:09:17
we have shows

00:08:09:17 - 00:08:11:12
that fusion actually works

00:08:11:12 - 00:08:12:05
really well

00:08:12:05 - 00:08:13:18
for certain things.

00:08:13:18 - 00:08:14:18
And if you apply

00:08:14:18 - 00:08:15:22
in the right way,

00:08:15:22 - 00:08:17:09
then fusion is actually

00:08:17:09 - 00:08:19:08
a very successful surgery

00:08:19:08 - 00:08:19:21
and a very

00:08:19:21 - 00:08:22:01
and it can lead to,

00:08:22:01 - 00:08:23:11
long term success.

00:08:23:11 - 00:08:24:12
What can you tell me

00:08:24:12 - 00:08:25:19
what I've heard this like?

00:08:25:19 - 00:08:26:06
Because I follow

00:08:26:06 - 00:08:26:22
sports a lot. Right.

00:08:26:22 - 00:08:28:04
And you'll hear of athletes

00:08:28:04 - 00:08:29:03
who've gotten, like a C

00:08:29:03 - 00:08:30:06
something fuzed or whatever.

00:08:30:06 - 00:08:31:00
What is actual

00:08:31:00 - 00:08:32:00
what is fusion?

00:08:32:00 - 00:08:33:04
Fusion is when you've

00:08:33:04 - 00:08:34:02
you've fuzed

00:08:34:02 - 00:08:35:05
the bones together.

00:08:35:05 - 00:08:35:10
Okay.

00:08:35:10 - 00:08:37:01
So typically in the spine

00:08:37:01 - 00:08:39:06
you have a vertebra

00:08:39:06 - 00:08:40:05
and a disc. Yes.

00:08:40:05 - 00:08:41:08
And another vertebra.

00:08:41:08 - 00:08:42:04
So there's

00:08:42:04 - 00:08:43:22
the disc in between is

00:08:43:22 - 00:08:44:20
what helps it move.

00:08:44:20 - 00:08:45:17
It's like the cushion

00:08:45:17 - 00:08:47:05
between the bones.

00:08:47:05 - 00:08:48:06
And so,

00:08:48:06 - 00:08:49:00
sometimes

00:08:49:00 - 00:08:51:16
that disc is so degenerated

00:08:51:16 - 00:08:53:06
and so dysfunctional

00:08:53:06 - 00:08:55:03
and it's causing problems

00:08:55:03 - 00:08:57:00
like, say, the inside of it,

00:08:57:00 - 00:08:58:14
you know, imagine like,

00:08:58:14 - 00:09:00:02
the, the, the,

00:09:00:02 - 00:09:00:16
you know, the,

00:09:00:16 - 00:09:02:13
the inside of your tire,

00:09:02:13 - 00:09:03:00
right?

00:09:03:00 - 00:09:04:19
It kind of popped out. Yeah.

00:09:04:19 - 00:09:06:05
So then, it may,

00:09:06:05 - 00:09:06:22
you know,

00:09:06:22 - 00:09:07:14
it can same thing

00:09:07:14 - 00:09:08:14
can happen with your discs

00:09:08:14 - 00:09:10:04
where the inside of your disc

00:09:10:04 - 00:09:11:09
pops out,

00:09:11:09 - 00:09:12:05
and then it can

00:09:12:05 - 00:09:13:20
push on things around it

00:09:13:20 - 00:09:14:10
and around

00:09:14:10 - 00:09:15:18
it is actually sometimes

00:09:15:18 - 00:09:16:13
really important things

00:09:16:13 - 00:09:18:08
like your your nerves. Yeah.

00:09:18:08 - 00:09:19:02
Your spinal cord.

00:09:19:02 - 00:09:19:22
Okay. Things like that.

00:09:19:22 - 00:09:20:20
So just like one thing

00:09:20:20 - 00:09:21:18
leads to another, right.

00:09:21:18 - 00:09:22:10
It's like this

00:09:22:10 - 00:09:23:09
thing is impacting

00:09:23:09 - 00:09:24:05
this other thing and.

00:09:24:05 - 00:09:25:17
Right. Yeah. Right. Right.

00:09:25:17 - 00:09:26:19
And so then you have to

00:09:26:19 - 00:09:27:08
then remove

00:09:27:08 - 00:09:29:06
that dysfunctional disc

00:09:29:06 - 00:09:31:03
and remove the compression.

00:09:31:03 - 00:09:31:10
Sure.

00:09:31:10 - 00:09:31:19
Whatever

00:09:31:19 - 00:09:33:01
it is totally compressed.

00:09:33:01 - 00:09:34:10
So it's a nerve.

00:09:34:10 - 00:09:35:19
If it's the spinal cord

00:09:35:19 - 00:09:36:15
then you remove

00:09:36:15 - 00:09:37:16
that compression

00:09:37:16 - 00:09:38:13
and then you have to

00:09:38:13 - 00:09:39:06
then fill it

00:09:39:06 - 00:09:40:03
with something else.

00:09:40:03 - 00:09:40:13
Yeah.

00:09:40:13 - 00:09:42:04
You have to fill that space

00:09:42:04 - 00:09:44:01
where the disc used to be.

00:09:44:01 - 00:09:44:15
And we have things

00:09:44:15 - 00:09:46:01
like disc replacement,

00:09:46:01 - 00:09:46:18
like an Oreo

00:09:46:18 - 00:09:47:08
without the cream

00:09:47:08 - 00:09:47:16
in the middle.

00:09:47:16 - 00:09:48:05
Right, right,

00:09:48:05 - 00:09:48:19
right, right, right.

00:09:48:19 - 00:09:49:16
And now we're filling it

00:09:49:16 - 00:09:50:05
with what.

00:09:50:05 - 00:09:52:18
Just the other word bone.

00:09:52:18 - 00:09:53:10
Fusing the bone.

00:09:53:10 - 00:09:54:09
So if.

00:09:54:09 - 00:09:54:17
Yeah,

00:09:54:17 - 00:09:55:13
we can't

00:09:55:13 - 00:09:57:02
put in the cream back in.

00:09:57:02 - 00:09:58:19
So that's the hard part.

00:09:58:19 - 00:09:59:08
We're still trying

00:09:59:08 - 00:10:00:01
to figure that out.

00:10:00:01 - 00:10:00:21
Yeah yeah yeah.

00:10:00:21 - 00:10:01:14
But if you

00:10:01:14 - 00:10:02:08
take the cream out.

00:10:02:08 - 00:10:03:18
Okay, you take the disc out,

00:10:03:18 - 00:10:04:11
we have to fill it

00:10:04:11 - 00:10:05:10
with something. Sure.

00:10:05:10 - 00:10:07:01
So then we put in,

00:10:07:01 - 00:10:08:02
like a cage,

00:10:08:02 - 00:10:09:20
like some sort of implant.

00:10:09:20 - 00:10:11:09
A disc replacement sometimes.

00:10:11:09 - 00:10:12:16
So you can do that. Yeah.

00:10:12:16 - 00:10:13:16
And so there's different ways

00:10:13:16 - 00:10:15:10
of treating and addressing

00:10:15:10 - 00:10:16:22
disc pathology. Sure.

00:10:16:22 - 00:10:17:04
Okay.

00:10:17:04 - 00:10:18:10
So with you,

00:10:18:10 - 00:10:19:04
with your magic

00:10:19:04 - 00:10:19:16
that you deal with

00:10:19:16 - 00:10:20:00
in the

00:10:20:00 - 00:10:21:11
millimeters underwater,

00:10:21:11 - 00:10:23:04
what is the

00:10:23:04 - 00:10:24:00
how does this compare

00:10:24:00 - 00:10:24:07
to, let's

00:10:24:07 - 00:10:25:15
say, traditional,

00:10:25:15 - 00:10:26:18
you know, old school

00:10:26:18 - 00:10:28:04
spine surgery or regular?

00:10:28:04 - 00:10:28:16
Regular

00:10:28:16 - 00:10:30:07
not not what you're doing

00:10:30:07 - 00:10:31:14
in terms of recovery. Right.

00:10:31:14 - 00:10:32:08
Because

00:10:32:08 - 00:10:33:07
many, many surgeons,

00:10:33:07 - 00:10:33:22
I say the vast

00:10:33:22 - 00:10:34:16
majority of surgeons

00:10:34:16 - 00:10:35:16
are still doing

00:10:35:16 - 00:10:36:20
traditional surgery

00:10:36:20 - 00:10:37:02
where they're

00:10:37:02 - 00:10:38:00
just like cutting open

00:10:38:00 - 00:10:38:19
the back and stuff. Right.

00:10:38:19 - 00:10:39:20
And that's what it is,

00:10:39:20 - 00:10:40:21
cutting open the back. Yeah.

00:10:40:21 - 00:10:42:11
So you make a big incision,

00:10:42:11 - 00:10:43:20
right. You want how big?

00:10:43:20 - 00:10:44:12
Like typically

00:10:44:12 - 00:10:45:20
it depends and depends

00:10:45:20 - 00:10:47:05
on what you're trying to do.

00:10:47:05 - 00:10:48:00
It could be as big

00:10:48:00 - 00:10:49:12
as you know, your,

00:10:49:12 - 00:10:50:06
your back your

00:10:50:06 - 00:10:51:07
from the top of your back

00:10:51:07 - 00:10:52:09
to the bottom,

00:10:52:09 - 00:10:52:17
you know,

00:10:52:17 - 00:10:54:21
if your back to you may do

00:10:54:21 - 00:10:56:09
scoliosis surgery. Okay.

00:10:56:09 - 00:10:56:20
You know, where

00:10:56:20 - 00:10:57:10
you have to put in

00:10:57:10 - 00:10:58:02
lots of screws

00:10:58:02 - 00:10:58:22
and rods and fuze

00:10:58:22 - 00:11:00:02
all your bones

00:11:00:02 - 00:11:01:06
from the top to the bottom,

00:11:01:06 - 00:11:01:16
for it

00:11:01:16 - 00:11:03:12
could be just in your lumbar.

00:11:03:12 - 00:11:04:16
If it's just in your lumbar,

00:11:04:16 - 00:11:06:02
then it's like it could be,

00:11:06:02 - 00:11:08:00
you know, five, six inches,

00:11:08:00 - 00:11:08:05
you know.

