00:00:00:01 - 00:00:02:08
Welcome to Live Well with UCI Health.

00:00:02:08 - 00:00:04:12
I am Ryan Manno from iHeart Radio.

00:00:04:12 - 00:00:06:12
The Ellen K Morning Show on KOST 103.5

00:00:06:12 - 00:00:07:10
I am thrilled and honored

00:00:07:10 - 00:00:08:03
to be sitting next

00:00:08:03 - 00:00:09:05
to this gentleman today,

00:00:09:05 - 00:00:10:15
Doctor Michael Oh.

00:00:10:15 - 00:00:12:01
Director of the Comprehensive

00:00:12:01 - 00:00:13:22
Spine Program here at UCI Health.

00:00:13:22 - 00:00:16:14
Welcome. Spine Center, now. Spine Center,

00:00:16:14 - 00:00:17:22
the whole center. Forget the program.

00:00:17:22 - 00:00:19:11
The program is just a part of the center.

00:00:19:11 - 00:00:21:08
Right. Welcome. Thank you for being here.

00:00:21:08 - 00:00:22:19
All right. Thanks for having me.

00:00:22:19 - 00:00:24:16
So we're going to talk about the

00:00:24:16 - 00:00:25:18
the spine today.

00:00:25:18 - 00:00:27:16
Yeah. The back the all the things. Right.

00:00:27:16 - 00:00:30:14
That kind of run this... neck and back pain.

00:00:30:14 - 00:00:32:03
That's the number one

00:00:32:03 - 00:00:34:04
cause of worldwide disability.

00:00:34:04 - 00:00:35:13
It's not cancer

00:00:35:13 - 00:00:37:13
but it's certainly disabling.

00:00:37:13 - 00:00:38:16
And it's something

00:00:38:16 - 00:00:40:11
that most people will suffer

00:00:40:11 - 00:00:42:10
through once in their lifetime.

00:00:42:10 - 00:00:44:18
It has a prevalence of 96%.

00:00:44:18 - 00:00:45:21
So most people have it.

00:00:45:21 - 00:00:47:15
Some people will have chronically.

00:00:47:15 - 00:00:48:05
And that's

00:00:48:05 - 00:00:49:20
when you start losing function.

00:00:49:20 - 00:00:50:20
When you lose function,

00:00:50:20 - 00:00:52:02
you lose quality of life. Sure.

00:00:52:02 - 00:00:53:09
I mean, I know even just for,

00:00:53:09 - 00:00:55:12
you know, people without chronic back

00:00:55:12 - 00:00:56:20
pain, if you sleep weird or wake up

00:00:56:20 - 00:00:58:13
and your back hurts or your neck hurts,

00:00:58:13 - 00:00:59:20
that's enough to ruin a day.

00:00:59:20 - 00:01:01:00
Now imagine living with that.

00:01:01:00 - 00:01:02:22
You know, day in, day out.

00:01:02:22 - 00:01:03:18
It changes everything.

00:01:03:18 - 00:01:05:04
Yeah, it changes where you go,

00:01:05:04 - 00:01:06:21
how you go, what you want,

00:01:06:21 - 00:01:09:19
and certainly pain and depression are linked

00:01:09:19 - 00:01:10:18
hand in hand.

00:01:10:18 - 00:01:11:20
So I would assume,

00:01:11:20 - 00:01:12:20
and you correct me here

00:01:12:20 - 00:01:14:07
because I'm just making assumptions that

00:01:14:07 - 00:01:15:22
because it is such a sensitive area,

00:01:15:22 - 00:01:16:15
there's a lot of things

00:01:16:15 - 00:01:18:12
going on there with nerves and discs

00:01:18:12 - 00:01:19:17
and all the things.

00:01:19:17 - 00:01:21:15
There's probably some fear with people

00:01:21:15 - 00:01:23:01
seeking treatment for it.

00:01:23:01 - 00:01:24:19
Do you find that? Yeah, yeah.

00:01:24:19 - 00:01:27:22
Most people don't seek out care

00:01:27:22 - 00:01:29:04
initially for their back pain

00:01:29:04 - 00:01:30:22
because they think that at the end of it

00:01:30:22 - 00:01:31:23
it's going to be big surgery.

00:01:31:23 - 00:01:33:16
But that's not the case.

00:01:33:16 - 00:01:35:02
You probably do more harm

00:01:35:02 - 00:01:37:02
by not seeking out care early,

00:01:37:02 - 00:01:37:12
because that's

00:01:37:12 - 00:01:39:19
when the noninvasive interventions

00:01:39:19 - 00:01:41:05
can help the most.

00:01:41:05 - 00:01:44:03
So that's probably the myth, is that back

00:01:44:03 - 00:01:46:02
pain will just go away by itself.

00:01:46:02 - 00:01:48:21
That early intervention is

00:01:48:21 - 00:01:51:01
will set you on this pathway to surgery.

00:01:51:01 - 00:01:52:00
And that's not the case.

00:01:52:00 - 00:01:53:01
Most of the time.

00:01:53:01 - 00:01:53:18
We manage it

00:01:53:18 - 00:01:54:16
nine out of ten times

00:01:54:16 - 00:01:56:16
without any surgical intervention.

00:01:56:16 - 00:01:57:05
I love this,

00:01:57:05 - 00:01:58:16
I was watching a video

00:01:58:16 - 00:01:59:04
that you did

00:01:59:04 - 00:01:59:21
on my on my way

00:01:59:21 - 00:02:00:21
here, and,

00:02:00:21 - 00:02:02:01
and I was fascinated

00:02:02:01 - 00:02:03:05
by the fact that you said nine

00:02:03:05 - 00:02:04:14
out of ten times, you wouldn't

00:02:04:14 - 00:02:06:04
you don't do the surgery.

00:02:06:04 - 00:02:07:07
So what do you do?

00:02:07:07 - 00:02:07:20
I see

00:02:07:20 - 00:02:08:21
patients with back pain

00:02:08:21 - 00:02:10:20
and try to figure out what's causing it.

00:02:10:20 - 00:02:11:02
Yeah.

00:02:11:02 - 00:02:12:00
So that's

00:02:12:00 - 00:02:12:13
I think

00:02:12:13 - 00:02:15:17
the role of spine surgeon is right now

00:02:16:08 - 00:02:18:01
we're sort of the quarterbacks

00:02:18:01 - 00:02:20:12
or the primary care of back pain

00:02:20:12 - 00:02:23:13
because we see it at every stage, okay.

00:02:23:14 - 00:02:25:16
Knowing that we can do the surgery.

00:02:25:16 - 00:02:27:05
But nine out of ten times

00:02:27:05 - 00:02:29:13
we don't do surgery on those patients

00:02:29:13 - 00:02:30:18
I see in my clinics.

00:02:30:18 - 00:02:33:08
They get to see my colleagues in

00:02:33:08 - 00:02:34:11
Samueli Integrative Health

00:02:34:11 - 00:02:35:11
and they get acupuncture,

00:02:35:11 - 00:02:37:18
or they see our physical therapists,

00:02:37:18 - 00:02:39:08
either in the community or here

00:02:39:08 - 00:02:39:21
at UCI

00:02:39:21 - 00:02:41:08
who have a great group,

00:02:41:08 - 00:02:44:04
or they go to our PMR group,

00:02:44:04 - 00:02:45:19
the physical medicine group,

00:02:45:19 - 00:02:47:16
or they go to interventional pain

00:02:47:16 - 00:02:49:05
where they might get injections.

00:02:49:05 - 00:02:51:10
So those are all things that we can do

00:02:51:10 - 00:02:53:15
way before surgery.

00:02:53:15 - 00:02:56:17
But if you have some of those

00:02:57:06 - 00:02:58:23
red flag signs and so that's

00:02:58:23 - 00:02:59:12
those are the things

00:02:59:12 - 00:03:00:15
I'm not going to be talking about

00:03:00:15 - 00:03:01:06
really today.

