October 21, 2025 • 30 mins
In this groundbreaking episode of Live Well with UCI Health, we sit down with Dr. Don Young Park, Director of the Advanced Endoscopic and Outpatient Spine Program at UCI Health, to explore the cutting edge of spine surgery.
From ultra-minimally invasive techniques to augmented reality-guided procedures, Dr. Park is revolutionizing how we treat back pain—offering faster recovery, less trauma, and life-changing results. With over 600 successful cases and global recognition, he’s not just a surgeon—he’s a pioneer.
🧠 Topics Covered:
What makes back pain so debilitating—and how to fix it
The evolution from traditional to endoscopic spine surgery
How AR and AI are transforming the operating room
Real patient outcomes and recovery stories
Tips for maintaining lifelong spine health
💡 Whether you're a patient, a healthcare professional, or just curious about the future of medicine, this conversation will leave you inspired and informed.
🔗 Learn more about UCI Health: ucihealth.org
📩 For appointments or more info: Contact UCI Health
👍 Like, comment, and subscribe for more expert insights on living well.
#UCIHealth #SpineSurgery #BackPainRelief #MinimallyInvasive #AugmentedReality #AIinMedicine #LiveWellPodcast #iHeartRadio #HealthcareInnovation
From ultra-minimally invasive techniques to augmented reality-guided procedures, Dr. Park is revolutionizing how we treat back pain—offering faster recovery, less trauma, and life-changing results. With over 600 successful cases and global recognition, he’s not just a surgeon—he’s a pioneer.
🧠 Topics Covered:
What makes back pain so debilitating—and how to fix it
The evolution from traditional to endoscopic spine surgery
How AR and AI are transforming the operating room
Real patient outcomes and recovery stories
Tips for maintaining lifelong spine health
💡 Whether you're a patient, a healthcare professional, or just curious about the future of medicine, this conversation will leave you inspired and informed.
🔗 Learn more about UCI Health: ucihealth.org
📩 For appointments or more info: Contact UCI Health
👍 Like, comment, and subscribe for more expert insights on living well.
#UCIHealth #SpineSurgery #BackPainRelief #MinimallyInvasive #AugmentedReality #AIinMedicine #LiveWellPodcast #iHeartRadio #HealthcareInnovation
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
All right, welcome to Live Well with UCI Health. I
(00:02):
am Ryan Manna with Coast one A three point five
and iHeartRadio. Thrilled to be joined today by doctor Don
Young Park. I don't want to mess up your title,
doctor Director of the Advanced Endoscopic and Outpatient Spine Program
here at UCI Health. Doctor, thank you so much.
Speaker 2 (00:14):
Well, thank you for having me. Thank you. I really
appreciate you. I appreciate you.
Speaker 1 (00:17):
It's a pleasure to meet you. Tell us about you.
I know I saw Stanford in there.
Speaker 3 (00:19):
Yes, I did my training at Stanford in my Orthopedic
Surgery residency for spine surgery fellowship there.
Speaker 1 (00:24):
Yeah, and I know that you're one of the leaders.
People call on you a lot to for your You're
an opinion leader as they say.
Speaker 3 (00:30):
Yeah, right into scopic spine surgery and minimally in vasis
spine surgery. So one of my other titles is the
director of the minimally invasive Spine Surgery at UCI Health.
Speaker 2 (00:38):
Yeah. How long have we been at this in the
game thirteen years now?
Speaker 3 (00:41):
Yeah, I graduated a fellowship in twenty twelve.
Speaker 2 (00:44):
There's a couple.
Speaker 1 (00:45):
Things like you can live with, like if your finger
hurts that you know, kind of ruins your day for
a little bit. But like when you have back pain,
there are a few things in life that are more debilitating.
When your back is whack like you, it throws off
everything that's correct.
Speaker 3 (00:58):
It really does affect everyone's activities, their daily function, their enjoyment,
the quality of life, all of that's affected now a
lot of it's a lot of people are talking about
health span. I think back pain has a lot to
do with health span, and so if you have debilitating
back problems, then I think then it's going to completely
affect your life from beginning to end.
Speaker 1 (01:19):
In your practice, in your study with what you do,
do you find there's something predominant that leads to back.
Speaker 3 (01:24):
Pain injuries, that's one, but it's a multifactorial. So you
can have injuries like a sports injury. You can have
genetic predisposition. Some people are more prone to it. They
runs in families sometimes. And then you know, I think
wear and tear. You know what we do to our bodies,
and so if we're really hard on our bodies, we
(01:45):
put a lot of stress and strain into our spine
and our bodies and it will be affected by it.
Speaker 1 (01:52):
I've always heard that there are a couple of things
you shouldn't skimp out on. It's anything between you and
the ground, your shoes, your mattress, and your tires on
your car. And I bet bad mattress and bad shoes
if you're like a runner, or if you're on your
feet all day, that can over time contribute to some backstuff.
Speaker 3 (02:07):
Definitely, definitely. And one of the things I always recommend
is having really good shoes. And I see a lot
of these new shoes and new brands, and everyone's wearing
them now because of that, you know, because it does
translate up, you know, from your feet to your legs
and to your back.
Speaker 2 (02:23):
Yeah.
Speaker 1 (02:24):
So, okay, by the time someone comes to see you
and they've exhausted all options right for treatment and surgery
has been recommended, what is your guidance.
Speaker 3 (02:33):
Well, I first look at the patient symptoms, I get
good history, understand what happened with the patient. What have
they done non surgically to treat it? Have they exhausted
all non surgical treatment options? That is reasonable, you know
for the patient. And many times patients have done rounds
and rounds and rounds of non surgical treatment and they're
(02:53):
kind of like, this is the last resort, which is
I think a very reasonable thing to think about. Many
patients come to me and they say, I wanted to
avoid surgery like the plague. Sure, right, I never wanted
spine surgery ever. Yes, And you know when they hear
about what I do, then they're intrigued. They're like, oh,
and one of the things that the patients always tell
(03:14):
me is that, well I wanted that non non invasive surgery.
I was like, well, that doesn't quite make sense, but
I know what you're talking about, sure, And what are
they talking about. They're talking about endoscopic spine surgery. This
ultraminimally invasive spine surgery that I do.
Speaker 2 (03:28):
How minimally are we talking? These are millimeters? Millimeters?
Speaker 3 (03:32):
Ultramimally invasive is the kind of like the next evolution
of spine surgery.
Speaker 2 (03:37):
So we've gone through this phase.
Speaker 3 (03:39):
When I was in residency and fellowship, it was minimally
invasive was kind of the you know, the big thing,
and that's you know, incisions of centimeters, so maybe two
three centimeters in decision, and you know, it does wonders.
A lot of patients do really well from that. But
now we're talking about millimeters and so several millimeter incisions.
So these are really truly all incisions where sometimes I
(04:01):
can't even see the incisions on their backs, Like where
did I do surgery? And I'm embarrassed to say it,
but they'll call me a musician because I feel like,
you know, I'm doing magic, but I'm really not. I
feel like you're sitting with a magician right now learning this.
That's what they're that's what they're calling me, and I'm like, no, no,
I'm not a magician. I'm actually doing real surgery. It's
just that the technique allows me to do the things
(04:22):
I need to do to treat the patient and undo
the pathology that has been growing for years inside their spine,
inside their bodies with these tiny incisions.
Speaker 2 (04:33):
So on a very.
Speaker 1 (04:33):
Literal level, put this in terms for people that aren't
in the o R with you and aren't seeing what
you're doing when you make these small incisions, then what
like are you going, what are you using? What are
you doing?
Speaker 3 (04:44):
So I put in camera so it's a very Now
we have like four K high definition TVs everywhere, right, yes,
and I can put in four K cameras into the
spine and with an endoscope it's you know, the one
that I use is about four millimeters in diameter. So
then I put that into the spine and then I'm
able to visualize the anatomy. I can see everything in
(05:08):
four K and it's underwater, and it's very similar to
our mind.