00:11:08:05 - 00:11:09:16
So it still could be a

00:11:09:16 - 00:11:11:02
sizable incision.

00:11:11:02 - 00:11:11:20
It's not the size

00:11:11:20 - 00:11:12:10
of the incision.

00:11:12:10 - 00:11:14:04
That really is the issue,

00:11:14:04 - 00:11:14:20
okay?

00:11:14:20 - 00:11:16:11
It's what you do inside.

00:11:16:11 - 00:11:17:10
So when you do

00:11:17:10 - 00:11:18:13
traditional surgery

00:11:18:13 - 00:11:20:01
you have to make an incision.

00:11:20:01 - 00:11:21:03
Then you have to detach

00:11:21:03 - 00:11:21:22
all the muscles

00:11:21:22 - 00:11:24:03
that are on top of the spine.

00:11:24:03 - 00:11:24:18
Then you have to

00:11:24:18 - 00:11:27:08
then retract those muscles

00:11:27:08 - 00:11:28:02
so that I can see

00:11:28:02 - 00:11:28:21
what's going on. Right.

00:11:28:21 - 00:11:31:04
So traditionally I would use

00:11:31:04 - 00:11:32:23
loops or, you know, those,

00:11:32:23 - 00:11:34:05
magnifying glasses

00:11:34:05 - 00:11:35:11
that you use like surgery.

00:11:35:11 - 00:11:36:04
Yeah.

00:11:36:04 - 00:11:37:17
Or a microscope,

00:11:37:17 - 00:11:38:22
an operating microscope.

00:11:38:22 - 00:11:40:02
But, you know,

00:11:40:02 - 00:11:40:18
you're looking at it

00:11:40:18 - 00:11:41:14
from the outside.

00:11:41:14 - 00:11:42:16
So I'm looking at it

00:11:42:16 - 00:11:43:12
through my lenses.

00:11:43:12 - 00:11:44:15
My eyes are on the outside

00:11:44:15 - 00:11:46:14
looking toward the spine.

00:11:46:14 - 00:11:47:22
And so I need a big incision

00:11:47:22 - 00:11:49:04
to see, like,

00:11:49:04 - 00:11:50:03
I need to know,

00:11:50:03 - 00:11:51:02
like what's what?

00:11:51:02 - 00:11:51:20
Because I don't want to

00:11:51:20 - 00:11:52:13
injure anything.

00:11:52:13 - 00:11:52:21
I don't want to

00:11:52:21 - 00:11:54:00
damage anything.

00:11:54:00 - 00:11:55:10
And so

00:11:55:10 - 00:11:57:13
that retraction of muscles,

00:11:57:13 - 00:11:58:14
it's been shown

00:11:58:14 - 00:12:00:05
that, really does

00:12:00:05 - 00:12:01:22
lead to a lot of,

00:12:01:22 - 00:12:03:01
a lot of issues.

00:12:03:01 - 00:12:03:18
So the muscles

00:12:03:18 - 00:12:04:23
they can die off

00:12:04:23 - 00:12:06:02
because they're denervated.

00:12:06:02 - 00:12:07:07
You basically took

00:12:07:07 - 00:12:07:21
all the nerves

00:12:07:21 - 00:12:09:01
that go to those muscles

00:12:09:01 - 00:12:10:13
and you stripped them off.

00:12:10:13 - 00:12:11:21
You took them off the bone,

00:12:11:21 - 00:12:13:08
and then then you

00:12:13:08 - 00:12:13:23
retract it

00:12:13:23 - 00:12:15:10
under high pressure.

00:12:15:10 - 00:12:17:18
And for an hour 2 or 3 hours.

00:12:17:18 - 00:12:18:07
4 hours.

00:12:18:07 - 00:12:20:06
So then you undo that

00:12:20:06 - 00:12:21:08
and then there's no blood

00:12:21:08 - 00:12:22:10
supply to that muscle.

00:12:22:10 - 00:12:23:16
So those muscles die off.

00:12:23:16 - 00:12:24:21
Yeah. Right.

00:12:24:21 - 00:12:25:17
And then you

00:12:25:17 - 00:12:27:02
sew everything back up

00:12:27:02 - 00:12:28:17
and then over time

00:12:28:17 - 00:12:29:23
what ends up happening

00:12:29:23 - 00:12:30:18
the fusion

00:12:30:18 - 00:12:32:08
say it works great.

00:12:32:08 - 00:12:33:03
It's fuzed,

00:12:33:03 - 00:12:34:22
but the muscles are dead,

00:12:34:22 - 00:12:36:09
the muscles are gone.

00:12:36:09 - 00:12:36:15
Right.

00:12:36:15 - 00:12:37:06
And the muscles are

00:12:37:06 - 00:12:38:17
what you used to stand

00:12:38:17 - 00:12:39:08
and what you use

00:12:39:08 - 00:12:40:04
to change position.

00:12:40:04 - 00:12:40:14
Of course,

00:12:40:14 - 00:12:42:10
lean forward, lean back.

00:12:42:10 - 00:12:43:23
And so because of that,

00:12:43:23 - 00:12:44:17
those muscles are

00:12:44:17 - 00:12:46:00
super important

00:12:46:00 - 00:12:46:20
for your long

00:12:46:20 - 00:12:48:16
term back health.

00:12:48:16 - 00:12:48:21
Right.

00:12:48:21 - 00:12:49:10
And I'm always

00:12:49:10 - 00:12:50:02
telling patients

00:12:50:02 - 00:12:51:05
you need to work on your core

00:12:51:05 - 00:12:52:15
your back muscles,

00:12:52:15 - 00:12:53:15
your leg muscles.

00:12:53:15 - 00:12:54:18
That's the trifecta

00:12:54:18 - 00:12:56:15
for good back health. Yeah.

00:12:56:15 - 00:12:57:18
But if you

00:12:57:18 - 00:12:59:06
remove one of those

00:12:59:06 - 00:13:00:14
then you can really kind

00:13:00:14 - 00:13:01:09
of tip things

00:13:01:09 - 00:13:02:18
over on the balance

00:13:02:18 - 00:13:05:01
in terms of back pain.

00:13:05:01 - 00:13:06:02
So then you can get

00:13:06:02 - 00:13:07:03
what's called chronic back

00:13:07:03 - 00:13:09:01
pain from that,

00:13:09:01 - 00:13:10:11
because your muscles

00:13:10:11 - 00:13:12:08
are atrophied. They're dead.

00:13:12:08 - 00:13:13:08
They're not there anymore

00:13:13:08 - 00:13:14:16
to help you stand.

00:13:14:16 - 00:13:15:01
So that's

00:13:15:01 - 00:13:16:12
one of the big issues of,

00:13:16:12 - 00:13:18:16
conventional spine surgery,

00:13:18:16 - 00:13:20:02
is that you have to

00:13:20:02 - 00:13:21:18
first see everything,

00:13:21:18 - 00:13:22:04
but you have to

00:13:22:04 - 00:13:23:13
retract everything.

00:13:23:13 - 00:13:24:06
So what I do is

00:13:24:06 - 00:13:25:22
I don't do any of that.

00:13:25:22 - 00:13:28:03
I go between the muscles,

00:13:28:03 - 00:13:30:00
the little muscle fibers,

00:13:30:00 - 00:13:31:19
and I don't detach any of it.

00:13:31:19 - 00:13:32:07
I don't

00:13:32:07 - 00:13:32:23
denervate anything.

00:13:32:23 - 00:13:34:02
I don't retract anything.

00:13:34:02 - 00:13:34:16
I don't put anything

00:13:34:16 - 00:13:35:22
under pressure.

00:13:35:22 - 00:13:36:07
And I

00:13:36:07 - 00:13:37:09
create a space

00:13:37:09 - 00:13:38:23
on this over the spine,

00:13:38:23 - 00:13:39:23
and then I fill it

00:13:39:23 - 00:13:41:03
with water. Okay.

00:13:41:03 - 00:13:41:16
And then it's like

00:13:41:16 - 00:13:42:16
a little water bubble.

00:13:42:16 - 00:13:44:04
Yeah, on top of the spine.

00:13:44:04 - 00:13:44:15
But everything's

00:13:44:15 - 00:13:45:09
still intact.

00:13:45:09 - 00:13:46:09
The muscles,

00:13:46:09 - 00:13:47:03
the skin,

00:13:47:03 - 00:13:48:01
everything other than those

00:13:48:01 - 00:13:48:21
little tiny incisions

00:13:48:21 - 00:13:50:08
to to do the,

00:13:50:08 - 00:13:51:21
the actual surgery.

00:13:51:21 - 00:13:53:14
And then inside there,

00:13:53:14 - 00:13:54:11
I put the camera

00:13:54:11 - 00:13:55:13
in that water bubble

00:13:55:13 - 00:13:56:01
and put the

00:13:56:01 - 00:13:56:20
surgical instruments

00:13:56:20 - 00:13:57:14
inside that water

00:13:57:14 - 00:13:58:17
bubble as well.

00:13:58:17 - 00:13:59:11
And then I'm able to

00:13:59:11 - 00:14:00:13
start the surgery,

00:14:00:13 - 00:14:01:11
and I can see

00:14:01:11 - 00:14:02:14
the same kind of anatomy

00:14:02:14 - 00:14:03:05
that I see

00:14:03:05 - 00:14:04:09
when you do it open,

00:14:04:09 - 00:14:05:02
because I've done

00:14:05:02 - 00:14:06:02
all of that.

00:14:06:02 - 00:14:07:08
I've done open surgery,

00:14:07:08 - 00:14:08:01
I've done

00:14:08:01 - 00:14:09:14
minimally invasive surgery,

00:14:09:14 - 00:14:10:15
and I can see it.

00:14:10:15 - 00:14:13:03
But under such good detail

00:14:13:03 - 00:14:14:09
that, you know,

00:14:14:09 - 00:14:15:15
I think that you're able

00:14:15:15 - 00:14:16:18
to really understand

00:14:16:18 - 00:14:18:15
the anatomy quite well,

00:14:18:15 - 00:14:19:23
you know, and,

00:14:19:23 - 00:14:20:06
be able

00:14:20:06 - 00:14:21:06
to accomplish the surgery.