00:03:01:06 - 00:03:01:18
Okay.

00:03:01:18 - 00:03:03:06
The things where you have

00:03:03:06 - 00:03:05:02
significant amount of weakness,

00:03:05:02 - 00:03:06:14
you have bowel bladder,

00:03:06:14 - 00:03:07:16
you have weight loss,

00:03:07:16 - 00:03:09:11
you have fever, chills.

00:03:09:11 - 00:03:11:00
Those are the red flag signs

00:03:11:00 - 00:03:11:14
that this back

00:03:11:14 - 00:03:14:14
pain is not your typical back pain.

00:03:14:14 - 00:03:15:09
That's

00:03:15:09 - 00:03:16:03
the ones that you want

00:03:16:03 - 00:03:17:23
to get addressed early on. Right.

00:03:17:23 - 00:03:18:20
So what does it mean

00:03:18:20 - 00:03:21:06
to be a comprehensive spine program.

00:03:21:06 - 00:03:22:23
What does that specifically mean?

00:03:22:23 - 00:03:25:06
So the comprehensive Spine program

00:03:25:06 - 00:03:25:20
Spine center

00:03:25:20 - 00:03:26:15
designation comes

00:03:26:15 - 00:03:28:09
because we're not just one

00:03:28:09 - 00:03:29:14
or group of doctors.

00:03:29:14 - 00:03:32:05
It's a group of multi specialists okay.

00:03:32:05 - 00:03:33:18
So you have surgeons

00:03:33:18 - 00:03:35:22
non surgeons we have interventionists.

00:03:35:22 - 00:03:37:04
You have radiologists

00:03:37:04 - 00:03:38:22
all in this group

00:03:38:22 - 00:03:39:22
looking at the patient

00:03:39:22 - 00:03:41:03
from different angles.

00:03:41:03 - 00:03:42:10
The reason why you want that

00:03:42:10 - 00:03:44:17
because back pain can cause

00:03:44:17 - 00:03:46:15
can be caused by many different things.

00:03:46:15 - 00:03:47:18
And so you

00:03:47:18 - 00:03:49:12
in order to get to the root cause

00:03:49:12 - 00:03:52:00
you want many eyes on it not just one.

00:03:52:00 - 00:03:53:22
Because there's that saying about

00:03:53:22 - 00:03:55:09
if you have a hammer,

00:03:55:09 - 00:03:57:08
everything looks like a nail.

00:03:57:08 - 00:03:59:21
So if you go to just

00:03:59:21 - 00:04:00:17
if you go to a surgeon

00:04:00:17 - 00:04:02:03
that's outside of a comprehensive,

00:04:02:03 - 00:04:03:05
they might be more inclined

00:04:03:05 - 00:04:04:13
towards surgery. Sure.

00:04:04:13 - 00:04:06:20
But if you're part of a comprehensive

00:04:06:20 - 00:04:07:15
spine center,

00:04:07:15 - 00:04:09:05
then you're going to get the full luck.

00:04:09:05 - 00:04:10:01
So it's basically

00:04:10:01 - 00:04:12:04
you're taking a look at people

00:04:12:04 - 00:04:13:05
that do different things.

00:04:13:05 - 00:04:14:09
Ten let's say ten,

00:04:14:09 - 00:04:15:21
a group of ten brilliant minds,

00:04:15:21 - 00:04:17:01
right, that all specialize

00:04:17:01 - 00:04:18:04
in this one area.

00:04:18:04 - 00:04:19:09
And you,

00:04:19:09 - 00:04:21:16
you create a good plan

00:04:21:16 - 00:04:22:23
or outlook for this person.

00:04:22:23 - 00:04:25:06
So as a as a group we've created pathways

00:04:25:06 - 00:04:25:12
okay.

00:04:25:12 - 00:04:26:12
So if you have back

00:04:26:12 - 00:04:27:21
pain with certain characteristics

00:04:27:21 - 00:04:29:01
you go down this pathway

00:04:29:01 - 00:04:30:10
or another pathway.

00:04:30:10 - 00:04:32:09
We also have joint conferences.

00:04:32:09 - 00:04:33:23
Sure it's more complicated.

00:04:33:23 - 00:04:36:04
We have orthopedic spine surgeons,

00:04:36:04 - 00:04:38:14
neurosurgeons, radiologists,

00:04:38:14 - 00:04:39:10
pain physicians

00:04:39:10 - 00:04:41:08
all in the same room going over

00:04:41:08 - 00:04:43:06
individual cases saying, okay,

00:04:43:06 - 00:04:44:22
I would probably do it this way.

00:04:44:22 - 00:04:46:05
And most of the time

00:04:46:05 - 00:04:48:03
we try to get a consensus. Yeah.

00:04:48:03 - 00:04:49:05
And so again,

00:04:49:05 - 00:04:50:09
that's part of what

00:04:50:09 - 00:04:52:17
a comprehensive spine center is,

00:04:52:17 - 00:04:54:04
is to try to get a consensus

00:04:54:04 - 00:04:55:20
so we can give more precise

00:04:55:20 - 00:04:56:22
and safer

00:04:56:22 - 00:04:58:22
treatments, therapy recommendations

00:04:58:22 - 00:05:00:14
to our patients. I would want that.

00:05:00:14 - 00:05:02:03
I think anyone would, right?

00:05:02:03 - 00:05:02:21
Rather than talking to

00:05:02:21 - 00:05:03:13
one guy being like,

00:05:03:13 - 00:05:04:14
this is what you should do, right?

00:05:04:14 - 00:05:06:03
I want everybody to tell me.

00:05:06:03 - 00:05:07:19
Most of the time, people,

00:05:07:19 - 00:05:08:14
they go by

00:05:08:14 - 00:05:10:16
what they heard from their friends.

00:05:10:16 - 00:05:11:11
So I think

00:05:11:11 - 00:05:13:11
especially with the amount of information

00:05:13:11 - 00:05:15:03
out there with artificial intelligence.

00:05:15:03 - 00:05:17:03
Yeah, with things like ChatGPT,

00:05:18:11 - 00:05:19:23
the good part about it is

00:05:19:23 - 00:05:21:15
that you can combine,

00:05:21:15 - 00:05:25:01
interpret and analyze a lot more data

00:05:25:04 - 00:05:26:04
quickly. Yeah.

00:05:26:04 - 00:05:27:09
So I think the information

00:05:27:09 - 00:05:28:12
that's available to patients

00:05:28:12 - 00:05:29:05
nowadays,

00:05:29:05 - 00:05:30:20
it used to be just word of mouth,

00:05:30:20 - 00:05:32:17
but now there's a lot more places

00:05:32:17 - 00:05:34:00
where you can get information

00:05:34:00 - 00:05:36:11
on your particular type of condition,

00:05:36:11 - 00:05:37:15
your back pain.

00:05:37:15 - 00:05:39:15
If it's a word that you might not know

00:05:39:15 - 00:05:40:22
like spondylolisthesis.

00:05:40:22 - 00:05:41:18
You can just do it.

00:05:41:18 - 00:05:42:22
What does that mean? What is that?

00:05:42:22 - 00:05:44:09
It means that you

00:05:44:09 - 00:05:46:00
developed a slip in your low back.

00:05:46:00 - 00:05:46:12
Okay,

00:05:46:12 - 00:05:48:09
so everything is supposed to be stacked

00:05:48:09 - 00:05:49:09
on top of each other.

00:05:49:09 - 00:05:50:02
Lined up.

00:05:50:02 - 00:05:50:09
Yeah,

00:05:50:09 - 00:05:53:00
but people either through arthritis.

00:05:53:00 - 00:05:54:11
So that's a joint problem.