Speaker 2 (05:11):
Right now, you do surgery underwater.
Speaker 3 (05:13):
Yeah, underwater and sometimes myself with all the water that
spills on me, but then literally underwater in the spine,
you know. And it's very similar to arthroscopy. So if
you do knee surgery, shoulder surgery, you know, even now
hip hands orthopedics is now a large part arthroscopic. That
(05:33):
means you're in the joints. You're putting a camera in
the joints. Endoscopic is putting a camera in the body somewhere.
It could be, you know, in your gut. But here
I'm doing it in the spine. And so I put
the camera in the spine and then I'm able to
visualize with extreme visualization. I can see really well the anatomy.
(05:53):
I can see the nerves it. So it makes me
a safer surgeon. So I know with two hundred times magnification, yeah,
that you know that structure is not to be touched.
I need to be preserving that and I can it's
safe to do the surgery that I do to really
kind of decompress or fix the problems that the that
(06:14):
the spine is going through.
Speaker 2 (06:16):
Yeah, and let's talk about those problems.
Speaker 1 (06:17):
What specific spine conditions can can be treated with what
you're doing.
Speaker 3 (06:21):
Right, So common things like lumbar discarnations. Now, these are
things that happen to young people people you know, like
you know, weightlifters, football, high school players who you know
are deadlifting and they tweak their back and get a discarnation.
These are patients so that I see all the time,
and then older fake patients as well. So as people age,
their discs degenerate, that degeneration causes arthritis. That oarthritis can
(06:44):
then lead to compression of their nerves and what's called
lumbar stenosis. That lumbar stenosis can then lead to symptoms
like pain in their legs like sciatica, and that kind
of sciatica pain can be treated with this as well.
Other things that I can treat is common things like
slippage of the spine where the spine is unstable and
it slips back and forth abnormally. So that's something that
(07:07):
I think can be treated as well endoscopically. I can
even do what's called the endoscopic fusion. Now, a lot
of people have this like notion that fusion is all bad. Yes,
and actually, if you look at the studies, the randomized
concle trials, the evidence out there, the best evidence we
have shows that fusion actually works really well for certain things,
and if you apply it in the right way, then
(07:30):
fusion is actually a very successful surgery and it can
lead to long term success.
Speaker 1 (07:36):
I've heard this because I follow sports a lot and right,
and you'll hear of athletes who've gotten like a c
something fused or whatever.
Speaker 3 (07:41):
What is actual what is fusion. Fusion is when you
fuse the bones together. Okay, so typically in the spine
you have a vertebra and a disc and another vertebra,
so there's the disk in between. Is what helps it move.
It's like the cushion between the bone. And so sometimes
that disc is so degen it's so dysfunctional, and it's
(08:02):
causing problems. I say, the inside of it. Imagine like
inside of your tire. Sure right, it kind of popped out, Yeah,
so then it may it can the same thing can
happen with your discs where the inside of your disc
pops out and then it can push on things around
it and around it is actually sometimes really important things
like your your nerves, yeah, your spinal cord, things like that.
Speaker 1 (08:23):
So it's like one thing leads to another, right, it's
like this thing is impacting this other thing, and yeah.
Speaker 3 (08:28):
Right right, and so then you have to then remove
that dysfunctional disk and remove the compression of whatever it
is that's being compressed. It's a nerve, if it's the
spinal cord, then you remove that compression and then you
have to then fill it with something else. Yeah, you
have to fill that space where the disc used to be.
Speaker 1 (08:46):
And we have things like this envisioning like an oreo
without the cream in the middle, right, So now we're
filling it with what just the other word, fusing the bone.
Speaker 3 (08:54):
So yeah, we can't put in the cream back in.
So that's the hard part. Still trying to figure that out.
But if you take the cream out, you take the
disc out, and then we have to fill it with something. Sure,
so then we put in like a cage, like some
sort of implant, a disk replacement sometimes, so you can
do that, and so there's different ways of treating and
(09:15):
addressing disc pathology.
Speaker 1 (09:17):
Sure, okay, so with you with your magic that you
do with in the millimeters underwater, how does this compare
to let's say, traditional old school spine surgery or regularly
regular not not what you're doing in terms of recovery?
Speaker 3 (09:29):
Many many surgeons, I say, the vast majority of surgeons
are still doing traditional surgery.
Speaker 2 (09:33):
Where they're just like cutting open the back and stuff.
Speaker 3 (09:35):
Right, And that's what it is, cutting open the back.
So you make a big incision you want.
Speaker 2 (09:40):
How big like?
Speaker 3 (09:41):
Typically it depends depends on what you're trying to do.
It could be as big as you know your your
back you're from the top of your back to the
bottom you know of your back to you do scoliosa surgery, okay,
you know where you have to put in lots of
screws and rods and fuse all your bones from the
top to the bottom. Or it could be just in
your lumbar. If it's in your lumbar, then it's like
(10:01):
it could be you know, five six inches, you know,
so it still could be a sizeable incision. It's not
the size of the incisions that really is the issue.
It's what you do inside. So when you do traditional surgery,
you have to make an incision. Then you have to
detach all the muscles that are on top of the spine.
Then you have to then retract those muscles so that
(10:22):
I can see what's going on. Right, So traditionally I
would use loops or you know, those magnifying glasses and
you use like surgery or a microscope, an operating microscope.
But you know you're looking at it from the outside.
So I'm looking at it through my lenses. My eyes
are on the outside looking toward the spine, and so
I need a big incision to see, like I need
(10:43):
to know, like what's what, because I don't want to
injure anything. I don't want to damage anything. And so
that retraction of muscles, it's been shown that really does
lead to a lot of a lot of issues. So
the muscles, they can die off because they're denervated. You
basically to all the nerves that go to those muscles
and you strip them off. You took them off the bone.
(11:04):
Then you retract it under high pressure and for an hour,
two hours, three hours, four hours, So then you undo
that and then there's no blood supply to that muscle,
So those muscles die off and then you sew everything
back up and then over time when ends up happening
the fusion say, it works great, it's fuse, but the
muscles are dead. The muscles are gone, right, and the
(11:24):
muscles are what you use to stand and what you
use to change positions, lean forward, lean back. So because
of that, those muscles are super important for your long
term back health, right, And I'm always telling patients you
need to work on your core, your back muscles, your
leg muscles. That's the trifecta for good back health. But
if you remove one of those, then you can really
(11:46):
kind of tip things over on the balance in terms
of back pain. So then you can get what's called
chronic back pain from that because your muscles are atrophy,
they're dead, they're not there anymore to help you stand.
So that's one of the big issues of conventional spine
surgery is that you have to first see everything, but
(12:06):
you have to retract everything. So what I do is
I don't do any of that. I go between the muscles,
the little muscle fibers, and I don't attach any of it.
I don't denervate anything. I don't retract anything, I don't
put anything under pressure, and I create a space on
this over the spine, and then I fill it with
water and then it's like a little water bubble on
top of the spine. But everything's still intact, the muscles,
(12:28):
the skin, everything other than those little tiny incisions to
do the actual surgery. And then inside there, I put
the camera in that water bubble and put the surgical
instruments inside that water bubble as well, and then I'm
able to start the surgery. And I can see the
same kind of anatomy that I see when you do
it open, because I've done all of that. I've done
open surgery, I've done minimally invasive surgery, and I can
(12:51):
see it, but under such good detail that, you know,
I think that you're able to really understand the anatomy
quite well be able to accomplish a surgery.
Speaker 2 (12:59):
And that's when things people actually ask it.
Speaker 3 (13:01):
They're like, well, with minimally invasis spine surgery, you know,
you can't see as well, and then with ultimately based
spine surgery you can't see even Yeah, yeah, it's even worse,
even worse. Yeah, it's actually not true because I have
this four K camera that I can put inside the spine,
so I imagine the eyes are now in the spine, not
outside in the environment, and so I can see so
(13:21):
much better than when I could without it.