00:14:21:06 - 00:14:21:23
And that's one of the things

00:14:21:23 - 00:14:23:03
people actually ask you.

00:14:23:03 - 00:14:24:01
They're like, well,

00:14:24:01 - 00:14:25:02
with minimally invasive

00:14:25:02 - 00:14:26:01
spine surgery,

00:14:26:01 - 00:14:26:12
you know,

00:14:26:12 - 00:14:27:21
you can't see as well.

00:14:27:21 - 00:14:28:14
And then with ultra

00:14:28:14 - 00:14:29:12
minimally spine surgery,

00:14:29:12 - 00:14:30:12
you can see even.

00:14:30:12 - 00:14:31:10
Yeah, yeah, it's even worse.

00:14:31:10 - 00:14:32:11
Even worse. Yeah.

00:14:32:11 - 00:14:33:18
It's actually not true

00:14:33:18 - 00:14:35:05
because I have this 4K

00:14:35:05 - 00:14:35:20
camera that

00:14:35:20 - 00:14:37:02
I can put inside the spine.

00:14:37:02 - 00:14:37:13
So imagine

00:14:37:13 - 00:14:38:09
the eyes are now

00:14:38:09 - 00:14:39:16
in the spine,

00:14:39:16 - 00:14:40:23
not outside

00:14:40:23 - 00:14:42:09
in the environment.

00:14:42:09 - 00:14:44:09
And so I can wow, see

00:14:44:09 - 00:14:45:13
so much better

00:14:45:13 - 00:14:47:23
than when I could without it.

00:14:47:23 - 00:14:49:05
So so okay, so

00:14:49:05 - 00:14:50:15
what about recovery time

00:14:50:15 - 00:14:51:03
like of you

00:14:51:03 - 00:14:52:22
for your standard, right.

00:14:52:22 - 00:14:54:08
Are they at home that day?

00:14:54:08 - 00:14:54:18
Yeah.

00:14:54:18 - 00:14:55:18
So I am like,

00:14:55:18 - 00:14:56:05
that's why

00:14:56:05 - 00:14:57:05
my program is called

00:14:57:05 - 00:14:58:04
the Endoscopic

00:14:58:04 - 00:14:59:08
and Outpatient Spine program.

00:14:59:08 - 00:15:00:22
So you're combining

00:15:00:22 - 00:15:01:06
the two

00:15:01:06 - 00:15:02:05
so patients can go home

00:15:02:05 - 00:15:02:17
the same day.

00:15:02:17 - 00:15:03:12
And these are patients

00:15:03:12 - 00:15:05:09
that are even older patients,

00:15:05:09 - 00:15:06:11
elderly patients,

00:15:06:11 - 00:15:08:11
you know, that, can go home.

00:15:08:11 - 00:15:09:22
They they're up right away.

00:15:09:22 - 00:15:10:13
Most patients

00:15:10:13 - 00:15:10:20
wake up

00:15:10:20 - 00:15:11:18
from these kinds of surgeries

00:15:11:18 - 00:15:13:16
that I do with no pain,

00:15:13:16 - 00:15:14:05
and then they're able

00:15:14:05 - 00:15:15:05
to walk right away

00:15:15:05 - 00:15:15:21
Like, instantly

00:15:15:21 - 00:15:16:07
they know

00:15:16:07 - 00:15:17:04
they have no more pain.

00:15:17:04 - 00:15:17:14
Right?

00:15:17:14 - 00:15:18:15
I asked them all the time

00:15:18:15 - 00:15:19:10
how much back pain

00:15:19:10 - 00:15:20:07
are you having? Yeah.

00:15:20:07 - 00:15:21:14
Like none. No.

00:15:21:14 - 00:15:22:05
And they're just

00:15:22:05 - 00:15:22:22
kind of surprised

00:15:22:22 - 00:15:23:05
that they're

00:15:23:05 - 00:15:23:20
playing pickleball

00:15:23:20 - 00:15:24:13
that night for.

00:15:24:13 - 00:15:25:15
No, I'm just kidding.

00:15:25:15 - 00:15:26:06
I don't want that.

00:15:26:06 - 00:15:26:21
No. I'm kidding.

00:15:26:21 - 00:15:28:02
In orthopedics,

00:15:28:02 - 00:15:29:23
pickleball is, is it that.

00:15:29:23 - 00:15:30:08
Yes.

00:15:30:08 - 00:15:31:00
It's really

00:15:31:00 - 00:15:32:14
it's one of the things

00:15:32:14 - 00:15:34:06
that helps to stay busy.

00:15:34:06 - 00:15:35:03
Okay.

00:15:35:03 - 00:15:35:08
Yeah.

00:15:35:08 - 00:15:36:13
And, I wouldn't

00:15:36:13 - 00:15:37:11
want them to play pickleball

00:15:37:11 - 00:15:38:01
right away.

00:15:38:01 - 00:15:40:00
Yeah, that is fascinating.

00:15:40:00 - 00:15:41:10
You're shedding light.

00:15:41:10 - 00:15:42:04
Okay, so.

00:15:42:04 - 00:15:43:05
So let's go back to this,

00:15:43:05 - 00:15:44:11
like, eyes inside the spine,

00:15:44:11 - 00:15:44:23
because there's something

00:15:44:23 - 00:15:45:05
you do,

00:15:45:05 - 00:15:46:02
and I really want to geek out

00:15:46:02 - 00:15:47:07
with you over this.

00:15:47:07 - 00:15:49:12
You have you wear

00:15:49:12 - 00:15:50:18
or you have worn

00:15:50:18 - 00:15:52:02
an AR augmented

00:15:52:02 - 00:15:53:13
reality headset

00:15:53:13 - 00:15:54:10
to do your surgery.

00:15:54:10 - 00:15:54:17
That's right.

00:15:54:17 - 00:15:55:15
And it was a first.

00:15:55:15 - 00:15:56:21
It's a first.

00:15:56:21 - 00:15:57:16
So I did the first

00:15:57:16 - 00:15:58:14
in the United States

00:15:58:14 - 00:15:59:09
I did unbelievable

00:15:59:09 - 00:16:00:10
in terms of the

00:16:00:10 - 00:16:02:03
the using the augmented

00:16:02:03 - 00:16:04:03
reality glasses.

00:16:04:03 - 00:16:04:17
For the

00:16:04:17 - 00:16:05:20
endoscopic spine surgery.

00:16:05:20 - 00:16:06:07
Yes.

00:16:06:07 - 00:16:08:02
And I did the first

00:16:08:02 - 00:16:12:13
AR guided fusion in the world.

00:16:12:13 - 00:16:13:23
And so that's where,

00:16:13:23 - 00:16:15:09
you know, it's really been,

00:16:15:09 - 00:16:16:22
a game changer for me.

00:16:16:22 - 00:16:17:17
And the reason is it's

00:16:17:17 - 00:16:20:01
like having a really enhanced

00:16:20:01 - 00:16:21:13
virtual view

00:16:21:13 - 00:16:22:20
of what's happening. Right?

00:16:22:20 - 00:16:25:16
It has the ability

00:16:25:16 - 00:16:27:12
to capture my environment,

00:16:27:12 - 00:16:30:12
as well as have large videos,

00:16:31:06 - 00:16:31:22
in front of you.

00:16:31:22 - 00:16:33:01
So it's like having

00:16:33:01 - 00:16:36:06
a 100 inch TV monitor

00:16:36:19 - 00:16:37:11
right in front of me.

00:16:37:11 - 00:16:38:06
Virtually.

00:16:38:06 - 00:16:38:14
Yeah,

00:16:38:14 - 00:16:39:19
but with 4K

00:16:39:19 - 00:16:42:08
and there's 4K and each eye,

00:16:42:08 - 00:16:43:19
so then I can see

00:16:43:19 - 00:16:44:16
so much better.

00:16:45:22 - 00:16:46:17
You know, because the

00:16:46:17 - 00:16:48:23
screen is so large. Yeah.

00:16:48:23 - 00:16:49:09
And what's

00:16:49:09 - 00:16:50:10
great about it, too,

00:16:50:10 - 00:16:51:02
is that

00:16:51:02 - 00:16:52:09
I can also put in

00:16:52:09 - 00:16:53:22
other things like the,

00:16:53:22 - 00:16:55:06
the medical record.

00:16:55:06 - 00:16:56:09
I can virtually place it

00:16:56:09 - 00:16:56:13
there.

00:16:56:13 - 00:16:58:01
I can place the,

00:16:58:01 - 00:17:00:08
the pre-operative MRI,

00:17:00:08 - 00:17:01:00
put it next to me

00:17:01:00 - 00:17:01:13
in the headset

00:17:01:13 - 00:17:03:00
so I can just look around

00:17:03:00 - 00:17:04:01
and see, oh,

00:17:04:01 - 00:17:04:11
there's the

00:17:04:11 - 00:17:06:03
endoscopic video. Okay.

00:17:06:03 - 00:17:06:14
What was it

00:17:06:14 - 00:17:07:11
about that patient

00:17:07:11 - 00:17:08:22
that then you can then

00:17:08:22 - 00:17:10:02
what was the MRI look like?

00:17:10:02 - 00:17:11:06
I can look over here

00:17:11:06 - 00:17:12:01
and so you can see

00:17:12:01 - 00:17:13:10
all of that

00:17:13:10 - 00:17:14:10
right away,

00:17:14:10 - 00:17:14:17
you know,

00:17:14:17 - 00:17:15:08
and so

00:17:15:08 - 00:17:17:11
the information that data

00:17:17:11 - 00:17:19:04
is at your fingertips. Yeah.

00:17:19:04 - 00:17:20:13
And or literally

00:17:20:13 - 00:17:22:04
in front of my eyes

00:17:22:04 - 00:17:22:19
and I don't,

00:17:22:19 - 00:17:23:05
you know,

00:17:23:05 - 00:17:24:10
what I had to do before

00:17:24:10 - 00:17:25:13
if I had a question

00:17:25:13 - 00:17:26:00
about something like,

00:17:26:00 - 00:17:26:16
oh, I don't really know

00:17:26:16 - 00:17:27:09
what's going on.