00:05:54:11 - 00:05:55:13
Disk problems,

00:05:55:13 - 00:05:56:19
or they were just born that way.

00:05:56:19 - 00:05:58:09
They developed this slip.

00:05:58:09 - 00:05:59:15
So when the bone slips,

00:05:59:15 - 00:06:01:09
it could certainly cause back pain,

00:06:01:09 - 00:06:02:10
but it could also cause

00:06:02:10 - 00:06:03:21
nerve pain down the legs.

00:06:03:21 - 00:06:05:01
This is not anything

00:06:05:01 - 00:06:06:03
that I even plan to talk about

00:06:06:03 - 00:06:06:22
when you said slip.

00:06:06:22 - 00:06:08:00
Is that like I hear people say,

00:06:08:00 - 00:06:09:10
like I slipped a disc? Yes.

00:06:09:10 - 00:06:10:06
Is that even a thing?

00:06:10:06 - 00:06:11:01
Slip a disc.

00:06:11:01 - 00:06:13:12
Slip disc is usually the layman's terms

00:06:13:12 - 00:06:15:12
for a herniated disc. Okay. Got it.

00:06:15:12 - 00:06:16:22
So you could have herniated disc.

00:06:16:22 - 00:06:18:12
You could have protruded disc,

00:06:18:12 - 00:06:19:23
you could have bulging disc.

00:06:19:23 - 00:06:20:15
Those are all

00:06:20:15 - 00:06:22:21
on the spectrum of disc problems.

00:06:22:21 - 00:06:24:01
So this pathology,

00:06:24:01 - 00:06:25:21
it could be a little bulge that's causing

00:06:25:21 - 00:06:26:23
temporary problems.

00:06:26:23 - 00:06:28:15
Or it could be a full herniation

00:06:28:15 - 00:06:29:08
that's causing

00:06:29:08 - 00:06:30:15
severe leg pain

00:06:30:15 - 00:06:32:09
that a lot of people know that

00:06:32:09 - 00:06:33:22
as sciatica. Okay.

00:06:33:22 - 00:06:35:06
Wow. See? I'm learning.

00:06:35:06 - 00:06:36:01
You mentioned AI.

00:06:36:01 - 00:06:37:23
Let's talk about some of the new stuff.

00:06:39:06 - 00:06:41:07
In what ways are you using AI?

00:06:41:07 - 00:06:42:03
What do you see

00:06:42:03 - 00:06:44:14
as like the future for what you do?

00:06:44:14 - 00:06:45:15
How much is it helping

00:06:45:15 - 00:06:47:07
you kind of run us through a little bit

00:06:47:07 - 00:06:49:22
of how how that's benefiting you.

00:06:49:22 - 00:06:50:22
It's amazing.

00:06:50:22 - 00:06:53:21
And we've all seen how fast AI is

00:06:53:21 - 00:06:55:14
been incorporated into a lot of things

00:06:55:14 - 00:06:58:01
we do well and how fast it's improving.

00:06:58:01 - 00:06:58:17
Yeah.

00:06:58:17 - 00:07:00:08
So the one of the places

00:07:00:08 - 00:07:01:04
where it's being used

00:07:01:04 - 00:07:02:13
the most is in our clinics.

00:07:02:13 - 00:07:04:14
So when we're seeing patients,

00:07:04:14 - 00:07:07:02
because there are AI tools, for example,

00:07:07:02 - 00:07:09:16
that are essentially scribes.

00:07:09:16 - 00:07:11:16
So I can turn on this AI tool.

00:07:11:16 - 00:07:13:11
And as we're having a conversation,

00:07:13:11 - 00:07:14:15
as I'm getting the history

00:07:14:15 - 00:07:15:12
from my patient,

00:07:15:12 - 00:07:16:16
it's taking notes

00:07:16:16 - 00:07:18:16
and turning it into a note.

00:07:18:16 - 00:07:20:00
And the reason why that's great

00:07:20:00 - 00:07:22:03
is because all these years

00:07:22:03 - 00:07:23:22
we've been taking care of the computer

00:07:23:22 - 00:07:25:11
in our hospitals and clinics.

00:07:25:11 - 00:07:26:17
We've just been sitting

00:07:26:17 - 00:07:27:15
looking at a computer.

00:07:27:15 - 00:07:28:23
But now with AI,

00:07:28:23 - 00:07:30:13
we can look at the patient again.

00:07:30:13 - 00:07:31:22
So we could have this conversation.

00:07:31:22 - 00:07:34:01
I can give you my full attention.

00:07:34:01 - 00:07:35:12
And the note is done

00:07:35:12 - 00:07:38:14
after we finished our visit,

00:07:38:14 - 00:07:39:20
because it's happening over here

00:07:39:20 - 00:07:41:06
while you're interacting,

00:07:41:06 - 00:07:42:05
instead of burying your face

00:07:42:05 - 00:07:42:20
in a computer.

00:07:42:20 - 00:07:44:10
I think it's amazing

00:07:44:10 - 00:07:46:08
that computer technology

00:07:46:08 - 00:07:47:19
is finally getting us away

00:07:47:19 - 00:07:48:12
from the computer

00:07:48:12 - 00:07:49:04
and letting us

00:07:49:04 - 00:07:51:13
have these human interactions again.

00:07:51:13 - 00:07:53:14
So that's one example.

00:07:53:14 - 00:07:56:16
But certainly on the patient side now,

00:07:56:20 - 00:07:57:20
when they come to me,

00:07:57:20 - 00:07:59:15
they come with a lot better questions.

00:07:59:15 - 00:08:00:07
Because why?

00:08:00:07 - 00:08:01:10
Because they're more educated.

00:08:01:10 - 00:08:02:16
They've they've done it.

00:08:02:16 - 00:08:04:01
And and they have better access

00:08:04:01 - 00:08:05:17
to this information. Right. Yeah.

00:08:05:17 - 00:08:06:12
So instead of

00:08:06:12 - 00:08:08:13
just someone from church saying,

00:08:08:13 - 00:08:11:08
oh, I had that problems, go see this guy.

00:08:11:08 - 00:08:13:05
Yeah. They'll do a lot more research.

00:08:13:05 - 00:08:15:11
And it's definitely better than

00:08:15:11 - 00:08:16:07
Doctor Google.

00:08:16:07 - 00:08:17:08
So sure,

00:08:17:08 - 00:08:18:22
we went through that

00:08:18:22 - 00:08:19:18
phase as well

00:08:19:18 - 00:08:20:18
where we had patients

00:08:20:18 - 00:08:21:03
coming in

00:08:21:03 - 00:08:22:20
with really not

00:08:22:20 - 00:08:23:17
well validated

00:08:23:17 - 00:08:25:02
kind of information,

00:08:25:02 - 00:08:26:02
but with AI

00:08:26:02 - 00:08:28:07
they come much better questions.

00:08:28:07 - 00:08:30:00
They come already prepared in clinic.

00:08:30:00 - 00:08:31:00
And when you have a

00:08:31:00 - 00:08:32:04
more informed patient,

00:08:32:04 - 00:08:33:05
you have better outcomes.

00:08:33:05 - 00:08:34:07
Is spinal fusion

00:08:34:07 - 00:08:35:10
I've heard that term a lot too.

00:08:35:10 - 00:08:36:03
Is spinal fusion

00:08:36:03 - 00:08:38:18
something you do or don't recommend?

00:08:38:18 - 00:08:40:11
I absolutely do spinal fusion

00:08:40:11 - 00:08:44:05
and it gets a bad reputation because

00:08:44:11 - 00:08:46:11
the bad rep honest is

00:08:46:11 - 00:08:48:01
if you do it for the wrong reason.

00:08:48:01 - 00:08:48:14
Okay,

00:08:48:14 - 00:08:49:19
so the main reasons

00:08:49:19 - 00:08:51:01
why we do spinal fusion

00:08:51:01 - 00:08:53:05
is that spondylolisthesis.