Speaker 1 (13:24):
What about recovery time, like for your standard, are they
at home that day?
Speaker 2 (13:29):
Yep.
Speaker 3 (13:30):
That's why my program is called the Endoscopic and Outpatient
Spine program. So you're combining to two so patients can
go home the same day. And these are patients that
are even older patients, elderly patients you know, that can
go home. They're upright away. Most patients wake up from
these kinds of surgeries that I do with no pain,
and then they're able to walk right away instantly. They
know they have no more pain, right.
Speaker 2 (13:51):
I asked them all the time, how much back pain
are you having? Yeah?
Speaker 3 (13:54):
None, No, and they're just kind of surprised. Yeah, they're
playing Pivo all that night for you. No, I'm just kidding.
Speaker 2 (13:59):
I don't want that.
Speaker 3 (14:00):
I'm kidding in orth Peedick's pickleball, Is is it bad?
Speaker 2 (14:04):
Yes?
Speaker 3 (14:04):
Really, It's one of the things that helps us stay
busy now, and I wouldn't want them to play pickaball
right away.
Speaker 1 (14:11):
Yeah, if that is fascinating though you're shedding light. So
let's go back to this like eyes inside the spine,
because there's something you do and I really want to
geek out with you over this. You wear or you
have worn, an AR augmented reality headset to do your
surgery right, and it was a first. It's a first.
Speaker 2 (14:26):
So I did the first in the United States.
Speaker 3 (14:27):
I did nunbelieve in terms of the using the augmented
reality glasses for the endoscopic spine surgery. Yes, and then
I did the first AR guided fusion in the world,
and so that's where you know, it's really been a
game changer for me. The reason is it's like having
a really enhanced virtual view of what's happening.
Speaker 2 (14:47):
Right.
Speaker 3 (14:47):
It has the ability to capture my environment as well
as have large videos in front of you. So it's
like having one hundred inch TV monitor in front of
me virtually, but with four K and there's four K
on each I so then I can see so much
better because the screen is so large. And what's great
(15:10):
about it too is that I can also put in
other things like the medical record.
Speaker 2 (15:15):
I can virtually place it there.
Speaker 3 (15:16):
I can place the preoperative MRI, put it next to me,
so I can just look around and see, oh, there's
the endoscopic video. Okay, what was it about that patient?
Speaker 1 (15:27):
That?
Speaker 2 (15:27):
Then you can then what was the MRI?
Speaker 3 (15:29):
Look like I can look over here and so you
can see all of that right away, you know. And
so the information that data is at your fingertips and
or literally in front of my eyes, and I don't
you know what I had to do before if I
had a question about sometimes I don't really know what's
going on, like you know, I'd have to step away
from the patient, go to the nurses station, look at
(15:50):
the computer hopefully it didn't log off, log back in, yeah,
because I'm scrapped in. Yeah, of course I have to
log back in somehow and then look for that information.
Whereas now I'm still doing surgery and I'm looking around
at that information. So it makes me more efficient, it
makes me safer. I think that's the future. Part of
the future of spine surgery and surgery. I think in general,
(16:13):
is this augmented reality.
Speaker 1 (16:15):
Are people coming to you now asking for this? People
obviously they would want this.
Speaker 3 (16:20):
A surgeons you know, from Taiwan, from Korea, from China.
They're asking me, how did you do that? How are
you doing this from Japan? And so then I'm showing
them how they do it, and then I think it's
it's growing slowly, so we'll see, you know, I think
there's still a lot that needs to be done in
this space.
Speaker 2 (16:37):
You know, it needs to be lighter light. What do
you mean by the headset? Oh, the actual headset. The
actual headset needs to be lighter, it needs to be faster.
So that's AR.
Speaker 1 (16:46):
How do you feel about AI in the future of
AI for what it is that you do.
Speaker 3 (16:49):
Well, I think AI is can be huge in terms
of combining AR and in my mind and what I
think of the future is that AI will be able
to tell me as a surgeon, are right if you
do the next surgical move with this instrument and put
it into this area. You know, predictive analytics says a
million moves, this is the fastest and the safest way
(17:11):
to go. So if it told me that, it's like
give me the answer key, I'm like, Okay, I'm going
to do that. Because surgery, like anything, is a series
of decisions. So if you make the wrong decision the
wrong time, you're going to go the wrong direction. Right,
So you want to have right direction, and so having
AI to help me in terms of getting the right decisions,
(17:34):
the right path to success, and making it the safest
and the most efficient way of doing it, that's where
I see AI. So if in the headset, if AI
is saying, Okay, you want to go to this area
in the spine, you want to take this instrument and
do this with that, then you're going to be safe
and you're going to be effective. You're away from the nerves,
you're not going to injure anything. And so for me,
(17:55):
that will give me a lot of reassurance.
Speaker 1 (17:57):
Sure so, but okay, so, and I'm not being onny
when I asked this, your human brain, do you ever
disagree with what AAI is telling you or do you
look at you know, do you look at it as like, okay,
I'll figure out I think that might be right.
Speaker 2 (18:08):
Yeah, I think that I probably would be.
Speaker 3 (18:10):
It's kind of like sometimes I think Google Maps is wrong, Like, no,
I'm going to go right, you know, It's like I
don't think that that, you know, sometimes so fascinating. I
think that the technology is just not you know, correct.
Sometimes I'm wrong about that and so but that's my decision.
That's the human decision to be able to discern. Now,
you know when people are afraid of AI, they're afraid
(18:33):
of AI taking over and just doing everything. Course, yes,
they're never going to be able to do the surgery
by itself because who's going to be responsible Like open
AI or Apple or like no one is going to
then be responded. I have to be responsible. So ultimately
surgery needs to be done by the surgeon. Now AI
can augment me, I can use augmented reality to augment me, right,
(18:53):
So I think that's where, uh, does these technologies come
into play in the future.
Speaker 1 (18:58):
So okay again, I want to go back to back
to you, you know, the folks that are benefiting from
everything that you've just described. How do you determine We've
talked about opening up the back, We've talked about the
different types of how do you determine if what you're
doing is best for that person versus something else.
Speaker 3 (19:14):
I know what pathologies are best suited for the patients
that I see, and so if I see something, I'm like,
you know, actually, maybe open surgery traditional surgery is better
for you.
Speaker 1 (19:25):
Really, so you you haven't would and do suggest that
in those cases.
Speaker 3 (19:30):
Right, and you know, maybe doing multi level fusion is
actually the best thing for you because your pathology is
just too much.
Speaker 2 (19:36):
You know.
Speaker 3 (19:36):
It's like endoscopic surgery is not for everything. It doesn't
solve everything, but it does solve a lot of the
most common things, right. But there are those outliers. It's
kind of like a Bell curve. You're going to have
some people where you just can't do that. Yeah, and
so then you have to do, you know, what's tried
and true, which is more traditional surgery, and I you know,
(19:58):
recommend that. Yeah, I mean once, well sure, but for
the vast majority of patients who I see in my clinic,
they actually can have the surgery and they can benefit
greatly from it. Like I said, like, you know, they
wake up with no pain. You know, they're walking right away.
Two weeks later, I see them in clinic and they're like, yeah,
I feel great, you know, in the start physical therapy.
(20:18):
Oftentimes by six weeks after surgery, they're like, Okay, I
don't want to see you again. If I never have
to see you again, I'm.
Speaker 2 (20:23):
Glad you brought that up.
Speaker 1 (20:24):
I think I think when people do think of bax
or spine surgery, any any type of surgery on that area.
Speaker 2 (20:29):
The follow up, the what's the rehab?
Speaker 1 (20:31):
All of this stuff is like a concern, right, so
what is your traditional you said, I see them in clinic,
Like what is that? What does that look like for
someone who's who's undergone what you do?