00:17:27:09 - 00:17:28:09
Like, you know,

00:17:28:09 - 00:17:29:01
I'd have to

00:17:29:01 - 00:17:30:12
step away from the patient,

00:17:30:12 - 00:17:31:17
go to the nurse's station.

00:17:31:17 - 00:17:34:00
Yes. Look at the computer.

00:17:34:00 - 00:17:36:05
Hopefully it didn't log off

00:17:36:05 - 00:17:36:21
long back.

00:17:36:21 - 00:17:38:03
Yeah, yeah, yeah,

00:17:38:03 - 00:17:39:00
because I'm scrubbed in.

00:17:39:00 - 00:17:39:03
Yeah.

00:17:39:03 - 00:17:39:14
Of course

00:17:39:14 - 00:17:41:17
I have to log back in somehow

00:17:41:17 - 00:17:42:07
and then look

00:17:42:07 - 00:17:43:05
for that information.

00:17:43:05 - 00:17:44:09
Whereas now

00:17:44:09 - 00:17:45:20
I'm still doing surgery

00:17:45:20 - 00:17:46:15
and I'm looking around

00:17:46:15 - 00:17:47:16
at that information,

00:17:47:16 - 00:17:48:03
so it makes me

00:17:48:03 - 00:17:48:18
more efficient.

00:17:48:18 - 00:17:49:23
It makes me safer.

00:17:49:23 - 00:17:50:08
Yeah.

00:17:50:08 - 00:17:52:01
I think that's the future

00:17:52:01 - 00:17:52:20
part of the future of

00:17:52:20 - 00:17:54:23
of spine surgery and surgery

00:17:54:23 - 00:17:57:05
I think, in general,

00:17:57:05 - 00:17:58:10
is this augmented reality.

00:17:58:11 - 00:17:59:11
Are people coming to you

00:17:59:11 - 00:18:01:04
now asking for this?

00:18:01:04 - 00:18:01:20
be people.

00:18:01:20 - 00:18:02:20
Obviously they would want this.

00:18:02:20 - 00:18:03:17
Yeah. We have surgeons,

00:18:03:17 - 00:18:04:17
you know, from Taiwan,

00:18:04:17 - 00:18:06:10
from Korea, from China.

00:18:06:10 - 00:18:07:11
They're they're asking me,

00:18:07:11 - 00:18:08:15
how did you do that? Yeah.

00:18:08:15 - 00:18:09:10
How are you doing

00:18:09:10 - 00:18:10:21
this? From Japan.

00:18:10:21 - 00:18:12:02
And so then I'm showing them

00:18:12:02 - 00:18:12:19
how they do it.

00:18:12:19 - 00:18:14:08
And then I think it's it's

00:18:14:08 - 00:18:16:11
growing slowly.

00:18:16:11 - 00:18:17:05
So we'll see.

00:18:17:05 - 00:18:17:15
You know,

00:18:17:15 - 00:18:19:03
I think there's still a lot

00:18:19:03 - 00:18:20:15
that needs to be done

00:18:20:15 - 00:18:22:03
in this space.

00:18:22:03 - 00:18:22:11
You know,

00:18:22:11 - 00:18:23:19
it needs to be lighter.

00:18:23:19 - 00:18:24:11
Lighter?

00:18:24:11 - 00:18:25:03
What do you mean by that?

00:18:25:03 - 00:18:25:23
The headset.

00:18:25:23 - 00:18:27:04
Oh, the the actual headset.

00:18:27:04 - 00:18:27:17
The actual headset

00:18:27:17 - 00:18:28:11
needs to be lighter.

00:18:28:11 - 00:18:28:18
Okay?

00:18:28:18 - 00:18:29:20
It needs to be faster

00:18:29:20 - 00:18:30:15
So that's AR.

00:18:30:15 - 00:18:31:01
What a

00:18:31:01 - 00:18:31:18
How do you feel about

00:18:31:18 - 00:18:33:02
AI in the future of AI

00:18:33:02 - 00:18:34:07
for what it is that you do?

00:18:34:07 - 00:18:34:11
Well,

00:18:34:11 - 00:18:35:00
I think AI is

00:18:35:00 - 00:18:36:03
going to be huge

00:18:36:03 - 00:18:37:19
in terms of combining

00:18:37:19 - 00:18:39:15
AR and Endo.

00:18:39:15 - 00:18:41:08
So in my mind,

00:18:41:08 - 00:18:42:18
what I think of the future is

00:18:42:18 - 00:18:43:22
that AI

00:18:43:22 - 00:18:45:06
will be able to tell me

00:18:45:06 - 00:18:46:14
as a surgeon,

00:18:46:14 - 00:18:46:21
all right,

00:18:46:21 - 00:18:48:07
if you do

00:18:48:07 - 00:18:50:12
the next surgical move

00:18:50:12 - 00:18:52:03
with this instrument

00:18:52:03 - 00:18:53:23
and put it into this area,

00:18:55:10 - 00:18:55:21
you know,

00:18:55:21 - 00:18:56:23
predictive

00:18:56:23 - 00:18:58:01
analytics says

00:18:58:01 - 00:18:59:00
a million moves.

00:18:59:00 - 00:19:00:02
This is the fastest

00:19:00:02 - 00:19:00:18
and the safest way

00:19:00:18 - 00:19:01:19
to go. Whoa.

00:19:01:19 - 00:19:03:13
So if it told me that

00:19:03:13 - 00:19:04:01
it's I can't

00:19:04:01 - 00:19:05:09
give me the answer key

00:19:05:09 - 00:19:06:00
on like, okay,

00:19:06:00 - 00:19:07:03
I'm going to do that. Yeah.

00:19:07:03 - 00:19:08:06
Because surgery

00:19:08:06 - 00:19:08:21
like anything

00:19:08:21 - 00:19:10:22
is a series of decisions.

00:19:10:22 - 00:19:11:20
Sure. Right.

00:19:11:20 - 00:19:12:16
So if you make

00:19:12:16 - 00:19:13:10
the wrong decision

00:19:13:10 - 00:19:14:12
in the wrong time,

00:19:14:12 - 00:19:14:21
you're going to go

00:19:14:21 - 00:19:16:04
the wrong direction, right?

00:19:16:04 - 00:19:18:01
So you want to have

00:19:18:01 - 00:19:19:21
the right direction.

00:19:19:21 - 00:19:22:13
And so having AI to help me

00:19:22:13 - 00:19:24:15
in terms of getting the,

00:19:24:15 - 00:19:25:20
the right

00:19:25:20 - 00:19:27:22
decisions, the right path

00:19:27:22 - 00:19:28:20
to success

00:19:28:20 - 00:19:30:03
and making it the safest

00:19:30:03 - 00:19:30:13
and the

00:19:30:13 - 00:19:31:07
most efficient

00:19:31:07 - 00:19:32:07
way of doing it.

00:19:32:07 - 00:19:33:07
That's where I see AI.

00:19:33:07 - 00:19:35:12
So if not in the headset,

00:19:35:12 - 00:19:36:19
if AI is saying, okay,

00:19:36:19 - 00:19:39:01
you want to go in this area

00:19:39:01 - 00:19:40:06
in the spine,

00:19:40:06 - 00:19:40:19
you want to take

00:19:40:19 - 00:19:41:20
this instrument

00:19:41:20 - 00:19:43:12
and do this with that,

00:19:43:12 - 00:19:44:08
then you're going to be safe

00:19:44:08 - 00:19:44:16
and you're going

00:19:44:16 - 00:19:45:08
to be effective.

00:19:45:08 - 00:19:46:07
You're away from the nerves,

00:19:46:07 - 00:19:46:18
you're not going

00:19:46:18 - 00:19:48:01
to injure anything.

00:19:48:01 - 00:19:48:19
And so for me,

00:19:48:19 - 00:19:49:08
that would give me

00:19:49:08 - 00:19:51:08
a lot of reassurance. Sure.

00:19:51:08 - 00:19:53:00
So so but but okay so

00:19:53:00 - 00:19:53:16
and I'm not being funny

00:19:53:16 - 00:19:55:05
when I ask your human brain,

00:19:55:05 - 00:19:56:02
do you ever disagree

00:19:56:02 - 00:19:57:11
with what AI is telling you?

00:19:57:11 - 00:19:58:13
Or do you look at,

00:19:58:13 - 00:19:58:21
you know,

00:19:58:21 - 00:20:00:13
do you look at it as like,

00:20:00:13 - 00:20:01:21
okay, I'm I'll figure out.

00:20:01:21 - 00:20:03:05
I think that might be right.

00:20:03:05 - 00:20:03:18
Right.

00:20:03:18 - 00:20:04:02
Yeah,

00:20:04:02 - 00:20:04:18
I think that

00:20:04:18 - 00:20:05:21
I probably would be.

00:20:05:21 - 00:20:07:04
It's kind of like,

00:20:07:04 - 00:20:07:22
sometimes I think

00:20:07:22 - 00:20:08:18
Google Maps is wrong.

00:20:09:18 - 00:20:10:06
Like, no, I'm

00:20:10:06 - 00:20:10:18
gonna go right.

00:20:10:18 - 00:20:11:10
I'm gonna go that way. Yeah.

00:20:11:10 - 00:20:11:19
You know,

00:20:11:19 - 00:20:12:02
I was like,

00:20:12:02 - 00:20:12:21
I don't think that.

00:20:12:21 - 00:20:13:14
Yeah, yeah.

00:20:13:14 - 00:20:14:08
You know, something

00:20:14:08 - 00:20:15:06
so fascinating,

00:20:15:06 - 00:20:15:20
I think that the

00:20:15:20 - 00:20:17:23
technology is just not

00:20:17:23 - 00:20:18:20
you know, correct.

00:20:18:20 - 00:20:19:04
Yeah.

00:20:19:04 - 00:20:19:16
Sometimes I'm

00:20:19:16 - 00:20:20:08
wrong about that.

00:20:20:08 - 00:20:21:00
And so

00:20:21:00 - 00:20:22:03
but that's my decision.

00:20:22:03 - 00:20:23:05
That's the human decision

00:20:23:05 - 00:20:25:15
to be able to,

00:20:25:15 - 00:20:26:14
discern. Yeah.