00:08:53:05 - 00:08:54:01
Yeah.

00:08:54:01 - 00:08:55:12
When you have that condition,

00:08:55:12 - 00:08:56:17
it's a great surgery.

00:08:56:17 - 00:08:59:17
When you have deformity like scoliosis.

00:08:59:19 - 00:09:01:17
We know that fusion works

00:09:01:17 - 00:09:03:13
in those kind of cases

00:09:03:13 - 00:09:06:15
when you have some sort of instability,

00:09:06:23 - 00:09:08:18
because those joints have worn out

00:09:08:18 - 00:09:10:10
or the discs have worn out to the point

00:09:10:10 - 00:09:12:04
where it's not holding

00:09:12:04 - 00:09:14:03
everything stacked on top of each other,

00:09:14:03 - 00:09:17:09
then we know that fusion works very well.

00:09:17:10 - 00:09:19:01
Okay, so what is the fear then?

00:09:19:01 - 00:09:20:03
What is the concern?

00:09:20:03 - 00:09:20:15
Is it that,

00:09:20:15 - 00:09:21:08
like I can't

00:09:21:08 - 00:09:22:11
I don't turn my neck as much?

00:09:22:11 - 00:09:23:00
Or like what?

00:09:23:00 - 00:09:25:04
What is the the fusion. You lose motion.

00:09:25:04 - 00:09:26:22
You do, you lose normal motion.

00:09:26:22 - 00:09:28:04
But in some people

00:09:28:04 - 00:09:30:00
it's better to have no motion

00:09:30:00 - 00:09:31:23
than to have painful motion. Yes.

00:09:31:23 - 00:09:34:21
So we're still at that era where

00:09:34:21 - 00:09:36:16
if you look back 30 years ago

00:09:36:16 - 00:09:38:12
in orthopedics,

00:09:38:12 - 00:09:39:21
if you had a problem with your hip,

00:09:39:21 - 00:09:41:13
the only thing they had to offer you

00:09:41:13 - 00:09:44:13
was really a hip fusion or a knee fusion.

00:09:44:15 - 00:09:45:21
It worked.

00:09:45:21 - 00:09:46:18
It worked in the sense

00:09:46:18 - 00:09:48:13
that if you had a lot of pain from it,

00:09:48:13 - 00:09:49:06
you weren't pain.

00:09:49:06 - 00:09:49:22
Yeah,

00:09:49:22 - 00:09:52:03
but you would lose motion of that

00:09:52:03 - 00:09:52:15
hip or knee,

00:09:52:15 - 00:09:54:10
which was terrible on those joints,

00:09:54:10 - 00:09:56:10
lumbar spine.

00:09:56:10 - 00:09:57:21
It doesn't move as much,

00:09:57:21 - 00:10:00:20
especially as you get older.

00:10:00:20 - 00:10:03:14
So the motion that you lose

00:10:03:14 - 00:10:05:18
is probably worth

00:10:05:18 - 00:10:07:08
the improvement in back pain.

00:10:07:08 - 00:10:09:01
Improvement in leg pain. Yeah.

00:10:09:01 - 00:10:09:12
So that's

00:10:09:12 - 00:10:10:12
why fusion,

00:10:10:12 - 00:10:11:23
as long as it's done for the right

00:10:11:23 - 00:10:14:00
reasons, it's not the effort.

00:10:14:00 - 00:10:15:14
It's actually a good thing

00:10:15:14 - 00:10:17:12
that helps a lot of people,

00:10:17:12 - 00:10:18:16
but it does get a bad rap

00:10:18:16 - 00:10:20:13
because it can be misused. Yeah.

00:10:20:13 - 00:10:23:00
So if you don't go through the process

00:10:23:00 - 00:10:23:17
of getting

00:10:23:17 - 00:10:25:23
a real diagnosis that pinpoints

00:10:25:23 - 00:10:28:10
why you're having this complaint back

00:10:28:10 - 00:10:30:08
pain, leg pain, weakness,

00:10:30:08 - 00:10:33:03
again, that hammer with a nail approach,

00:10:33:03 - 00:10:35:10
if you end up someplace like that,

00:10:35:10 - 00:10:36:09
then you're going to get fused

00:10:36:09 - 00:10:37:07
and you're not going to get better

00:10:37:07 - 00:10:37:20
for sure.

00:10:37:20 - 00:10:38:11
And I think,

00:10:38:11 - 00:10:40:06
I mean, I follow sports pretty closely.

00:10:40:06 - 00:10:41:07
I think a lot of athletes,

00:10:41:07 - 00:10:43:04
you know, end up doing fusion.

00:10:43:04 - 00:10:44:18
You know, football players who take,

00:10:44:18 - 00:10:46:15
you know, blows to their heads, spine

00:10:46:15 - 00:10:47:15
professional wrestlers,

00:10:47:15 - 00:10:48:16
people that whatever

00:10:48:16 - 00:10:50:06
they take impact to that

00:10:50:06 - 00:10:51:08
they've done fusion.

00:10:51:08 - 00:10:52:04
When people told them

00:10:52:04 - 00:10:52:21
your career is over,

00:10:52:21 - 00:10:54:01
but they've done the fusion

00:10:54:01 - 00:10:55:12
and got back out there.

00:10:55:12 - 00:10:55:19
Yeah, no,

00:10:55:19 - 00:10:56:07
I used to be

00:10:56:07 - 00:10:57:12
an NFL consultant

00:10:57:12 - 00:11:00:00
and we would do up to one level fusions

00:11:00:00 - 00:11:01:11
and let them go back to

00:11:01:11 - 00:11:03:00
professional football.

00:11:03:00 - 00:11:03:19
So certainly

00:11:03:19 - 00:11:05:19
you can go back to normal activity,

00:11:05:19 - 00:11:08:14
even supernormal activity after a fusion.

00:11:08:14 - 00:11:10:05
But now

00:11:10:05 - 00:11:12:03
we don't have as much data

00:11:12:03 - 00:11:13:14
on the artificial disc.

00:11:13:14 - 00:11:14:16
I wanted to talk about that next.

00:11:14:16 - 00:11:15:09
Let's talk about that.

00:11:15:09 - 00:11:16:14
That's kind of a hot topic.

00:11:16:14 - 00:11:17:09
Artificial disc. Yeah.

00:11:17:09 - 00:11:18:12
So absolutely.

00:11:18:12 - 00:11:21:04
That makes so much sense.

00:11:21:04 - 00:11:22:06
Instead of a fusion,

00:11:22:06 - 00:11:23:04
why don't we do

00:11:23:04 - 00:11:24:02
artificial joints

00:11:24:02 - 00:11:25:16
and artificial discs in the back

00:11:25:16 - 00:11:27:04
and we're getting there.

00:11:27:04 - 00:11:29:02
Yeah. Are we fully there?

00:11:29:02 - 00:11:30:22
Not yet. Talk to us about it.

00:11:30:22 - 00:11:32:03
What is the disc made of?

00:11:32:03 - 00:11:34:18
What's the... how does this work?

00:11:34:18 - 00:11:36:04
So when we replace a disc.

00:11:36:04 - 00:11:36:20
It's made

00:11:36:20 - 00:11:39:00
usually of some sort of spacer

00:11:39:00 - 00:11:39:20
in the middle

00:11:39:20 - 00:11:42:13
that acts like the disc that allow

00:11:42:13 - 00:11:43:11
it has in place

00:11:43:11 - 00:11:45:00
that are usually made out of titanium.

00:11:45:00 - 00:11:46:22
So it's usually a combination

00:11:46:22 - 00:11:48:04
of some sort of poly,

00:11:48:04 - 00:11:49:21
kind of like with hips and knees

00:11:49:21 - 00:11:50:16
a poly in the middle

00:11:50:16 - 00:11:52:19
and some metal on the surfaces

00:11:52:19 - 00:11:54:08
that interface with the bone.