Speaker 3 (20:40):
I see them in clinic in the you know, before
surgery is the consultation, make sure you know are the
appropriate candidates. And then after surgery, I'll see them usually
had two weeks after surgery, just to make sure that
their wounds are healing and they're doing okay, and then
I give them the physical therapy prescription. I think physical
therapy is actually very important you do because when people
are in pain, you know, they don't don't walk the same,
(21:01):
they don't carry their body the same, their their their
their bodies become dysfunctional and they get out of balance.
So then we need to rebalance them up again. We
need to train them back into more normal life, and
so that requires I think some supervisions and physical therapists
are the I think they are the best for that,
and so I do have most of my patients grow
(21:23):
through physical therapy, you know, to be able to recover
and usually it's about four to six weeks of physical
therapy that they go through.
Speaker 2 (21:31):
It's not bad. I was I was thinking it would
be longer.
Speaker 3 (21:34):
Even the fusion cases you know where you know it
does shift so that the advantage of endoscopic surgery and
minimum ultra minimum basis spine surgery is that it shifts
the recovery. So that's sooner, right, so you're you're you're
in less pain after surgery, you recover faster, go home
the same day or to stay overnight. Most patients get
able to do that, and so it shifts everything so
(21:57):
that you can get better back faster, You get back
to normal faster, get back to your normal life, get
back to function as quickly as possible. And that's the
basic tenet of this ultimately invasive spine surgery is being
able to get there. The way we can get there
is that it helps to reduce trauma. Right, our surgical footprint,
(22:18):
the things that we do inside is not as traumatic, right,
so I don't have to injure the patient as much
to do the same surgery to accomplish the same goals.
And so because of that, they're not hurting after surgery,
so they can recover faster, and then they can get
back to normal faster.
Speaker 1 (22:36):
Yeah, feel free to brag on this, because I have
a feeling I know the answer. How many other programs
are offering this level of innovation.
Speaker 3 (22:42):
Just a handful in terms of endoscopic spine surgery, a
handful in the country. Yeah, and then you know, in
terms of augmented reality, I'm the only one. And then
you know endoscopic fusion is like I was one of
the first in the country to do it. And then
you know, I think there's only a handful of programs.
(23:03):
It's growing though, and I think that's where adoption will
truly skyrocket with this, because most most surgeons are they're
they're not trained in this. They're trained in conventional surgery
because that's what the fellowships and the training programs, that's
what they all train and teach. And so once the
training programs like uce I, like other university training programs
(23:28):
around the country like Stanford or Harvard or whatever, they
get these kind of programs online and then able to
teach the residents and fellows this, then I think it'll
skyrocket because even now, when I teach my residence and
fellows and I show them what endoscopic surgery is, and
they see what conventional surgery is, It's well, I want that.
I want to do that because one it's it's really cool,
(23:50):
it's new, it's exciting. But also they see what the
patients they're how they do. They do much better, you know,
in terms of their recovery instead of well, if I
had a choice, and I'd want to choose that, But
if you haven't seen it, you don't know. So if
you don't know, then it's like, well, how are you
going to make a decision about it? Yeah, on a
personal level, what led you to this?
Speaker 1 (24:10):
What was your interest point, your you know, entry point
into wanting to be like the king of backs?
Speaker 3 (24:15):
Well, the I first heard about and this copic spine
surgery probably in two thousand and seventeen, and then that's
when it was starting to really come up. And one
of the places that it's like the epicenter is in Korea,
South Korea, and so you know, the South Koreans would
then come and present their their their data, how their
results were, and we're like, oh, that's too good to
(24:36):
be true, and you know, I really have to learn
this is this something that is real? And you know,
you don't want to adopt something too early before you know,
you know, the results really come out.
Speaker 2 (24:49):
And so I learned about it.
Speaker 3 (24:51):
I read the papers, and I went to labs and
courses and conferences about it and learn more and more
as much as I could COVID HIT.
Speaker 2 (25:01):
Then I had a lot of time. Of course, I had.
Speaker 3 (25:03):
A lot of time just to think about things and
what about life, what's going on, you know, and what
do I do next? And so then I went to
Korea and I learned endoscopic surgery from the masters that
were at that time doing it, and you know, I
was just completely blown away what I was seeing. I was,
you know, able to you know, just really grasp the
(25:25):
ideas and the principles of endoscopic surgery. So I took that,
came back to the US. I came back on a Sunday,
and then on a Wednesday, did my first surgery and
then has been going since. So I've done over six
hundred cases now and then I'm one of the first
in the country to do the biportal endoscopic spine surgery
(25:46):
that I mostly do. And then in terms of endoscopic fusions,
as one of the first in the country to do it.
So it just I saw the potential you know, when
you when I can see with my own eyes when
I went to Korea, I realize, Okay, this is something
really powerful.
Speaker 1 (26:04):
Yeah, that's incredible just on a personal you know, for
someone listening that may have not like something that requires
a lot of advanced care or the surgery, but like,
what are what are some good things maybe that you
abide by in terms of just your own physical motions
during the day, Like is planking bad for like what's
good and bad for you?
Speaker 2 (26:22):
For patients?
Speaker 1 (26:22):
Yeah, for anyone that's maybe dealing with like a sore
back or something like what's a good what's a good
daily routine.
Speaker 2 (26:28):
To be in for optimal back health?
Speaker 3 (26:30):
But I think, like I said before, the three things
that are really important are back muscles, core muscles, and
your leg muscles. Got it, So you have to really
have all three of those. It's kind of like your
the the tripod, okay, to your spine in terms of
spine health. So you want to strengthen those as much
(26:51):
as possible. So planks are good. You know, sit ups
are not as good because if you're curling your back
is you know, tendency to really have bad technique doing
sit ups and crunches and then you end up tweaking
your neck twiking your back, so it's not the best
way of doing it. But you know, leg lifts, you know,
planks are great, and different exercises you can do with
your legs while you're in the playing position, you know,
(27:14):
and while you're on your back with your legs lifted
and moving in different directions and different exercises.
Speaker 2 (27:19):
You can do with that.
Speaker 3 (27:20):
And then the things that you want to avoid, so
you want to avoid stressed to your back, the things
that stress your back. Bending deeply, twisting, extremely heavy lifting
with your back and then sitting for long periods of time.
Those things really do stress your discs and your back
and your spine, so you want to avoid that as
much as you can, you know, And so things like deadlifts,
(27:40):
you know, Olympic you know lifts, those are really bad
for your back if you do it poorly, and if
you do it right. You know, powerlifting could be great,
you know, for your body, but at the same time,
it's not something that you can do forever, so it's
always going to eventually wear on you. But you have
to have proper technique, and most people don't yeah, and
so I think that you know, proper posture, you know,
(28:02):
is really important. Proper technique and then also you know,
keeping your body strong and then avoiding the stress to
your spine, all of that's really important.
Speaker 2 (28:12):
Yeah, do you do you hear back?
Speaker 1 (28:13):
Obviously you follow up with your patients, But did they
come back to you and say, like, oh my god,
you changed my life? I get I bet you get
that all the time every day, right day. It's incredible.
Speaker 2 (28:21):
You know, it's a great feeling.
Speaker 3 (28:22):
It has to be and they you know, it really
is the reason why I do this and why I
went into you know, orthopedic surgery, spine surgery, to begin
with orthic surgery, because you know, you can fix a
lot of things. You can really change people's lives, you
can really make people better, yes, right, and the idea
is to get people back to normal functioning, to get
(28:42):
them back to where they need to be. And so
that's where orthopedics comes into play with spine surgery. What's
exciting with spine surgery and you know, I've kind of
geeked out about it already. All the technology, all the tech,
you know, the high tech that you can have, you know,
AI ar we haven't talked about robotics. I mean, you
can really combine all of that stuff into spine surgery
(29:04):
and that's super exciting too. And so I think for me,
like that's why I went into going into it and
into spine surgery. But also you know, not just technology,
but now it's also the results. Patients are coming back
and they're just like they're transformed. You know, their pain
is so it's gone there. You know, they're their function
(29:24):
is so much better and they're able to get back
to their lives or before surgery. And I always ask
this in clinic, you know, in every post I visit,
do you feel better? How do you feel compared to
before surgery? Like, oh, this is night and day, you know,
like this is so much better. And so it's like, Okay,
then I did my job and I feel like, you know,
I think that that makes it completely worth it.