00:20:26:14 - 00:20:27:16
Now,

00:20:27:16 - 00:20:28:00
you know,

00:20:28:00 - 00:20:29:14
when people are afraid of AI,

00:20:29:14 - 00:20:30:03
they're afraid of

00:20:30:03 - 00:20:30:22
AI taking over

00:20:30:22 - 00:20:31:19
and just doing everything.

00:20:31:19 - 00:20:32:21
Of course. Yes.

00:20:32:21 - 00:20:33:17
Like they're never going

00:20:33:17 - 00:20:33:23
to be able

00:20:33:23 - 00:20:35:22
to do the surgery by itself.

00:20:35:22 - 00:20:36:13
That's right.

00:20:36:13 - 00:20:37:03
Because who's going

00:20:37:03 - 00:20:40:03
to be responsible.

00:20:40:03 - 00:20:42:05
Like OpenAI or Apple or

00:20:42:05 - 00:20:45:00
like no one is going to then

00:20:45:00 - 00:20:46:08
I have to be responsible.

00:20:46:08 - 00:20:47:10
So ultimately surgery

00:20:47:10 - 00:20:47:23
needs to be done

00:20:47:23 - 00:20:48:16
by the surgeon.

00:20:48:16 - 00:20:51:16
Now AI can augment me

00:20:51:20 - 00:20:52:16
I can use augmented

00:20:52:16 - 00:20:54:14
reality to augment me. Right.

00:20:54:14 - 00:20:56:05
So I think that's where

00:20:57:04 - 00:20:58:04
there's these technologies

00:20:58:04 - 00:20:59:09
come into play in the future.

00:20:59:09 - 00:21:00:03
Yeah.

00:21:00:03 - 00:21:00:21
So okay again

00:21:00:21 - 00:21:02:15
I want to go back to back to,

00:21:02:15 - 00:21:03:08
you know, the folks

00:21:03:08 - 00:21:04:19
that are

00:21:04:19 - 00:21:06:02
benefiting from everything

00:21:06:02 - 00:21:07:03
that you've just described.

00:21:07:03 - 00:21:08:10
How do you determine.

00:21:08:10 - 00:21:09:10
We've talked about opening up

00:21:09:10 - 00:21:09:18
the back.

00:21:09:18 - 00:21:10:07
We've talked about

00:21:10:07 - 00:21:11:05
the different types of

00:21:11:05 - 00:21:11:21
how do you determine

00:21:11:21 - 00:21:13:04
if what you're doing

00:21:13:04 - 00:21:13:17
is best

00:21:13:17 - 00:21:15:00
for that person

00:21:15:00 - 00:21:16:19
versus something else.

00:21:16:19 - 00:21:17:01
Yeah.

00:21:17:01 - 00:21:20:10
So I know what pathologies

00:21:20:19 - 00:21:21:20
are best suited

00:21:21:20 - 00:21:24:06
for the patients okay. I see.

00:21:24:06 - 00:21:25:00
And so

00:21:25:00 - 00:21:25:19
if I see something

00:21:25:19 - 00:21:26:02
that I'm like,

00:21:26:02 - 00:21:26:23
you know actually

00:21:26:23 - 00:21:28:05
maybe open surgery,

00:21:28:05 - 00:21:28:22
traditional surgery

00:21:28:22 - 00:21:30:01
is better for you really.

00:21:30:01 - 00:21:31:09
So you have and would

00:21:31:09 - 00:21:32:09
and do suggest

00:21:32:09 - 00:21:33:20
that I do in those cases.

00:21:33:20 - 00:21:34:08
Right.

00:21:34:08 - 00:21:35:22
And you know, maybe doing

00:21:35:22 - 00:21:36:22
multi-level fusion

00:21:36:22 - 00:21:37:07
is actually

00:21:37:07 - 00:21:38:03
the best thing for you

00:21:38:03 - 00:21:39:06
because your pathology

00:21:39:06 - 00:21:40:09
is just too much.

00:21:40:09 - 00:21:41:14
You know, it's like

00:21:41:14 - 00:21:42:03
endoscopic

00:21:42:03 - 00:21:42:16
surgery

00:21:42:16 - 00:21:44:17
is not for everything.

00:21:44:17 - 00:21:46:16
It doesn't solve everything,

00:21:46:16 - 00:21:47:08
but it does solve

00:21:47:08 - 00:21:47:21
a lot

00:21:47:21 - 00:21:49:10
of the most common things.

00:21:49:10 - 00:21:50:02
Right.

00:21:50:02 - 00:21:51:16
But there are those outliers.

00:21:51:16 - 00:21:52:00
It's kind of

00:21:52:00 - 00:21:53:11
like a bell curve you have.

00:21:53:11 - 00:21:53:16
You're going

00:21:53:16 - 00:21:54:11
to have some people

00:21:54:11 - 00:21:56:02
where you just can't do that.

00:21:56:02 - 00:21:56:11
Yeah.

00:21:56:11 - 00:21:57:07
And so then you have to

00:21:57:07 - 00:21:58:14
do you know

00:21:58:14 - 00:21:59:09
what's tried and true,

00:21:59:09 - 00:22:00:01
which is more

00:22:00:01 - 00:22:01:11
traditional surgery.

00:22:01:11 - 00:22:02:12
And then I,

00:22:02:12 - 00:22:04:05
you know, recommend that.

00:22:04:05 - 00:22:04:15
Yeah.

00:22:04:15 - 00:22:05:20
Maybe once in a while. Sure.

00:22:05:20 - 00:22:06:13
But for the vast

00:22:06:13 - 00:22:07:15
majority of patients

00:22:07:15 - 00:22:09:15
who I see in my clinic,

00:22:09:15 - 00:22:10:19
they actually

00:22:10:19 - 00:22:11:18
can have the surgery

00:22:11:18 - 00:22:12:23
and they can benefit

00:22:12:23 - 00:22:14:10
greatly from it,

00:22:14:10 - 00:22:15:10
like I said, like, you know,

00:22:15:10 - 00:22:17:22
they wake up with no pain.

00:22:17:22 - 00:22:18:16
You know, they're walking

00:22:18:16 - 00:22:19:19
right away.

00:22:19:19 - 00:22:20:11
Two weeks later,

00:22:20:11 - 00:22:21:12
I see them in clinic

00:22:21:12 - 00:22:22:04
and they're like,

00:22:22:04 - 00:22:23:03
yeah, I feel great.

00:22:23:03 - 00:22:24:10
You know, in

00:22:24:10 - 00:22:24:14
start

00:22:24:14 - 00:22:26:09
physical therapy, oftentimes

00:22:26:09 - 00:22:27:16
by six weeks after

00:22:27:16 - 00:22:28:20
surgery, they're like, okay,

00:22:29:21 - 00:22:31:06
I don't want to see you again.

00:22:31:06 - 00:22:31:20
Hope I never

00:22:31:20 - 00:22:32:11
have to see you again.

00:22:32:11 - 00:22:33:03
I'm glad you brought that up,

00:22:33:03 - 00:22:33:14
because I wanted

00:22:33:14 - 00:22:34:17
to talk to you about what

00:22:34:17 - 00:22:35:04
I think.

00:22:35:04 - 00:22:36:09
I think when people do

00:22:36:09 - 00:22:37:09
think of backs or

00:22:37:09 - 00:22:37:22
spine surgery,

00:22:37:22 - 00:22:38:22
any any type of surgery

00:22:38:22 - 00:22:39:16
on that area,

00:22:39:16 - 00:22:40:16
the follow up,

00:22:40:16 - 00:22:42:04
the what's the rehab?

00:22:42:04 - 00:22:42:22
All of this stuff

00:22:42:22 - 00:22:43:19
is like a concern, right.

00:22:43:19 - 00:22:45:10
So what is your traditional

00:22:45:10 - 00:22:45:16
you said

00:22:45:16 - 00:22:46:21
I see them in clinic.

00:22:46:21 - 00:22:47:14
Like what is that?

00:22:47:14 - 00:22:48:09
What does that look like

00:22:48:09 - 00:22:49:01
for someone who's

00:22:49:01 - 00:22:51:10
who's undergone what you do?

00:22:51:10 - 00:22:53:08
I see them in clinic in the,

00:22:53:08 - 00:22:54:11
you know, before surgery

00:22:54:11 - 00:22:55:04
as a consultation.

00:22:55:04 - 00:22:55:21
Make sure you know,

00:22:55:21 - 00:22:56:17
are the appropriate

00:22:56:17 - 00:22:57:10
candidates. Sure.

00:22:57:10 - 00:22:58:20
And then after surgery,

00:22:58:20 - 00:22:59:15
I'll see them

00:22:59:15 - 00:23:00:10
usually at two weeks

00:23:00:10 - 00:23:00:20
after surgery,

00:23:00:20 - 00:23:02:07
just to make sure that their

00:23:02:07 - 00:23:03:06
wounds are healing

00:23:03:06 - 00:23:04:07
and they're doing okay.

00:23:04:07 - 00:23:04:20
And then I give them

00:23:04:20 - 00:23:05:14
the physical therapy

00:23:05:14 - 00:23:06:01
prescription.

00:23:06:01 - 00:23:06:19
I think physical therapy

00:23:06:19 - 00:23:07:15
is actually very important.

00:23:07:15 - 00:23:08:04
You do

00:23:08:04 - 00:23:09:05
because when

00:23:09:05 - 00:23:10:09
people are in pain,

00:23:10:09 - 00:23:10:14
you know,

00:23:10:14 - 00:23:12:15
they don't walk the same.

00:23:12:15 - 00:23:13:21
They don't carry their body

00:23:13:21 - 00:23:14:16
the same.

00:23:14:16 - 00:23:15:20
Their, their, their,

00:23:15:20 - 00:23:16:09
their bodies

00:23:16:09 - 00:23:18:04
become dysfunctional. Right?

00:23:18:04 - 00:23:19:14
They get out of balance.

00:23:19:14 - 00:23:20:10
So then we need to

00:23:20:10 - 00:23:21:16
rebalance them up again.

00:23:21:16 - 00:23:22:10
We need to

00:23:22:10 - 00:23:23:16
train them back

00:23:23:16 - 00:23:25:08
into more normal life.

00:23:25:08 - 00:23:25:17
Yeah.