00:11:54:08 - 00:11:55:22
So that's for the disc, for the

00:11:55:22 - 00:11:58:20
for the back lumber joints.

00:11:58:20 - 00:12:01:17
We only have one type of artificial joint

00:12:01:17 - 00:12:04:18
available right now, and UCI is the only

00:12:04:19 - 00:12:05:19
Center in Orange County

00:12:05:19 - 00:12:08:19
that does lumbar artificial joints.

00:12:09:00 - 00:12:09:19
So we do both

00:12:09:19 - 00:12:12:19
artificial joints, artificial discs.

00:12:12:20 - 00:12:14:04
The surgery for that,

00:12:14:04 - 00:12:15:13
though is a big surgery.

00:12:15:13 - 00:12:17:10
It's not minimally invasive.

00:12:17:10 - 00:12:18:08
It's not even.

00:12:18:08 - 00:12:19:20
And we're getting to ultra

00:12:19:20 - 00:12:21:22
minimally invasive in some areas.

00:12:21:22 - 00:12:22:22
So when you're talking

00:12:22:22 - 00:12:24:17
about getting a disc replacement

00:12:24:17 - 00:12:25:08
or a joint

00:12:25:08 - 00:12:26:15
replacement, it's

00:12:26:15 - 00:12:30:00
still a big open surgery in general.

00:12:30:01 - 00:12:30:13
Yeah.

00:12:30:13 - 00:12:33:13
So the is the trade off of preserving

00:12:33:13 - 00:12:34:10
some motion

00:12:34:10 - 00:12:36:09
worth that big open surgery one.

00:12:36:09 - 00:12:38:12
Now we also have

00:12:38:12 - 00:12:40:12
ultra-minimally invasive approaches

00:12:40:12 - 00:12:41:19
to some of the same problems.

00:12:41:19 - 00:12:43:20
Like how minimal are we how minimal.

00:12:43:20 - 00:12:45:09
So we're talking about

00:12:45:09 - 00:12:48:16
we have an outstanding

00:12:48:16 - 00:12:52:17
endoscopic spine surgery program by Don Park

00:12:52:17 - 00:12:54:21
I met him I know that doctor. Yes.

00:12:54:21 - 00:12:56:04
Yeah. Yeah, I like him.

00:12:56:04 - 00:12:58:05
He's a leader in this space.

00:12:58:05 - 00:12:59:12
And we have others

00:12:59:12 - 00:13:01:01
that are doing endoscopic spine

00:13:01:01 - 00:13:02:17
work here at UCI.

00:13:02:17 - 00:13:04:12
And that's ultra-minimally invasive

00:13:04:12 - 00:13:06:10
because you're going through

00:13:06:10 - 00:13:09:19
pencil size incisions to do decompression

00:13:09:19 - 00:13:11:11
and even fusions.

00:13:11:11 - 00:13:14:05
So the ultra-minimally invasive means

00:13:14:05 - 00:13:17:20
that you really have minimal disruption

00:13:17:20 - 00:13:20:00
of the tissue to get to...

00:13:20:00 - 00:13:21:22
and still accomplish the same thing,

00:13:21:22 - 00:13:22:23
which is either a fusion

00:13:22:23 - 00:13:23:19
or decompression.

00:13:23:19 - 00:13:25:04
Those are the two main things we do.

00:13:25:04 - 00:13:28:04
Wow. So ultra-minimally invasive.

00:13:28:04 - 00:13:29:07
And then you combine

00:13:29:07 - 00:13:30:03
things like robotics.

00:13:30:03 - 00:13:32:08
So over here at the Aven campus,

00:13:32:08 - 00:13:34:02
not only do we have the program,

00:13:34:02 - 00:13:36:05
but we have a robotics program

00:13:36:05 - 00:13:38:20
where we can do a up to three level

00:13:38:20 - 00:13:41:02
fusion surgery and get them home

00:13:41:02 - 00:13:42:07
the same day or the next day.

00:13:42:07 - 00:13:43:18
That's unbelievable. Wow.

00:13:43:18 - 00:13:44:12
And what a campus.

00:13:44:12 - 00:13:44:18
By the way,

00:13:44:18 - 00:13:46:04
let's talk about this new, new,

00:13:46:04 - 00:13:46:18
new joint.

00:13:46:18 - 00:13:47:13
Oh my God,

00:13:47:13 - 00:13:48:09
you had to be lit up

00:13:48:09 - 00:13:49:09
the first time you walked in there.

00:13:49:09 - 00:13:50:19
That place is magical.

00:13:50:19 - 00:13:51:23
I wanted to stay there.

00:13:51:23 - 00:13:54:11
It's better than my house.

00:13:54:11 - 00:13:56:14
I know. The bathrooms are cleaner for sure,

00:13:56:14 - 00:13:57:13
but let's talk about,

00:13:57:13 - 00:13:59:10
like, how a place like this,

00:13:59:10 - 00:14:00:14
like this new one in in

00:14:00:14 - 00:14:02:01
Irvine, is changing

00:14:02:01 - 00:14:02:19
spinal care,

00:14:02:19 - 00:14:04:06
you know, for for Orange County,

00:14:04:06 - 00:14:06:00
for the Southland in general,

00:14:06:00 - 00:14:08:20
besides having the healing marshes there

00:14:08:20 - 00:14:10:03
being a beautiful

00:14:10:03 - 00:14:11:20
the food, the menu, I mean all of it.

00:14:11:20 - 00:14:13:13
But it's well intentioned.

00:14:13:13 - 00:14:13:21
Yeah.

00:14:13:21 - 00:14:15:11
There's a lot of intentionality

00:14:15:11 - 00:14:17:09
to how the whole place was designed

00:14:17:09 - 00:14:17:23
to create this

00:14:17:23 - 00:14:19:15
calming atmosphere,

00:14:19:15 - 00:14:20:21
but also to bring in

00:14:20:21 - 00:14:22:10
the latest in technology.

00:14:22:10 - 00:14:24:10
So that's why our endoscopic programs

00:14:24:10 - 00:14:25:22
spine program is based.

00:14:25:22 - 00:14:27:19
There are robotic program is there.

00:14:27:19 - 00:14:29:19
And what we're focusing on again

00:14:29:19 - 00:14:32:01
is to take these long

00:14:32:01 - 00:14:33:13
post-operative courses.

00:14:33:13 - 00:14:36:01
So with ultra-minimally invasive

00:14:36:01 - 00:14:37:07
spine surgery,

00:14:37:07 - 00:14:40:07
the recovery is in weeks not months.

00:14:40:08 - 00:14:43:08
And with robotic fusion

00:14:43:19 - 00:14:44:09
we use

00:14:44:09 - 00:14:44:23
these patients

00:14:44:23 - 00:14:47:04
used to be in the hospital weeks.

00:14:47:04 - 00:14:49:04
Now they're going home in a day.

00:14:49:04 - 00:14:50:20
Are you confident in saying

00:14:50:20 - 00:14:51:21
that this is really

00:14:51:21 - 00:14:53:04
the only place you're going

00:14:53:04 - 00:14:55:02
to get this level of,

00:14:55:02 - 00:14:57:11
you know, pre-care like,

00:14:57:11 - 00:15:00:09
you know, the comprehensive care, the

00:15:00:09 - 00:15:01:04
the procedures.

00:15:01:04 - 00:15:01:20
I mean is this

00:15:01:20 - 00:15:02:20
is this the spot

00:15:02:20 - 00:15:04:20
I think anybody can call themselves

00:15:04:20 - 00:15:05:19
a comprehensive center.