Speaker 1 (29:46):
Wow, Well we are in the presence of greatness, sir.
Keep doing what you're doing. I mean, I don't know
where you go next from here, but but it's really
incredible and you're changing lives and really it's awesome and
a pleasure to hear your story and see what you're doing,
and all the breakthroughs that are probably yet to come,
and that that you're going to be on the forefront
of Doctor don Young Park live well with UCI Health.
Speaker 2 (30:04):
It has been a pleasure. This man is magical.
Speaker 1 (30:06):
I swear to God, if my back is ever screwed up,
I'm not going no one's touching it except you.
Speaker 2 (30:09):
Thank you, Thank you very much. Pleasure
All right, welcome to Live Well with UCI Health. I
(00:02):
am Ryan Manna with Coast one A three point five
and iHeartRadio. Thrilled to be joined today by doctor Don
Young Park. I don't want to mess up your title,
doctor Director of the Advanced Endoscopic and Outpatient Spine Program
here at UCI Health. Doctor, thank you so much.
Speaker 2 (00:14):
Well, thank you for having me. Thank you. I really
appreciate you. I appreciate you.
Speaker 1 (00:17):
It's a pleasure to meet you. Tell us about you.
I know I saw Stanford in there.
Speaker 3 (00:19):
Yes, I did my training at Stanford in my Orthopedic
Surgery residency for spine surgery fellowship there.
Speaker 1 (00:24):
Yeah, and I know that you're one of the leaders.
People call on you a lot to for your You're
an opinion leader as they say.
Speaker 3 (00:30):
Yeah, right into scopic spine surgery and minimally in vasis
spine surgery. So one of my other titles is the
director of the minimally invasive Spine Surgery at UCI Health.
Speaker 2 (00:38):
Yeah. How long have we been at this in the
game thirteen years now?
Speaker 3 (00:41):
Yeah, I graduated a fellowship in twenty twelve.
Speaker 2 (00:44):
There's a couple.
Speaker 1 (00:45):
Things like you can live with, like if your finger
hurts that you know, kind of ruins your day for
a little bit. But like when you have back pain,
there are a few things in life that are more debilitating.
When your back is whack like you, it throws off
everything that's correct.
Speaker 3 (00:58):
It really does affect everyone's activities, their daily function, their enjoyment,
the quality of life, all of that's affected now a
lot of it's a lot of people are talking about
health span. I think back pain has a lot to
do with health span, and so if you have debilitating
back problems, then I think then it's going to completely
affect your life from beginning to end.
Speaker 1 (01:19):
In your practice, in your study with what you do,
do you find there's something predominant that leads to back.
Speaker 3 (01:24):
Pain injuries, that's one, but it's a multifactorial. So you
can have injuries like a sports injury. You can have
genetic predisposition. Some people are more prone to it. They
runs in families sometimes. And then you know, I think
wear and tear. You know what we do to our bodies,
and so if we're really hard on our bodies, we
(01:45):
put a lot of stress and strain into our spine
and our bodies and it will be affected by it.
Speaker 1 (01:52):
I've always heard that there are a couple of things
you shouldn't skimp out on. It's anything between you and
the ground, your shoes, your mattress, and your tires on
your car. And I bet bad mattress and bad shoes
if you're like a runner, or if you're on your
feet all day, that can over time contribute to some backstuff.
Speaker 3 (02:07):
Definitely, definitely. And one of the things I always recommend
is having really good shoes. And I see a lot
of these new shoes and new brands, and everyone's wearing
them now because of that, you know, because it does
translate up, you know, from your feet to your legs
and to your back.
Speaker 2 (02:23):
Yeah.
Speaker 1 (02:24):
So, okay, by the time someone comes to see you
and they've exhausted all options right for treatment and surgery
has been recommended, what is your guidance.
Speaker 3 (02:33):
Well, I first look at the patient symptoms, I get
good history, understand what happened with the patient. What have
they done non surgically to treat it? Have they exhausted
all non surgical treatment options? That is reasonable, you know
for the patient. And many times patients have done rounds
and rounds and rounds of non surgical treatment and they're
(02:53):
kind of like, this is the last resort, which is
I think a very reasonable thing to think about. Many
patients come to me and they say, I wanted to
avoid surgery like the plague. Sure, right, I never wanted
spine surgery ever. Yes, And you know when they hear
about what I do, then they're intrigued. They're like, oh,
and one of the things that the patients always tell
(03:14):
me is that, well I wanted that non non invasive surgery.
I was like, well, that doesn't quite make sense, but
I know what you're talking about, sure, And what are
they talking about. They're talking about endoscopic spine surgery. This
ultraminimally invasive spine surgery that I do.
Speaker 2 (03:28):
How minimally are we talking? These are millimeters? Millimeters?
Speaker 3 (03:32):
Ultramimally invasive is the kind of like the next evolution
of spine surgery.
Speaker 2 (03:37):
So we've gone through this phase.
Speaker 3 (03:39):
When I was in residency and fellowship, it was minimally
invasive was kind of the you know, the big thing,
and that's you know, incisions of centimeters, so maybe two
three centimeters in decision, and you know, it does wonders.
A lot of patients do really well from that. But
now we're talking about millimeters and so several millimeter incisions.
So these are really truly all incisions where sometimes I
(04:01):
can't even see the incisions on their backs, Like where
did I do surgery? And I'm embarrassed to say it,
but they'll call me a musician because I feel like,
you know, I'm doing magic, but I'm really not. I
feel like you're sitting with a magician right now learning this.
That's what they're that's what they're calling me, and I'm like, no, no,
I'm not a magician. I'm actually doing real surgery. It's
just that the technique allows me to do the things
(04:22):
I need to do to treat the patient and undo
the pathology that has been growing for years inside their spine,
inside their bodies with these tiny incisions.
Speaker 2 (04:33):
So on a very.
Speaker 1 (04:33):
Literal level, put this in terms for people that aren't
in the o R with you and aren't seeing what
you're doing when you make these small incisions, then what
like are you going, what are you using? What are
you doing?
Speaker 3 (04:44):
So I put in camera so it's a very Now
we have like four K high definition TVs everywhere, right, yes,
and I can put in four K cameras into the
spine and with an endoscope it's you know, the one
that I use is about four millimeters in diameter. So
then I put that into the spine and then I'm
able to visualize the anatomy. I can see everything in
(05:08):
four K and it's underwater, and it's very similar to
our mind.
Speaker 2 (05:11):
Right now, you do surgery underwater.
Speaker 3 (05:13):
Yeah, underwater and sometimes myself with all the water that
spills on me, but then literally underwater in the spine,
you know. And it's very similar to arthroscopy. So if
you do knee surgery, shoulder surgery, you know, even now
hip hands orthopedics is now a large part arthroscopic. That
(05:33):
means you're in the joints. You're putting a camera in
the joints. Endoscopic is putting a camera in the body somewhere.
It could be, you know, in your gut. But here
I'm doing it in the spine. And so I put
the camera in the spine and then I'm able to
visualize with extreme visualization. I can see really well the anatomy.
(05:53):
I can see the nerves it. So it makes me
a safer surgeon. So I know with two hundred times magnification, yeah,
that you know that structure is not to be touched.
I need to be preserving that and I can it's
safe to do the surgery that I do to really
kind of decompress or fix the problems that the that
(06:14):
the spine is going through.
Speaker 2 (06:16):
Yeah, and let's talk about those problems.