00:23:25:17 - 00:23:26:20
And so that requires,

00:23:26:20 - 00:23:28:11
I think, some supervision

00:23:28:11 - 00:23:29:01
and physical

00:23:29:01 - 00:23:29:21
therapists are the

00:23:29:21 - 00:23:30:08
I think are

00:23:30:08 - 00:23:31:19
the best for that.

00:23:31:19 - 00:23:34:04
And so I do have most of

00:23:34:04 - 00:23:35:06
my patients go through

00:23:35:06 - 00:23:36:05
physical therapy,

00:23:37:05 - 00:23:37:19
you know, to be

00:23:37:19 - 00:23:39:00
able to recover.

00:23:39:00 - 00:23:40:06
And usually it's about 4

00:23:40:06 - 00:23:40:19
to 6 weeks

00:23:40:19 - 00:23:42:10
of physical therapy,

00:23:42:10 - 00:23:43:00
that they go through.

00:23:43:00 - 00:23:43:11
It's not bad.

00:23:43:11 - 00:23:43:19
I was

00:23:43:19 - 00:23:44:08
I was thinking

00:23:44:08 - 00:23:45:04
it would be longer.

00:23:45:04 - 00:23:45:21
No, that's

00:23:45:21 - 00:23:46:15
that's even the,

00:23:46:15 - 00:23:47:23
the fusion cases.

00:23:47:23 - 00:23:48:17
You know, where

00:23:48:17 - 00:23:49:18
you know it does shift.

00:23:49:18 - 00:23:50:23
So the advantage

00:23:50:23 - 00:23:52:04
of endoscopic surgery

00:23:52:04 - 00:23:53:00
and minimally

00:23:53:00 - 00:23:53:12
ultra minimally invasive

00:23:53:12 - 00:23:55:03
spine surgery is that it

00:23:55:03 - 00:23:56:15
shifts the recovery.

00:23:56:15 - 00:23:57:19
So that's sooner.

00:23:57:19 - 00:23:58:01
Right.

00:23:58:01 - 00:23:59:11
So you're you're

00:23:59:11 - 00:24:00:15
you're in less pain

00:24:00:15 - 00:24:01:15
after surgery.

00:24:01:15 - 00:24:03:09
You recover faster.

00:24:03:09 - 00:24:03:16
You know,

00:24:03:16 - 00:24:04:20
you can go home the same day

00:24:04:20 - 00:24:06:00
or to stay overnight.

00:24:06:00 - 00:24:06:18
Most patients

00:24:06:18 - 00:24:08:02
are able to do that.

00:24:08:02 - 00:24:10:01
And so it shifts everything

00:24:10:01 - 00:24:12:05
so that you can get

00:24:12:05 - 00:24:13:02
better faster.

00:24:13:02 - 00:24:13:17
You get back to

00:24:13:17 - 00:24:14:14
normal faster,

00:24:14:14 - 00:24:16:01
get back to your normal life,

00:24:16:01 - 00:24:17:02
get back to function,

00:24:17:02 - 00:24:17:11
of course,

00:24:17:11 - 00:24:18:10
as quickly as possible.

00:24:18:10 - 00:24:20:02
And that's the the,

00:24:20:02 - 00:24:22:00
the basic tenet of this ultra

00:24:22:00 - 00:24:22:16
minimally invasive

00:24:22:16 - 00:24:24:07
spine surgery is being able

00:24:24:07 - 00:24:25:04
to get there.

00:24:25:04 - 00:24:26:11
The way we can get there

00:24:26:11 - 00:24:27:08
is that it helps

00:24:27:08 - 00:24:28:20
to reduce trauma.

00:24:28:20 - 00:24:29:04
Right.

00:24:29:04 - 00:24:30:21
Our our surgical footprint,

00:24:30:21 - 00:24:32:10
the things that we do inside

00:24:33:11 - 00:24:35:00
is not as traumatic.

00:24:35:00 - 00:24:35:16
Yeah. Right.

00:24:35:16 - 00:24:37:15
So I don't have to. Yeah.

00:24:37:15 - 00:24:39:13
Injure the patient as much.

00:24:39:13 - 00:24:41:13
To do the same surgery

00:24:41:13 - 00:24:43:09
to accomplish the same goals.

00:24:43:09 - 00:24:43:19
Yeah.

00:24:43:19 - 00:24:45:13
And so because of that

00:24:45:13 - 00:24:46:15
they're not hurting

00:24:46:15 - 00:24:47:08
after surgery

00:24:47:08 - 00:24:48:15
so they can recover faster

00:24:48:15 - 00:24:49:14
and then they can get back

00:24:49:14 - 00:24:50:13
to normal faster.

00:24:50:13 - 00:24:51:04
Yeah.

00:24:51:04 - 00:24:52:04
Feel free to brag on this,

00:24:52:04 - 00:24:53:06
because I have a feeling

00:24:53:06 - 00:24:53:20
I know the answer.

00:24:53:20 - 00:24:54:23
How many other programs

00:24:54:23 - 00:24:55:10
are offering

00:24:55:10 - 00:24:56:13
this level of innovation?

00:24:56:13 - 00:24:57:10
Just a handful,

00:24:57:10 - 00:24:57:21
I think,

00:24:57:21 - 00:24:58:20
in terms of endoscopic

00:24:58:20 - 00:24:59:08
spine surgery.

00:24:59:08 - 00:25:00:11
A handful in the country.

00:25:00:11 - 00:25:01:10
Yeah.

00:25:01:10 - 00:25:02:11
And then,

00:25:02:11 - 00:25:02:17
you know,

00:25:02:17 - 00:25:03:16
in terms of augmented

00:25:03:16 - 00:25:04:18
reality, yeah,

00:25:04:18 - 00:25:06:18
I'm the only one.

00:25:06:18 - 00:25:08:03
And then,

00:25:08:03 - 00:25:09:15
you know, endoscopic fusions,

00:25:09:15 - 00:25:10:17
like, I was one of the first

00:25:10:17 - 00:25:11:14
in the country to do it.

00:25:12:18 - 00:25:13:21
And then, you know,

00:25:13:21 - 00:25:14:06
I think

00:25:14:06 - 00:25:16:11
there's only a handful of,

00:25:16:11 - 00:25:18:01
programs.

00:25:18:01 - 00:25:19:19
It's growing, though. Okay.

00:25:19:19 - 00:25:20:13
And I think that's

00:25:20:13 - 00:25:21:04
where adoption

00:25:21:04 - 00:25:22:13
will truly skyrocket

00:25:22:13 - 00:25:23:02
with this,

00:25:23:02 - 00:25:26:02
because most, most surgeons

00:25:26:02 - 00:25:27:19
are they're

00:25:27:19 - 00:25:29:07
they're not trained in this.

00:25:29:07 - 00:25:29:15
They're trained

00:25:29:15 - 00:25:30:17
in conventional surgery

00:25:30:17 - 00:25:32:12
because that's with the

00:25:32:12 - 00:25:33:02
fellowships

00:25:33:02 - 00:25:34:11
and the training programs.

00:25:34:11 - 00:25:35:17
That's what they all train

00:25:35:17 - 00:25:37:04
and teach. Yeah.

00:25:37:04 - 00:25:38:03
And so once

00:25:38:03 - 00:25:39:06
the training programs

00:25:39:06 - 00:25:40:09
like UCI,

00:25:40:09 - 00:25:42:18
like other university,

00:25:42:18 - 00:25:43:15
training programs

00:25:43:15 - 00:25:44:05
around the country

00:25:44:05 - 00:25:45:22
like Stanford or Harvard

00:25:45:22 - 00:25:46:11
or whatever,

00:25:46:11 - 00:25:47:19
they get

00:25:47:19 - 00:25:50:00
these kind of programs online

00:25:50:00 - 00:25:51:19
and then able to teach

00:25:51:19 - 00:25:52:08
the residents

00:25:52:08 - 00:25:53:15
and fellows this.

00:25:53:15 - 00:25:55:09
Then I think it'll skyrocket,

00:25:55:09 - 00:25:56:17
because even now,

00:25:56:17 - 00:25:57:12
when I

00:25:57:12 - 00:25:58:06
teach my residents

00:25:58:06 - 00:25:58:18
and fellows

00:25:58:18 - 00:25:59:16
and I show them

00:25:59:16 - 00:26:01:00
what endoscopies surgery is

00:26:01:00 - 00:26:01:15
and they see what

00:26:01:15 - 00:26:02:10
conventional surgery

00:26:02:10 - 00:26:03:18
is, that's cool, I want that.

00:26:03:18 - 00:26:04:15
Yeah, I want to do that

00:26:04:15 - 00:26:05:17
because one, it's

00:26:05:17 - 00:26:06:19
it's really cool.

00:26:06:19 - 00:26:08:19
It's new, it's exciting.

00:26:08:19 - 00:26:09:20
But also you see what

00:26:09:20 - 00:26:10:22
the patients there,

00:26:10:22 - 00:26:12:07
how they do,

00:26:12:07 - 00:26:14:00
they do much better,

00:26:14:00 - 00:26:14:15
you know, in terms

00:26:14:15 - 00:26:15:17
of their recovery

00:26:15:17 - 00:26:16:12
instead of like, well,

00:26:16:12 - 00:26:17:17
if I had a choice,

00:26:17:17 - 00:26:18:21
then I'd want to choose that.

00:26:18:21 - 00:26:19:19
Sure.

00:26:19:19 - 00:26:21:03
But if you haven't seen it,

00:26:21:03 - 00:26:22:08
you don't know.

00:26:22:08 - 00:26:23:11
So if you don't know,

00:26:23:11 - 00:26:24:06
then it's like, well,

00:26:24:06 - 00:26:24:13
how are you going

00:26:24:13 - 00:26:25:09
to make a decision on it?

00:26:25:09 - 00:26:26:21
Yeah, yeah.

00:26:26:21 - 00:26:27:22
On a personal level,

00:26:27:22 - 00:26:29:08
what how what

00:26:29:08 - 00:26:30:17
led you to this?

00:26:30:17 - 00:26:31:14
What was your interest

00:26:31:14 - 00:26:32:10
point, your,

00:26:32:10 - 00:26:33:13
you know, entry point

00:26:33:13 - 00:26:35:16
into wanting to be like the

00:26:35:16 - 00:26:37:06
the king of backs?