00:15:05:19 - 00:15:06:23
But we really do have a

00:15:06:23 - 00:15:08:09
truly comprehensive center.

00:15:08:09 - 00:15:09:06
And because we're part

00:15:09:06 - 00:15:11:02
of an academic campus. That's right.

00:15:11:02 - 00:15:11:10
There's

00:15:11:10 - 00:15:13:04
actually a rigorous definition

00:15:13:04 - 00:15:14:21
of when he can be a center.

00:15:14:21 - 00:15:15:07
And part of

00:15:15:07 - 00:15:17:09
that has to do with a teaching component

00:15:17:09 - 00:15:19:12
that we do here, but also the research.

00:15:19:12 - 00:15:19:22
Do you teach?

00:15:19:22 - 00:15:21:07
Are you a professor of this as well?

00:15:21:07 - 00:15:22:01
Really,

00:15:22:01 - 00:15:23:06
I teach residents,

00:15:23:06 - 00:15:24:03
so the residents are

00:15:24:03 - 00:15:26:02
the ones that are training

00:15:26:02 - 00:15:27:07
to go into specialties.

00:15:27:07 - 00:15:29:02
And then I train fellows

00:15:29:02 - 00:15:31:02
who are doing subspecialty.

00:15:31:02 - 00:15:32:14
So these are already people

00:15:32:14 - 00:15:35:04
that are almost 30 years old

00:15:35:04 - 00:15:35:21
at that point,

00:15:35:21 - 00:15:37:14
but they're getting additional training.

00:15:37:14 - 00:15:39:19
And then I also teach medical students

00:15:39:19 - 00:15:40:20
and some undergraduates.

00:15:40:20 - 00:15:43:10
So, so anywhere from 20 year

00:15:43:10 - 00:15:46:10
old to almost 35 year old, middle aged

00:15:46:10 - 00:15:48:07
people that are still in training

00:15:48:07 - 00:15:49:19
to become spine surgeons. Man.

00:15:49:19 - 00:15:50:11
And I was looking

00:15:50:11 - 00:15:51:20
at your level of schooling to

00:15:51:20 - 00:15:53:02
you were at what, USC

00:15:53:02 - 00:15:54:11
then you went out to New York

00:15:54:11 - 00:15:56:06
and you were in Missouri,

00:15:56:06 - 00:15:57:12
Missouri, Toronto.

00:15:57:12 - 00:15:58:09
Yeah, you've been all over.

00:15:58:09 - 00:15:59:05
So I think you've

00:15:59:05 - 00:16:01:14
had some good teachers yourself. Yeah.

00:16:01:14 - 00:16:05:04
So not nothing we do is brand new.

00:16:05:04 - 00:16:06:16
We all learn from someone.

00:16:06:16 - 00:16:07:16
We have mentors.

00:16:07:16 - 00:16:08:11
And I think

00:16:08:11 - 00:16:09:04
in any field

00:16:09:04 - 00:16:11:13
that's important to have mentors.

00:16:11:13 - 00:16:13:19
And you seem excited by the change.

00:16:13:19 - 00:16:13:23
Right?

00:16:13:23 - 00:16:15:15
I think maybe some people could just

00:16:15:15 - 00:16:16:14
go, well, this is how I learned it.

00:16:16:14 - 00:16:17:19
This is how I'll do it. Right?

00:16:17:19 - 00:16:19:16
But like to...

00:16:19:16 - 00:16:20:10
I’m sure things have changed

00:16:20:10 - 00:16:23:10
so much since you’ve started, right?

00:16:23:10 - 00:16:24:17
Like from opening up

00:16:24:17 - 00:16:26:14
wide on every surgery or something.

00:16:26:14 - 00:16:26:21
Right.

00:16:26:21 - 00:16:28:11
To to this, this thing

00:16:28:11 - 00:16:30:03
that we are now doing.

00:16:30:03 - 00:16:31:11
The thing that we're doing

00:16:31:11 - 00:16:31:18
right now

00:16:31:18 - 00:16:34:19
is we really are in a unique period.

00:16:34:19 - 00:16:36:10
Not everybody gets to

00:16:36:10 - 00:16:38:19
live through a revolution. Yes.

00:16:38:19 - 00:16:39:22
So we're living through

00:16:39:22 - 00:16:42:07
the information revolution

00:16:42:07 - 00:16:46:06
and the rapid changes that we see from...

00:16:46:06 - 00:16:47:22
when I started training,

00:16:47:22 - 00:16:49:19
I used to have to pull off

00:16:49:19 - 00:16:50:19
the side of the road

00:16:50:19 - 00:16:53:21
to get to a payphone to answer a page.

00:16:54:12 - 00:16:55:02
Right.

00:16:55:02 - 00:16:56:18
And now we're talking about

00:16:56:18 - 00:16:58:02
AI earlier, right?

00:16:58:02 - 00:16:58:15
Yeah.

00:16:58:15 - 00:17:01:15
It really is the supercharged

00:17:01:16 - 00:17:02:12
kind of evolution

00:17:02:12 - 00:17:04:23
that we're, we're undergoing right now.

00:17:04:23 - 00:17:07:00
And unless you're adaptable,

00:17:07:00 - 00:17:08:09
I think that's one of the more

00:17:08:09 - 00:17:11:03
most important qualities for any field.

00:17:11:03 - 00:17:12:20
Any field, anybody.

00:17:12:20 - 00:17:14:05
You have to be able to adapt

00:17:14:05 - 00:17:15:11
to the rapid changes

00:17:15:11 - 00:17:17:08
in our information technologies.

00:17:17:08 - 00:17:18:08
What are some other things

00:17:18:08 - 00:17:19:10
that you're looking at on

00:17:19:10 - 00:17:20:10
the on the horizon

00:17:20:10 - 00:17:22:13
that are exciting you about what you do?

00:17:22:13 - 00:17:24:01
So on the spine

00:17:24:01 - 00:17:27:05
side, you really do think that there is

00:17:28:00 - 00:17:31:00
we're at the point right now where

00:17:31:02 - 00:17:32:14
we can combine robotics

00:17:32:14 - 00:17:34:04
and the scope of the things

00:17:34:04 - 00:17:35:10
that we're doing already

00:17:35:10 - 00:17:36:20
in different silos,

00:17:36:20 - 00:17:37:11
combine it

00:17:37:11 - 00:17:39:17
with this artificial intelligence.

00:17:39:17 - 00:17:40:01
Yeah.

00:17:40:01 - 00:17:42:21
And and that really gets to

00:17:42:21 - 00:17:44:07
sort of predictive

00:17:45:15 - 00:17:46:12
analysis.

00:17:46:12 - 00:17:48:02
So a lot of the things that we do

00:17:48:02 - 00:17:48:15
in surgery

00:17:48:15 - 00:17:49:05
right now

00:17:49:05 - 00:17:50:07
is after the fact,

00:17:50:07 - 00:17:51:22
after someone has a big problem,

00:17:51:22 - 00:17:52:23
we try to fix it.

00:17:52:23 - 00:17:54:23
After someone's had chronic pain,

00:17:54:23 - 00:17:57:10
we try to intervene and do something.

00:17:57:10 - 00:17:59:02
But are there

00:17:59:02 - 00:18:00:20
things that we can do in the future

00:18:00:20 - 00:18:02:22
that is a much smaller,

00:18:02:22 - 00:18:04:00
earlier intervention?

00:18:04:00 - 00:18:05:11
Even though it might be surgery,

00:18:05:11 - 00:18:06:23
it might be much earlier.

00:18:06:23 - 00:18:08:23
It might be a very specific type

00:18:08:23 - 00:18:11:00
of surgery for a specific patient.

00:18:11:00 - 00:18:13:01
And we can predict that with this,

00:18:13:01 - 00:18:13:23
it could save them

00:18:13:23 - 00:18:16:02
ten years of extended life

00:18:16:02 - 00:18:17:16
because they're not in the wheelchair.