Speaker 1 (06:17):
What specific spine conditions can can be treated with what
you're doing.
Speaker 3 (06:21):
Right, So common things like lumbar discarnations. Now, these are
things that happen to young people people you know, like
you know, weightlifters, football, high school players who you know
are deadlifting and they tweak their back and get a discarnation.
These are patients so that I see all the time,
and then older fake patients as well. So as people age,
their discs degenerate, that degeneration causes arthritis. That oarthritis can
(06:44):
then lead to compression of their nerves and what's called
lumbar stenosis. That lumbar stenosis can then lead to symptoms
like pain in their legs like sciatica, and that kind
of sciatica pain can be treated with this as well.
Other things that I can treat is common things like
slippage of the spine where the spine is unstable and
it slips back and forth abnormally. So that's something that
(07:07):
I think can be treated as well endoscopically. I can
even do what's called the endoscopic fusion. Now, a lot
of people have this like notion that fusion is all bad. Yes,
and actually, if you look at the studies, the randomized
concle trials, the evidence out there, the best evidence we
have shows that fusion actually works really well for certain things,
and if you apply it in the right way, then
(07:30):
fusion is actually a very successful surgery and it can
lead to long term success.
Speaker 1 (07:36):
I've heard this because I follow sports a lot and right,
and you'll hear of athletes who've gotten like a c
something fused or whatever.
Speaker 3 (07:41):
What is actual what is fusion. Fusion is when you
fuse the bones together. Okay, so typically in the spine
you have a vertebra and a disc and another vertebra,
so there's the disk in between. Is what helps it move.
It's like the cushion between the bone. And so sometimes
that disc is so degen it's so dysfunctional, and it's
(08:02):
causing problems. I say, the inside of it. Imagine like
inside of your tire. Sure right, it kind of popped out, Yeah,
so then it may it can the same thing can
happen with your discs where the inside of your disc
pops out and then it can push on things around
it and around it is actually sometimes really important things
like your your nerves, yeah, your spinal cord, things like that.
Speaker 1 (08:23):
So it's like one thing leads to another, right, it's
like this thing is impacting this other thing, and yeah.
Speaker 3 (08:28):
Right right, and so then you have to then remove
that dysfunctional disk and remove the compression of whatever it
is that's being compressed. It's a nerve, if it's the
spinal cord, then you remove that compression and then you
have to then fill it with something else. Yeah, you
have to fill that space where the disc used to be.
Speaker 1 (08:46):
And we have things like this envisioning like an oreo
without the cream in the middle, right, So now we're
filling it with what just the other word, fusing the bone.
Speaker 3 (08:54):
So yeah, we can't put in the cream back in.
So that's the hard part. Still trying to figure that out.
But if you take the cream out, you take the
disc out, and then we have to fill it with something. Sure,
so then we put in like a cage, like some
sort of implant, a disk replacement sometimes, so you can
do that, and so there's different ways of treating and
(09:15):
addressing disc pathology.
Speaker 1 (09:17):
Sure, okay, so with you with your magic that you
do with in the millimeters underwater, how does this compare
to let's say, traditional old school spine surgery or regularly
regular not not what you're doing in terms of recovery?
Speaker 3 (09:29):
Many many surgeons, I say, the vast majority of surgeons
are still doing traditional surgery.
Speaker 2 (09:33):
Where they're just like cutting open the back and stuff.
Speaker 3 (09:35):
Right, And that's what it is, cutting open the back.
So you make a big incision you want.
Speaker 2 (09:40):
How big like?
Speaker 3 (09:41):
Typically it depends depends on what you're trying to do.
It could be as big as you know your your
back you're from the top of your back to the
bottom you know of your back to you do scoliosa surgery, okay,
you know where you have to put in lots of
screws and rods and fuse all your bones from the
top to the bottom. Or it could be just in
your lumbar. If it's in your lumbar, then it's like
(10:01):
it could be you know, five six inches, you know,
so it still could be a sizeable incision. It's not
the size of the incisions that really is the issue.
It's what you do inside. So when you do traditional surgery,
you have to make an incision. Then you have to
detach all the muscles that are on top of the spine.
Then you have to then retract those muscles so that
(10:22):
I can see what's going on. Right, So traditionally I
would use loops or you know, those magnifying glasses and
you use like surgery or a microscope, an operating microscope.
But you know you're looking at it from the outside.
So I'm looking at it through my lenses. My eyes
are on the outside looking toward the spine, and so
I need a big incision to see, like I need
(10:43):
to know, like what's what, because I don't want to
injure anything. I don't want to damage anything. And so
that retraction of muscles, it's been shown that really does
lead to a lot of a lot of issues. So
the muscles, they can die off because they're denervated. You
basically to all the nerves that go to those muscles
and you strip them off. You took them off the bone.
(11:04):
Then you retract it under high pressure and for an hour,
two hours, three hours, four hours, So then you undo
that and then there's no blood supply to that muscle,
So those muscles die off and then you sew everything
back up and then over time when ends up happening
the fusion say, it works great, it's fuse, but the
muscles are dead. The muscles are gone, right, and the
(11:24):
muscles are what you use to stand and what you
use to change positions, lean forward, lean back. So because
of that, those muscles are super important for your long
term back health, right, And I'm always telling patients you
need to work on your core, your back muscles, your
leg muscles. That's the trifecta for good back health. But
if you remove one of those, then you can really
(11:46):
kind of tip things over on the balance in terms
of back pain. So then you can get what's called
chronic back pain from that because your muscles are atrophy,
they're dead, they're not there anymore to help you stand.
So that's one of the big issues of conventional spine
surgery is that you have to first see everything, but
(12:06):
you have to retract everything. So what I do is
I don't do any of that. I go between the muscles,
the little muscle fibers, and I don't attach any of it.
I don't denervate anything. I don't retract anything, I don't
put anything under pressure, and I create a space on
this over the spine, and then I fill it with
water and then it's like a little water bubble on
top of the spine. But everything's still intact, the muscles,
(12:28):
the skin, everything other than those little tiny incisions to
do the actual surgery. And then inside there, I put
the camera in that water bubble and put the surgical
instruments inside that water bubble as well, and then I'm
able to start the surgery. And I can see the
same kind of anatomy that I see when you do
it open, because I've done all of that. I've done
open surgery, I've done minimally invasive surgery, and I can
(12:51):
see it, but under such good detail that, you know,
I think that you're able to really understand the anatomy
quite well be able to accomplish a surgery.
Speaker 2 (12:59):
And that's when things people actually ask it.
Speaker 3 (13:01):
They're like, well, with minimally invasis spine surgery, you know,
you can't see as well, and then with ultimately based
spine surgery you can't see even Yeah, yeah, it's even worse,
even worse. Yeah, it's actually not true because I have
this four K camera that I can put inside the spine,
so I imagine the eyes are now in the spine, not
outside in the environment, and so I can see so
(13:21):
much better than when I could without it.
Speaker 1 (13:24):
What about recovery time, like for your standard, are they
at home that day?
Speaker 2 (13:29):
Yep.
Speaker 3 (13:30):
That's why my program is called the Endoscopic and Outpatient
Spine program. So you're combining to two so patients can
go home the same day. And these are patients that
are even older patients, elderly patients you know, that can
go home. They're upright away. Most patients wake up from
these kinds of surgeries that I do with no pain,
and then they're able to walk right away instantly. They
know they have no more pain, right.
Speaker 2 (13:51):
I asked them all the time, how much back pain
are you having? Yeah?
Speaker 3 (13:54):
None, No, and they're just kind of surprised. Yeah, they're
playing Pivo all that night for you. No, I'm just kidding.
Speaker 2 (13:59):
I don't want that.
Speaker 3 (14:00):
I'm kidding in orth Peedick's pickleball, Is is it bad?
Speaker 2 (14:04):
Yes?
Speaker 3 (14:04):
Really, It's one of the things that helps us stay
busy now, and I wouldn't want them to play pickaball
right away.