00:26:37:06 - 00:26:39:10
Well, the I first heard about

00:26:39:10 - 00:26:40:21
endoscopic spine surgery

00:26:40:21 - 00:26:43:15
probably in 2017.

00:26:44:00 - 00:26:44:18
Around then. That's

00:26:44:18 - 00:26:45:13
when it was starting

00:26:45:13 - 00:26:46:04
to really come up.

00:26:46:04 - 00:26:47:09
And one of the places

00:26:47:09 - 00:26:47:17
that it's

00:26:47:17 - 00:26:48:12
like the epicenter

00:26:48:12 - 00:26:50:05
is in Korea, South Korea

00:26:50:05 - 00:26:51:11
and so

00:26:51:11 - 00:26:51:18
you know

00:26:51:18 - 00:26:52:18
the South Koreans would

00:26:52:18 - 00:26:54:04
then come and present their,

00:26:54:04 - 00:26:55:11
their, their data,

00:26:55:11 - 00:26:56:22
how their results were.

00:26:56:22 - 00:26:57:16
And I'm like, oh,

00:26:57:16 - 00:26:59:04
that's too good to be true.

00:26:59:04 - 00:27:00:12
And you know,

00:27:00:12 - 00:27:01:13
I really have to learn

00:27:01:13 - 00:27:02:22
this is is something that

00:27:02:22 - 00:27:04:14
is real.

00:27:04:14 - 00:27:05:01
And, you know,

00:27:05:01 - 00:27:05:12
you don't want to

00:27:05:12 - 00:27:06:04
adopt something

00:27:06:04 - 00:27:08:01
too early before,

00:27:08:01 - 00:27:08:14
you know,

00:27:08:14 - 00:27:09:22
you know, the results

00:27:09:22 - 00:27:11:20
really come out. Yeah.

00:27:11:20 - 00:27:13:23
And so I learned about it.

00:27:13:23 - 00:27:15:19
I read the papers

00:27:15:19 - 00:27:17:11
and I went to labs

00:27:17:11 - 00:27:18:20
and courses and

00:27:18:20 - 00:27:20:13
and conferences about it

00:27:20:13 - 00:27:21:08
and learned more

00:27:21:08 - 00:27:22:13
and more as much as I could.

00:27:22:13 - 00:27:24:01
Then Covid hit. Okay.

00:27:24:01 - 00:27:26:06
Then I had a lot of time for,

00:27:26:06 - 00:27:26:17
a lot of time

00:27:26:17 - 00:27:28:11
just to think about things.

00:27:28:11 - 00:27:30:00
Or what about life? What?

00:27:30:00 - 00:27:30:14
Yeah, yeah,

00:27:30:14 - 00:27:30:21
I know,

00:27:30:21 - 00:27:32:06
and what do I do next? Yeah.

00:27:32:06 - 00:27:33:21
And so then I went to Korea,

00:27:35:01 - 00:27:35:22
and I learned

00:27:35:22 - 00:27:38:00
endoscopic surgery from the masters

00:27:38:00 - 00:27:39:11
that were at that time

00:27:39:11 - 00:27:40:07
doing it.

00:27:40:07 - 00:27:41:21
And,

00:27:41:21 - 00:27:42:02
you know,

00:27:42:02 - 00:27:43:02
I was just

00:27:43:02 - 00:27:45:00
completely blown away

00:27:45:00 - 00:27:46:09
by what I was seeing.

00:27:46:09 - 00:27:47:09
I was,

00:27:47:09 - 00:27:48:17
you know, able to,

00:27:48:17 - 00:27:49:01
you know,

00:27:49:01 - 00:27:50:15
just really grasp the ideas

00:27:50:15 - 00:27:51:11
and the principles

00:27:51:11 - 00:27:52:18
of endoscopic surgery.

00:27:52:18 - 00:27:54:22
So I took that,

00:27:54:22 - 00:27:57:21
came back to the US,

00:27:57:21 - 00:27:59:04
came back on a Sunday,

00:27:59:04 - 00:28:00:02
and then on a Wednesday,

00:28:00:02 - 00:28:01:10
I did my first surgery.

00:28:01:10 - 00:28:01:23
And then it has

00:28:01:23 - 00:28:02:14
been going since.

00:28:02:14 - 00:28:03:15
So I've done over

00:28:03:15 - 00:28:05:19
600 cases now.

00:28:05:19 - 00:28:06:08
And then I have

00:28:06:08 - 00:28:07:07
one of the first

00:28:07:07 - 00:28:09:12
in the country to do,

00:28:09:12 - 00:28:11:02
the biportal endoscopic

00:28:11:02 - 00:28:11:16
spine surgery

00:28:11:16 - 00:28:13:12
that I, mostly do.

00:28:13:12 - 00:28:14:14
And then in terms

00:28:14:14 - 00:28:15:16
of endoscopic fusions,

00:28:15:16 - 00:28:16:08
that's one of the first

00:28:16:08 - 00:28:17:05
in the country to do it.

00:28:17:05 - 00:28:19:11
So, it just I,

00:28:19:11 - 00:28:21:14
I saw the potential.

00:28:21:14 - 00:28:22:05
You know what?

00:28:22:05 - 00:28:22:11
You know what

00:28:22:11 - 00:28:24:11
I can see with my own eyes.

00:28:24:11 - 00:28:26:05
When I went to Korea,

00:28:26:05 - 00:28:29:02
I realized, okay, this is,

00:28:29:02 - 00:28:30:13
something really powerful.

00:28:30:13 - 00:28:31:20
Yeah. That's incredible.

00:28:32:22 - 00:28:33:08
Just on a

00:28:33:08 - 00:28:34:12
personal, you know,

00:28:34:12 - 00:28:35:10
for for someone listening

00:28:35:10 - 00:28:37:04
that may have not like,

00:28:37:04 - 00:28:38:05
something that requires

00:28:38:05 - 00:28:39:05
a lot of,

00:28:39:05 - 00:28:40:04
you know, advanced

00:28:40:04 - 00:28:41:01
care of the surgery,

00:28:41:01 - 00:28:41:16
but, like, what are

00:28:41:16 - 00:28:42:13
what are some good things

00:28:42:13 - 00:28:43:09
maybe that you abide

00:28:43:09 - 00:28:43:23
by in terms of

00:28:43:23 - 00:28:45:12
just your own physical,

00:28:45:12 - 00:28:46:16
motions during the day,

00:28:46:16 - 00:28:47:16
like, is planking

00:28:47:16 - 00:28:48:06
bad for like,

00:28:48:06 - 00:28:49:11
what's good and bad for you

00:28:49:11 - 00:28:50:06
for patients? Yeah.

00:28:50:06 - 00:28:50:22
For for anyone

00:28:50:22 - 00:28:51:20
that's maybe dealing with,

00:28:51:20 - 00:28:52:13
like a sore back

00:28:52:13 - 00:28:52:22
or something.

00:28:52:22 - 00:28:53:20
Like what's a good

00:28:53:20 - 00:28:55:06
what's a good daily routine

00:28:55:06 - 00:28:57:16
to be in for optimal back health.

00:28:57:16 - 00:28:58:02
Well,

00:28:58:02 - 00:28:59:18
I think like I said before,

00:28:59:18 - 00:29:00:11
the three things

00:29:00:11 - 00:29:01:06
that are really important

00:29:01:06 - 00:29:02:03
are back

00:29:02:03 - 00:29:03:17
muscles, core muscles

00:29:03:17 - 00:29:04:16
other than your leg muscles.

00:29:04:16 - 00:29:05:02
Got it.

00:29:05:02 - 00:29:06:05
So now

00:29:06:05 - 00:29:07:11
you have to really have

00:29:07:11 - 00:29:09:01
all three of those.

00:29:09:01 - 00:29:11:00
It's kind of like your the,

00:29:11:00 - 00:29:13:13
the tripod okay.

00:29:13:13 - 00:29:14:21
To your spine.

00:29:14:21 - 00:29:16:14
In terms of spine health.

00:29:16:14 - 00:29:18:17
So you want to strengthen

00:29:18:17 - 00:29:19:16
those as much as possible.

00:29:19:16 - 00:29:20:13
So planks are good.

00:29:20:13 - 00:29:20:21
You know

00:29:20:21 - 00:29:21:22
sit ups are not as good

00:29:21:22 - 00:29:22:23
because if you're curling

00:29:22:23 - 00:29:23:13
your back is,

00:29:23:13 - 00:29:23:19
you know,

00:29:23:19 - 00:29:25:08
tendency to really have bad

00:29:25:08 - 00:29:26:20
technique, doing

00:29:26:20 - 00:29:28:13
sit ups and crunches,

00:29:28:13 - 00:29:29:09
and then you end up

00:29:29:09 - 00:29:30:04
tweaking your neck,

00:29:30:04 - 00:29:30:19
tweaking your back.

00:29:30:19 - 00:29:32:03
So it's not the best way

00:29:32:03 - 00:29:33:11
of doing it, but,

00:29:33:11 - 00:29:35:14
you know, leg lifts,

00:29:35:14 - 00:29:36:06
you know,

00:29:36:06 - 00:29:37:07
planks are great

00:29:37:07 - 00:29:38:20
and different exercises

00:29:38:20 - 00:29:39:13
you can do with your legs

00:29:39:13 - 00:29:40:08
while you're in the plank

00:29:40:08 - 00:29:41:17
position.

00:29:41:17 - 00:29:42:00
You know,

00:29:42:00 - 00:29:43:07
and while you're on your back

00:29:43:07 - 00:29:44:08
with your legs lifted

00:29:44:08 - 00:29:45:07
and moving

00:29:45:07 - 00:29:46:07
in different directions

00:29:46:07 - 00:29:47:10
and different exercises,

00:29:47:10 - 00:29:48:17
you can do with that. Yeah.

00:29:48:17 - 00:29:49:09
And then

00:29:49:09 - 00:29:49:22
the things that

00:29:49:22 - 00:29:50:19
you want to avoid.

00:29:50:19 - 00:29:51:22
So you want to avoid stress

00:29:51:22 - 00:29:53:08
to your back okay.