00:18:17:16 - 00:18:18:18
Yeah, right.

00:18:18:18 - 00:18:19:19
They're not bed bound.

00:18:19:19 - 00:18:22:09
They don't these kind of complications.

00:18:22:09 - 00:18:25:06
So I think when you combine again

00:18:25:06 - 00:18:27:06
the precision of robotics

00:18:27:06 - 00:18:29:15
analytics of AI,

00:18:29:15 - 00:18:30:22
and we're going to be able to predict

00:18:30:22 - 00:18:32:11
who does what.

00:18:32:11 - 00:18:34:00
Which kind of procedures.

00:18:34:00 - 00:18:36:07
Yes, we can even identify people

00:18:36:07 - 00:18:37:18
that are going to have

00:18:37:18 - 00:18:40:00
early degenerative disease, for example,

00:18:40:00 - 00:18:41:04
and potentially intervene

00:18:41:04 - 00:18:42:17
early with stem cells,

00:18:42:17 - 00:18:44:15
other therapies, then that's exciting.

00:18:44:15 - 00:18:46:05
So the part about

00:18:46:05 - 00:18:47:10
the personalized medicine,

00:18:47:10 - 00:18:49:15
the predictive medicine,

00:18:49:15 - 00:18:51:19
I think that is really exciting.

00:18:51:19 - 00:18:54:19
What are your favorite nonsense?

00:18:54:23 - 00:18:56:06
Okay, so you mentioned

00:18:56:06 - 00:18:57:02
it caught my ear earlier.

00:18:57:02 - 00:18:58:05
You mentioned acupuncture.

00:18:58:05 - 00:18:59:23
I was surprised to hear you hear

00:18:59:23 - 00:19:00:07
you say that.

00:19:00:07 - 00:19:00:19
I don't know why,

00:19:00:19 - 00:19:01:17
but it just surprised me.

00:19:01:17 - 00:19:03:16
What are some of your sort of preferred

00:19:03:16 - 00:19:06:16
or favorite non-surgical treatments?

00:19:07:03 - 00:19:09:02
Yoga. Pilates? Swimming.

00:19:09:02 - 00:19:10:14
Listen to this.

00:19:10:14 - 00:19:12:00
I tell all of my patients

00:19:12:00 - 00:19:14:07
that don't worry about the six pack abs.

00:19:14:07 - 00:19:16:16
There's another group of core muscles

00:19:16:16 - 00:19:17:10
that are used

00:19:17:10 - 00:19:19:00
when you're sitting properly.

00:19:19:00 - 00:19:20:06
So it's really

00:19:20:06 - 00:19:23:00
you have to build those core muscles

00:19:23:00 - 00:19:24:03
throughout your whole life.

00:19:24:03 - 00:19:26:01
And those are the activities. Yoga, Pilates.

00:19:26:01 - 00:19:27:04
There's some tai chi

00:19:27:04 - 00:19:28:06
that could work as well.

00:19:28:06 - 00:19:30:21
Anything where you have to stand balance.

00:19:30:21 - 00:19:31:21
Those are activities

00:19:31:21 - 00:19:34:17
that help maintain those core muscles

00:19:34:17 - 00:19:36:21
Core, posture, and then weight.

00:19:36:21 - 00:19:38:07
If you could keep track

00:19:38:07 - 00:19:40:01
of all three of those,

00:19:40:01 - 00:19:41:23
you're never going to need back surgery.

00:19:41:23 - 00:19:42:12
Yeah.

00:19:42:12 - 00:19:44:06
Do you recoil

00:19:44:06 - 00:19:45:04
or cringe a little anytime

00:19:45:04 - 00:19:47:01
you see someone running down the sidewalk

00:19:47:01 - 00:19:47:19
as a spine?

00:19:47:19 - 00:19:48:12
No. It does.

00:19:48:12 - 00:19:48:16
What?

00:19:48:16 - 00:19:49:11
Running is great,

00:19:49:11 - 00:19:51:08
but it's not great for the back.

00:19:51:08 - 00:19:51:23
It's great for what?

00:19:51:23 - 00:19:53:11
I mean, it's great for your heart.

00:19:53:11 - 00:19:55:21
Okay. So I think it has benefits.

00:19:55:21 - 00:19:56:08
And certainly

00:19:56:08 - 00:19:56:23
when you're running,

00:19:56:23 - 00:19:59:04
you do engage those core muscles as well,

00:19:59:04 - 00:20:01:00
but not as intentionally.

00:20:01:00 - 00:20:03:07
So I think running is fine.

00:20:03:07 - 00:20:03:16
Yeah.

00:20:03:16 - 00:20:05:05
But when they come to me

00:20:05:05 - 00:20:06:17
with back issues,

00:20:06:17 - 00:20:09:05
I say I give them this exact same talk.

00:20:09:05 - 00:20:09:16
Yeah.

00:20:09:16 - 00:20:10:20
What are some things

00:20:10:20 - 00:20:11:09
maybe that

00:20:11:09 - 00:20:13:01
we don't even know

00:20:13:01 - 00:20:15:12
that we do during the day that are

00:20:15:12 - 00:20:16:06
I don't know

00:20:16:06 - 00:20:16:14
I don't know

00:20:16:14 - 00:20:18:01
if harmful is the right word, but, like,

00:20:18:01 - 00:20:21:01
not great for our spine sitting.

00:20:21:02 - 00:20:23:00
Yeah. So most people don't sit right.

00:20:23:00 - 00:20:24:14
So for example, I.

00:20:24:14 - 00:20:26:16
Oh yeah. This is a demonstration.

00:20:26:16 - 00:20:29:05
Thing is you need to be at 90 degrees,

00:20:29:05 - 00:20:30:11
90 degrees

00:20:30:11 - 00:20:31:01
and sitting

00:20:31:01 - 00:20:32:17
towards the front of your chair. Okay.

00:20:32:17 - 00:20:35:00
If your chair is the wrong height for you

00:20:35:00 - 00:20:35:23
then you can't get those.

00:20:35:23 - 00:20:37:07
What's the right height?

00:20:37:07 - 00:20:39:19
The one that keeps everything 90.

00:20:39:19 - 00:20:40:22
Okay. You want 90 degrees.

00:20:40:22 - 00:20:41:15
You want to be towards

00:20:41:15 - 00:20:42:14
the front of the chair

00:20:42:14 - 00:20:43:21
and you want to sit

00:20:43:21 - 00:20:46:03
letting those balance muscles work

00:20:46:03 - 00:20:48:01
while you're working there.

00:20:48:01 - 00:20:49:18
They're usually involuntary muscles.

00:20:49:18 - 00:20:51:02
You don't even get the strengthening

00:20:51:02 - 00:20:52:20
your your back a little too as you do it.

00:20:52:20 - 00:20:53:20
And then as soon as you do

00:20:53:20 - 00:20:55:00
some slouch, then

00:20:55:00 - 00:20:55:19
you know that it's time

00:20:55:19 - 00:20:57:04
to get up and

00:20:57:04 - 00:20:59:06
walk around the desk and reset yourself.

00:20:59:06 - 00:21:00:22
How do you feel about standing desks?

00:21:00:22 - 00:21:01:17
That's okay too.

00:21:01:17 - 00:21:04:12
I think it's the standing and sitting.

00:21:04:12 - 00:21:05:17
It's a mic. We need a little.

00:21:05:17 - 00:21:06:20
You need a little bit of both.

00:21:06:20 - 00:21:08:01
So I think those are great.

00:21:08:01 - 00:21:10:18
Anything that gets you moving more yeah.

00:21:10:18 - 00:21:12:01
Is better for you back.

00:21:12:01 - 00:21:13:20
Are you doing clinical trials right now?