Speaker 1 (14:11):
Yeah, if that is fascinating though you're shedding light. So
let's go back to this like eyes inside the spine,
because there's something you do and I really want to
geek out with you over this. You wear or you
have worn, an AR augmented reality headset to do your
surgery right, and it was a first. It's a first.
Speaker 2 (14:26):
So I did the first in the United States.
Speaker 3 (14:27):
I did nunbelieve in terms of the using the augmented
reality glasses for the endoscopic spine surgery. Yes, and then
I did the first AR guided fusion in the world,
and so that's where you know, it's really been a
game changer for me. The reason is it's like having
a really enhanced virtual view of what's happening.
Speaker 2 (14:47):
Right.
Speaker 3 (14:47):
It has the ability to capture my environment as well
as have large videos in front of you. So it's
like having one hundred inch TV monitor in front of
me virtually, but with four K and there's four K
on each I so then I can see so much
better because the screen is so large. And what's great
(15:10):
about it too is that I can also put in
other things like the medical record.
Speaker 2 (15:15):
I can virtually place it there.
Speaker 3 (15:16):
I can place the preoperative MRI, put it next to me,
so I can just look around and see, oh, there's
the endoscopic video. Okay, what was it about that patient?
Speaker 1 (15:27):
That?
Speaker 2 (15:27):
Then you can then what was the MRI?
Speaker 3 (15:29):
Look like I can look over here and so you
can see all of that right away, you know. And
so the information that data is at your fingertips and
or literally in front of my eyes, and I don't
you know what I had to do before if I
had a question about sometimes I don't really know what's
going on, like you know, I'd have to step away
from the patient, go to the nurses station, look at
(15:50):
the computer hopefully it didn't log off, log back in, yeah,
because I'm scrapped in. Yeah, of course I have to
log back in somehow and then look for that information.
Whereas now I'm still doing surgery and I'm looking around
at that information. So it makes me more efficient, it
makes me safer. I think that's the future. Part of
the future of spine surgery and surgery. I think in general,
(16:13):
is this augmented reality.
Speaker 1 (16:15):
Are people coming to you now asking for this? People
obviously they would want this.
Speaker 3 (16:20):
A surgeons you know, from Taiwan, from Korea, from China.
They're asking me, how did you do that? How are
you doing this from Japan? And so then I'm showing
them how they do it, and then I think it's
it's growing slowly, so we'll see, you know, I think
there's still a lot that needs to be done in
this space.
Speaker 2 (16:37):
You know, it needs to be lighter light. What do
you mean by the headset? Oh, the actual headset. The
actual headset needs to be lighter, it needs to be faster.
So that's AR.
Speaker 1 (16:46):
How do you feel about AI in the future of
AI for what it is that you do.
Speaker 3 (16:49):
Well, I think AI is can be huge in terms
of combining AR and in my mind and what I
think of the future is that AI will be able
to tell me as a surgeon, are right if you
do the next surgical move with this instrument and put
it into this area. You know, predictive analytics says a
million moves, this is the fastest and the safest way
(17:11):
to go. So if it told me that, it's like
give me the answer key, I'm like, Okay, I'm going
to do that. Because surgery, like anything, is a series
of decisions. So if you make the wrong decision the
wrong time, you're going to go the wrong direction. Right,
So you want to have right direction, and so having
AI to help me in terms of getting the right decisions,
(17:34):
the right path to success, and making it the safest
and the most efficient way of doing it, that's where
I see AI. So if in the headset, if AI
is saying, Okay, you want to go to this area
in the spine, you want to take this instrument and
do this with that, then you're going to be safe
and you're going to be effective. You're away from the nerves,
you're not going to injure anything. And so for me,
(17:55):
that will give me a lot of reassurance.
Speaker 1 (17:57):
Sure so, but okay, so, and I'm not being onny
when I asked this, your human brain, do you ever
disagree with what AAI is telling you or do you
look at you know, do you look at it as like, okay,
I'll figure out I think that might be right.
Speaker 2 (18:08):
Yeah, I think that I probably would be.
Speaker 3 (18:10):
It's kind of like sometimes I think Google Maps is wrong, Like, no,
I'm going to go right, you know, It's like I
don't think that that, you know, sometimes so fascinating. I
think that the technology is just not you know, correct.
Sometimes I'm wrong about that and so but that's my decision.
That's the human decision to be able to discern. Now,
you know when people are afraid of AI, they're afraid
(18:33):
of AI taking over and just doing everything. Course, yes,
they're never going to be able to do the surgery
by itself because who's going to be responsible Like open
AI or Apple or like no one is going to
then be responded. I have to be responsible. So ultimately
surgery needs to be done by the surgeon. Now AI
can augment me, I can use augmented reality to augment me, right,
(18:53):
So I think that's where, uh, does these technologies come
into play in the future.
Speaker 1 (18:58):
So okay again, I want to go back to back
to you, you know, the folks that are benefiting from
everything that you've just described. How do you determine We've
talked about opening up the back, We've talked about the
different types of how do you determine if what you're
doing is best for that person versus something else.
Speaker 3 (19:14):
I know what pathologies are best suited for the patients
that I see, and so if I see something, I'm like,
you know, actually, maybe open surgery traditional surgery is better
for you.
Speaker 1 (19:25):
Really, so you you haven't would and do suggest that
in those cases.
Speaker 3 (19:30):
Right, and you know, maybe doing multi level fusion is
actually the best thing for you because your pathology is
just too much.
Speaker 2 (19:36):
You know.
Speaker 3 (19:36):
It's like endoscopic surgery is not for everything. It doesn't
solve everything, but it does solve a lot of the
most common things, right. But there are those outliers. It's
kind of like a Bell curve. You're going to have
some people where you just can't do that. Yeah, and
so then you have to do, you know, what's tried
and true, which is more traditional surgery, and I you know,
(19:58):
recommend that. Yeah, I mean once, well sure, but for
the vast majority of patients who I see in my clinic,
they actually can have the surgery and they can benefit
greatly from it. Like I said, like, you know, they
wake up with no pain. You know, they're walking right away.
Two weeks later, I see them in clinic and they're like, yeah,
I feel great, you know, in the start physical therapy.
(20:18):
Oftentimes by six weeks after surgery, they're like, Okay, I
don't want to see you again. If I never have
to see you again, I'm.
Speaker 2 (20:23):
Glad you brought that up.
Speaker 1 (20:24):
I think I think when people do think of bax
or spine surgery, any any type of surgery on that area.
Speaker 2 (20:29):
The follow up, the what's the rehab?
Speaker 1 (20:31):
All of this stuff is like a concern, right, so
what is your traditional you said, I see them in clinic,
Like what is that? What does that look like for
someone who's who's undergone what you do?
Speaker 3 (20:40):
I see them in clinic in the you know, before
surgery is the consultation, make sure you know are the
appropriate candidates. And then after surgery, I'll see them usually
had two weeks after surgery, just to make sure that
their wounds are healing and they're doing okay, and then
I give them the physical therapy prescription. I think physical
therapy is actually very important you do because when people
are in pain, you know, they don't don't walk the same,
(21:01):
they don't carry their body the same, their their their
their bodies become dysfunctional and they get out of balance.
So then we need to rebalance them up again. We
need to train them back into more normal life, and
so that requires I think some supervisions and physical therapists
are the I think they are the best for that,
and so I do have most of my patients grow
(21:23):
through physical therapy, you know, to be able to recover
and usually it's about four to six weeks of physical
therapy that they go through.
Speaker 2 (21:31):
It's not bad. I was I was thinking it would
be longer.