00:29:53:08 - 00:29:53:15
The things

00:29:53:15 - 00:29:55:00
that stress your back

00:29:55:00 - 00:29:56:09
bending deeply

00:29:56:09 - 00:29:58:03
twisting extremely

00:29:58:03 - 00:29:59:16
heavy lifting with your back

00:29:59:16 - 00:30:00:06
and then sitting

00:30:00:06 - 00:30:01:18
for long periods of time,

00:30:01:18 - 00:30:03:08
those things really do

00:30:03:08 - 00:30:04:15
stress your discs

00:30:04:15 - 00:30:06:09
and your back and your spine.

00:30:06:09 - 00:30:07:21
So you want to avoid that

00:30:07:21 - 00:30:09:07
as much as you can.

00:30:09:07 - 00:30:09:14
You know.

00:30:09:14 - 00:30:10:22
And so things like deadlifts

00:30:10:22 - 00:30:11:21
you know Olympic

00:30:11:21 - 00:30:12:20
you know let's say

00:30:12:20 - 00:30:13:18
those are really bad

00:30:13:18 - 00:30:14:09
for your back

00:30:14:09 - 00:30:15:18
if you do it poorly.

00:30:15:18 - 00:30:16:23
And if you do it right

00:30:16:23 - 00:30:17:18
you know power lifting

00:30:17:18 - 00:30:18:12
could be great.

00:30:18:12 - 00:30:19:11
You know for your body.

00:30:19:11 - 00:30:20:12
But at the same time

00:30:20:12 - 00:30:21:05
it's not something that

00:30:21:05 - 00:30:22:03
you can do forever.

00:30:22:03 - 00:30:23:06
No, it's always going

00:30:23:06 - 00:30:26:04
to eventually wear on you.

00:30:26:04 - 00:30:27:04
But you have to

00:30:27:04 - 00:30:27:23
have proper technique,

00:30:27:23 - 00:30:29:14
and most people don't. Yeah.

00:30:29:14 - 00:30:31:01
And so I think that,

00:30:31:01 - 00:30:32:21
you know, proper posture,

00:30:32:21 - 00:30:33:13
you know, is

00:30:33:13 - 00:30:34:18
really important,

00:30:34:18 - 00:30:36:03
proper technique.

00:30:36:03 - 00:30:37:17
And then also,

00:30:37:17 - 00:30:38:10
you know,

00:30:38:10 - 00:30:39:14
keeping your body strong

00:30:39:14 - 00:30:41:02
and then avoiding the stress

00:30:41:02 - 00:30:41:18
to your spine.

00:30:41:18 - 00:30:42:05
Sure.

00:30:42:05 - 00:30:42:17
All of that's

00:30:42:17 - 00:30:43:14
really important.

00:30:43:14 - 00:30:44:16
Yeah.

00:30:44:16 - 00:30:45:18
Do you, do you hear back?

00:30:45:18 - 00:30:46:06
Obviously

00:30:46:06 - 00:30:46:17
you follow up

00:30:46:17 - 00:30:47:06
with your patients,

00:30:47:06 - 00:30:48:02
but do they come back to you

00:30:48:02 - 00:30:48:13
and say like,

00:30:48:13 - 00:30:48:23
oh my God,

00:30:48:23 - 00:30:50:00
you changed my life?

00:30:50:00 - 00:30:50:21
I bet you get that

00:30:50:21 - 00:30:51:09
all the time.

00:30:51:09 - 00:30:51:23
Every day, right?

00:30:51:23 - 00:30:52:23
Every day. It's incredible.

00:30:52:23 - 00:30:54:04
Yeah, it's a great feeling.

00:30:54:04 - 00:30:54:22
It has to be.

00:30:54:22 - 00:30:55:13
And, you know,

00:30:55:13 - 00:30:56:03
it really

00:30:56:03 - 00:30:57:15
is the reason why I do this

00:30:57:15 - 00:30:58:23
and why I went into,

00:30:58:23 - 00:30:59:18
you know,

00:30:59:18 - 00:31:00:12
orthopedic surgery,

00:31:00:12 - 00:31:02:08
spine surgery to begin with,

00:31:02:08 - 00:31:03:00
orthopedic surgery,

00:31:03:00 - 00:31:03:20
because, you know,

00:31:03:20 - 00:31:05:14
you can fix a lot of things.

00:31:05:14 - 00:31:07:00
You can really change

00:31:07:00 - 00:31:07:17
people's lives.

00:31:07:17 - 00:31:08:18
You can really make

00:31:08:18 - 00:31:10:14
people better. Yes. Right.

00:31:10:14 - 00:31:12:10
And the idea is to get people

00:31:12:10 - 00:31:13:18
back to

00:31:13:18 - 00:31:14:16
normal functioning,

00:31:14:16 - 00:31:15:10
to get them back

00:31:15:10 - 00:31:16:20
to where they need to be.

00:31:16:20 - 00:31:17:09
And so that's

00:31:17:09 - 00:31:18:04
where orthopedics

00:31:18:04 - 00:31:19:02
comes into play

00:31:19:02 - 00:31:19:21
with spine surgery.

00:31:19:21 - 00:31:20:13
What's exciting about

00:31:20:13 - 00:31:21:05
spine surgery?

00:31:21:05 - 00:31:22:18
And, you know,

00:31:22:18 - 00:31:23:10
I've kind of

00:31:23:10 - 00:31:24:01
geeked out about it

00:31:24:01 - 00:31:24:16
already is

00:31:24:16 - 00:31:25:13
all the technology,

00:31:25:13 - 00:31:26:23
all the tech, you know, the

00:31:26:23 - 00:31:27:19
the high tech

00:31:27:19 - 00:31:29:02
that you can have.

00:31:29:02 - 00:31:30:21
You know AI, AR.

00:31:30:21 - 00:31:32:01
We haven’t talked about robotics.

00:31:32:01 - 00:31:32:06
I mean,

00:31:32:06 - 00:31:33:14
you can really combine

00:31:33:14 - 00:31:34:23
all of that stuff

00:31:34:23 - 00:31:36:21
into spine surgery.

00:31:36:21 - 00:31:37:17
And that's super

00:31:37:17 - 00:31:39:20
exciting too. And so I think

00:31:40:20 - 00:31:41:16
for me,

00:31:41:16 - 00:31:42:10
that's why I went

00:31:42:10 - 00:31:43:20
into going into it

00:31:43:20 - 00:31:46:04
and into spine surgery,

00:31:46:04 - 00:31:47:04
but also,

00:31:47:04 - 00:31:47:12
you know,

00:31:47:12 - 00:31:48:12
not just technology,

00:31:48:12 - 00:31:49:19
but now it's also

00:31:49:19 - 00:31:50:20
the results.

00:31:50:20 - 00:31:51:22
Patients are coming back

00:31:51:22 - 00:31:53:02
and they're just like

00:31:53:02 - 00:31:54:01
they're transformed.

00:31:54:01 - 00:31:54:09
You know,

00:31:54:09 - 00:31:56:00
their pain is some it's gone.

00:31:56:00 - 00:31:57:15
Their you know, their their,

00:31:57:15 - 00:31:59:14
function is so much better.

00:31:59:14 - 00:32:00:01
And they're able

00:32:00:01 - 00:32:01:23
to get back to their lives,

00:32:01:23 - 00:32:02:20
before surgery.

00:32:02:20 - 00:32:04:05
And I always asked this

00:32:04:05 - 00:32:05:03
in clinic,

00:32:05:03 - 00:32:07:01
you know, in every post-op visit

00:32:07:01 - 00:32:07:20
All right.

00:32:07:20 - 00:32:08:21
Do you feel better?

00:32:08:21 - 00:32:09:16
How do you feel compared

00:32:09:16 - 00:32:10:08
to before surgery?

00:32:10:08 - 00:32:12:12
Like, this is night and day,

00:32:12:12 - 00:32:13:22
you know, like,

00:32:13:22 - 00:32:15:02
this is so much better.

00:32:15:02 - 00:32:15:21
And so it's like,

00:32:15:21 - 00:32:17:10
okay, then I did my job

00:32:17:10 - 00:32:18:07
and I feel like,

00:32:18:07 - 00:32:19:05
you know, I think that

00:32:19:05 - 00:32:19:19
that it makes it

00:32:19:19 - 00:32:20:13
completely worth it.

00:32:20:13 - 00:32:21:01
Wow.

00:32:21:01 - 00:32:21:06
Well,

00:32:21:06 - 00:32:22:00
we are in the presence

00:32:22:00 - 00:32:22:18
of greatness, sir.

00:32:22:18 - 00:32:23:23
Keep doing what you're doing.

00:32:23:23 - 00:32:24:23
I mean, I don't know where

00:32:24:23 - 00:32:25:22
where you go next from here,

00:32:25:22 - 00:32:26:11
but but it's

00:32:26:11 - 00:32:27:01
really incredible.

00:32:27:01 - 00:32:27:20
And you're changing lives

00:32:27:20 - 00:32:29:03
and really,

00:32:29:03 - 00:32:30:05
it's awesome and a pleasure

00:32:30:05 - 00:32:30:23
to hear your story

00:32:30:23 - 00:32:32:12
and see what you're doing

00:32:32:12 - 00:32:33:08
and all the breakthroughs

00:32:33:08 - 00:32:34:21
that are probably yet to come

00:32:34:21 - 00:32:35:13
and that

00:32:35:13 - 00:32:35:23
you're going to be on

00:32:35:23 - 00:32:37:04
the forefront of Doctor

00:32:37:04 - 00:32:38:13
Don Young Park,

00:32:38:13 - 00:32:39:16
Live Well with UCI Health.

00:32:39:16 - 00:32:40:14
It has been a pleasure.

00:32:40:14 - 00:32:40:19
It has been a pleasure.

00:32:40:19 - 00:32:41:18
This man is magical.

00:32:41:18 - 00:32:42:07
I swear to God,

00:32:42:07 - 00:32:43:01
if my back is ever

00:32:43:01 - 00:32:43:17
screwed up, I'm not

00:32:43:17 - 00:32:44:13
No one's touching it

00:32:44:13 - 00:32:45:06
except you.

00:32:45:06 - 00:32:45:17
Thank you.

00:32:45:17 - 00:32:46:05
Thank you very much.

00:32:46:05 - 00:32:46:14
Pleasure.