00:21:13:20 - 00:21:14:08
Yeah.

00:21:14:08 - 00:21:16:09
We have lots of research studies here.

00:21:16:09 - 00:21:17:15
We have research

00:21:17:15 - 00:21:19:05
looking at again

00:21:19:05 - 00:21:20:15
some of those predictive markers.

00:21:20:15 - 00:21:21:12
I love that stuff

00:21:21:12 - 00:21:23:13
that lead to degeneration of this.

00:21:23:13 - 00:21:26:09
We have studies into new biologics

00:21:26:09 - 00:21:28:13
that can be used for fusions for example.

00:21:28:13 - 00:21:30:23
And then we have a unique

00:21:30:23 - 00:21:33:06
second opinion research study.

00:21:33:06 - 00:21:36:13
This is we offer a free second opinion.

00:21:36:13 - 00:21:37:10
So there are a lot of places

00:21:37:10 - 00:21:38:13
that offer second opinion.

00:21:38:13 - 00:21:39:21
But they use it as a

00:21:39:21 - 00:21:41:09
as a way to get patients.

00:21:41:09 - 00:21:43:01
We're using it to actually study

00:21:43:01 - 00:21:46:21
second opinions to see which opinions

00:21:47:13 - 00:21:49:02
patients take the first one,

00:21:49:02 - 00:21:50:16
the second one,

00:21:50:16 - 00:21:51:10
which ones are

00:21:51:10 - 00:21:53:22
they more likely to take the

00:21:53:22 - 00:21:55:13
the non operative opinions

00:21:55:13 - 00:21:57:09
or the operative opinions.

00:21:57:09 - 00:21:58:06
And we're trying to see

00:21:58:06 - 00:22:00:01
how much this offering

00:22:00:01 - 00:22:01:07
a free second opinion

00:22:02:06 - 00:22:04:13
changes patients behaviors.

00:22:04:13 - 00:22:04:22
Yeah.

00:22:04:22 - 00:22:07:03
So it's a free research study

00:22:07:03 - 00:22:08:17
that's offered in what I tell

00:22:08:17 - 00:22:11:08
people is don't get surgery anywhere else

00:22:11:08 - 00:22:12:23
until you've got a free second opinion at

00:22:12:23 - 00:22:15:19
UCI Comprehensive Spine Center. I love that.

00:22:15:19 - 00:22:16:12
That's amazing.

00:22:16:12 - 00:22:18:11
So we've talked about the exciting parts.

00:22:18:11 - 00:22:19:00
I mean,

00:22:19:00 - 00:22:20:14
and it sounds really, you know,

00:22:20:14 - 00:22:21:22
so exciting about all the things

00:22:21:22 - 00:22:22:17
that you guys are doing.

00:22:22:17 - 00:22:26:02
And but as, as, as doctor Oh personally,

00:22:26:05 - 00:22:28:04
what is your favorite part of your job?

00:22:28:04 - 00:22:29:14
What's the best part of your job?

00:22:29:14 - 00:22:30:15
Doing what you do.

00:22:30:15 - 00:22:31:01
To me,

00:22:31:01 - 00:22:32:08
it's kind of create

00:22:32:08 - 00:22:34:22
a program that on scale

00:22:34:22 - 00:22:36:14
will lead to better, more precise

00:22:36:14 - 00:22:38:04
treatments for patients.

00:22:38:04 - 00:22:39:23
There's only so much I can do by myself.

00:22:39:23 - 00:22:40:12
But

00:22:40:12 - 00:22:43:22
but if I'm training a whole generation

00:22:43:22 - 00:22:46:14
of fellows, residents

00:22:46:14 - 00:22:49:09
that have the same kind of adaptability

00:22:49:09 - 00:22:51:15
that use information technology

00:22:51:15 - 00:22:53:15
the same way that I think

00:22:53:15 - 00:22:55:05
will be important going forward,

00:22:55:05 - 00:22:56:17
that incorporates robotics.

00:22:56:17 - 00:22:57:22
And endoscopic.

00:22:57:22 - 00:23:01:12
I think that the impact on this community,

00:23:01:12 - 00:23:02:03
the larger

00:23:02:03 - 00:23:03:09
spine community,

00:23:03:09 - 00:23:06:02
is, is worth my time and effort.

00:23:06:02 - 00:23:07:06
And so that's

00:23:07:06 - 00:23:09:01
what gets me excited to come to work.

00:23:09:01 - 00:23:09:11
Yeah.

00:23:09:11 - 00:23:10:21
Is that the

00:23:10:21 - 00:23:12:07
that I truly believe that

00:23:12:07 - 00:23:13:03
what we're doing here

00:23:13:03 - 00:23:14:13
at UCI and through the Comprehensive

00:23:14:13 - 00:23:15:06
Spine Center

00:23:15:06 - 00:23:16:12
is improving care

00:23:16:12 - 00:23:17:21
for all of our patients

00:23:17:21 - 00:23:19:07
in the spine space,

00:23:19:07 - 00:23:21:05
and to be able to magnify

00:23:21:05 - 00:23:22:21
that and scale that through education

00:23:22:21 - 00:23:24:21
and research is an opportunity

00:23:24:21 - 00:23:25:15
few people have.

00:23:25:15 - 00:23:27:01
And I'm really fortunate

00:23:27:01 - 00:23:27:18
to have that here.

00:23:27:18 - 00:23:28:03
I love it,

00:23:28:03 - 00:23:30:00
and I'm sure there is nothing like,

00:23:30:00 - 00:23:30:07
you know,

00:23:30:07 - 00:23:31:07
the first time you see

00:23:31:07 - 00:23:33:17
somebody who's come in to see you

00:23:33:17 - 00:23:35:06
and they feel so hopeless

00:23:35:06 - 00:23:36:00
and helpless,

00:23:36:00 - 00:23:37:03
right, about how they're feeling

00:23:37:03 - 00:23:38:13
and their limited mobility

00:23:38:13 - 00:23:39:10
and their pain,

00:23:39:10 - 00:23:41:19
and then to see them, what, months later

00:23:41:19 - 00:23:44:01
and to look at you and say thank you.

00:23:44:01 - 00:23:46:08
You've given me a new lease on life.

00:23:46:08 - 00:23:48:10
That's got to feel good. That feels good.

00:23:48:10 - 00:23:49:03
Yeah.

00:23:49:03 - 00:23:51:01
But what drives me is the complications.

00:23:51:01 - 00:23:53:05
If I see complications,

00:23:53:05 - 00:23:55:22
how to create a system

00:23:55:22 - 00:23:57:08
that's complication free,

00:23:57:08 - 00:23:59:08
how to find another way

00:23:59:08 - 00:24:00:20
to do the same thing

00:24:00:20 - 00:24:03:03
that's again safer, better, faster.

00:24:03:03 - 00:24:03:15
I love that

00:24:03:15 - 00:24:06:04
that's what actually drives me every day.

00:24:06:04 - 00:24:08:14
The nice words to yeah, I get it.

00:24:08:14 - 00:24:10:13
Yes, those are all nice. Sure.

00:24:10:13 - 00:24:12:10
But but it's actually the complications

00:24:12:10 - 00:24:13:04
that drives me.

00:24:13:04 - 00:24:13:12
Well,

00:24:13:12 - 00:24:15:01
I really think you for the time you.

00:24:15:01 - 00:24:16:10
This is eye opening

00:24:16:10 - 00:24:18:12
and clearly this is the place to be

00:24:18:12 - 00:24:19:20
if there's any

00:24:19:20 - 00:24:21:06
any issues going on with the spine.

00:24:21:06 - 00:24:22:09
Thank you so much, Doctor Oh.

00:24:22:09 - 00:24:24:00
He's got your back.

00:24:24:00 - 00:24:26:09
Live Well. UCI Health. Thank you, Doctor. Thanks.