Speaker 3 (21:34):
Even the fusion cases you know where you know it
does shift so that the advantage of endoscopic surgery and
minimum ultra minimum basis spine surgery is that it shifts
the recovery. So that's sooner, right, so you're you're you're
in less pain after surgery, you recover faster, go home
the same day or to stay overnight. Most patients get
able to do that, and so it shifts everything so
(21:57):
that you can get better back faster, You get back
to normal faster, get back to your normal life, get
back to function as quickly as possible. And that's the
basic tenet of this ultimately invasive spine surgery is being
able to get there. The way we can get there
is that it helps to reduce trauma. Right, our surgical footprint,
(22:18):
the things that we do inside is not as traumatic, right,
so I don't have to injure the patient as much
to do the same surgery to accomplish the same goals.
And so because of that, they're not hurting after surgery,
so they can recover faster, and then they can get
back to normal faster.
Speaker 1 (22:36):
Yeah, feel free to brag on this, because I have
a feeling I know the answer. How many other programs
are offering this level of innovation.
Speaker 3 (22:42):
Just a handful in terms of endoscopic spine surgery, a
handful in the country. Yeah, and then you know, in
terms of augmented reality, I'm the only one. And then
you know endoscopic fusion is like I was one of
the first in the country to do it. And then
you know, I think there's only a handful of programs.
(23:03):
It's growing though, and I think that's where adoption will
truly skyrocket with this, because most most surgeons are they're
they're not trained in this. They're trained in conventional surgery
because that's what the fellowships and the training programs, that's
what they all train and teach. And so once the
training programs like uce I, like other university training programs
(23:28):
around the country like Stanford or Harvard or whatever, they
get these kind of programs online and then able to
teach the residents and fellows this, then I think it'll
skyrocket because even now, when I teach my residence and
fellows and I show them what endoscopic surgery is, and
they see what conventional surgery is, It's well, I want that.
I want to do that because one it's it's really cool,
(23:50):
it's new, it's exciting. But also they see what the
patients they're how they do. They do much better, you know,
in terms of their recovery instead of well, if I
had a choice, and I'd want to choose that, But
if you haven't seen it, you don't know. So if
you don't know, then it's like, well, how are you
going to make a decision about it? Yeah, on a
personal level, what led you to this?
Speaker 1 (24:10):
What was your interest point, your you know, entry point
into wanting to be like the king of backs?
Speaker 3 (24:15):
Well, the I first heard about and this copic spine
surgery probably in two thousand and seventeen, and then that's
when it was starting to really come up. And one
of the places that it's like the epicenter is in Korea,
South Korea, and so you know, the South Koreans would
then come and present their their their data, how their
results were, and we're like, oh, that's too good to
(24:36):
be true, and you know, I really have to learn
this is this something that is real? And you know,
you don't want to adopt something too early before you know,
you know, the results really come out.
Speaker 2 (24:49):
And so I learned about it.
Speaker 3 (24:51):
I read the papers, and I went to labs and
courses and conferences about it and learn more and more
as much as I could COVID HIT.
Speaker 2 (25:01):
Then I had a lot of time. Of course, I had.
Speaker 3 (25:03):
A lot of time just to think about things and
what about life, what's going on, you know, and what
do I do next? And so then I went to
Korea and I learned endoscopic surgery from the masters that
were at that time doing it, and you know, I
was just completely blown away what I was seeing. I was,
you know, able to you know, just really grasp the
(25:25):
ideas and the principles of endoscopic surgery. So I took that,
came back to the US. I came back on a Sunday,
and then on a Wednesday, did my first surgery and
then has been going since. So I've done over six
hundred cases now and then I'm one of the first
in the country to do the biportal endoscopic spine surgery
(25:46):
that I mostly do. And then in terms of endoscopic fusions,
as one of the first in the country to do it.
So it just I saw the potential you know, when
you when I can see with my own eyes when
I went to Korea, I realize, Okay, this is something
really powerful.
Speaker 1 (26:04):
Yeah, that's incredible just on a personal you know, for
someone listening that may have not like something that requires
a lot of advanced care or the surgery, but like,
what are what are some good things maybe that you
abide by in terms of just your own physical motions
during the day, Like is planking bad for like what's
good and bad for you?
Speaker 2 (26:22):
For patients?
Speaker 1 (26:22):
Yeah, for anyone that's maybe dealing with like a sore
back or something like what's a good what's a good
daily routine.
Speaker 2 (26:28):
To be in for optimal back health?
Speaker 3 (26:30):
But I think, like I said before, the three things
that are really important are back muscles, core muscles, and
your leg muscles. Got it, So you have to really
have all three of those. It's kind of like your
the the tripod, okay, to your spine in terms of
spine health. So you want to strengthen those as much
(26:51):
as possible. So planks are good. You know, sit ups
are not as good because if you're curling your back
is you know, tendency to really have bad technique doing
sit ups and crunches and then you end up tweaking
your neck twiking your back, so it's not the best
way of doing it. But you know, leg lifts, you know,
planks are great, and different exercises you can do with
your legs while you're in the playing position, you know,
(27:14):
and while you're on your back with your legs lifted
and moving in different directions and different exercises.
Speaker 2 (27:19):
You can do with that.
Speaker 3 (27:20):
And then the things that you want to avoid, so
you want to avoid stressed to your back, the things
that stress your back. Bending deeply, twisting, extremely heavy lifting
with your back and then sitting for long periods of time.
Those things really do stress your discs and your back
and your spine, so you want to avoid that as
much as you can, you know, And so things like deadlifts,
(27:40):
you know, Olympic you know lifts, those are really bad
for your back if you do it poorly, and if
you do it right. You know, powerlifting could be great,
you know, for your body, but at the same time,
it's not something that you can do forever, so it's
always going to eventually wear on you. But you have
to have proper technique, and most people don't yeah, and
so I think that you know, proper posture, you know,
(28:02):
is really important. Proper technique and then also you know,
keeping your body strong and then avoiding the stress to
your spine, all of that's really important.
Speaker 2 (28:12):
Yeah, do you do you hear back?
Speaker 1 (28:13):
Obviously you follow up with your patients, But did they
come back to you and say, like, oh my god,
you changed my life? I get I bet you get
that all the time every day, right day. It's incredible.
Speaker 2 (28:21):
You know, it's a great feeling.
Speaker 3 (28:22):
It has to be and they you know, it really
is the reason why I do this and why I
went into you know, orthopedic surgery, spine surgery, to begin
with orthic surgery, because you know, you can fix a
lot of things. You can really change people's lives, you
can really make people better, yes, right, and the idea
is to get people back to normal functioning, to get
(28:42):
them back to where they need to be. And so
that's where orthopedics comes into play with spine surgery. What's
exciting with spine surgery and you know, I've kind of
geeked out about it already. All the technology, all the tech,
you know, the high tech that you can have, you know,
AI ar we haven't talked about robotics. I mean, you
can really combine all of that stuff into spine surgery
(29:04):
and that's super exciting too. And so I think for me,
like that's why I went into going into it and
into spine surgery. But also you know, not just technology,
but now it's also the results. Patients are coming back
and they're just like they're transformed. You know, their pain
is so it's gone there. You know, they're their function
(29:24):
is so much better and they're able to get back
to their lives or before surgery. And I always ask
this in clinic, you know, in every post I visit,
do you feel better? How do you feel compared to
before surgery? Like, oh, this is night and day, you know,
like this is so much better. And so it's like, Okay,
then I did my job and I feel like, you know,
I think that that makes it completely worth it.
Speaker 1 (29:46):
Wow, Well we are in the presence of greatness, sir.
Keep doing what you're doing. I mean, I don't know
where you go next from here, but but it's really
incredible and you're changing lives and really it's awesome and
a pleasure to hear your story and see what you're doing,
and all the breakthroughs that are probably yet to come,
and that that you're going to be on the forefront
of Doctor don Young Park live well with UCI Health.
Speaker 2 (30:04):
It has been a pleasure. This man is magical.
Speaker 1 (30:06):
I swear to God, if my back is ever screwed up,
I'm not going no one's touching it except you.
Speaker 2 (30:09):
Thank you, Thank you very much. Pleasure
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