By: Barbara Buccilli, MD
Of all the things I learned in medical school, the one lesson that will always stay with me throughout my career is that medicine is continually evolving, and as doctors, we must evolve with it. While we receive our medical school degrees, we should never leave medical school completely behind, as medicine will outpace us if we do. This profession is for individuals who have an insatiable hunger for learning, much like a shark’s constant need to swim.
We should continuously pursue new technologies until they become the standard of care, and even then, we should remain open to newer technologies replacing them. Over the past year, I have developed a fascination with magnetic brain stimulation, the integration of virtual reality and robotics in stroke recovery, and brain-computer interface (BCI) technologies. How far can we push these new techniques, and how far can they push us? What if we combine them with stem cell infusions or medications that enhance plasticity?
I have witnessed firsthand how patients can greatly benefit from some of these innovations. Virtual reality and robotics significantly enhance motivation, as patients feel more empowered and in control of their progress. It transforms potentially tedious and painful experiences into adventures and challenges. Thanks to virtual reality, patients can turn their daily exercise into a walk on the beach or through a museum. Robots can support them, adding their strength to the patients’ to allow them to stand, walk, grab objects. Just imagine the potential impact even simpler devices can have on pediatric neurorehabilitation, when once a middle-aged man proudly announced to me that he achieved a perfect 5-star rating for the first time in one of our therapeutic minigames. This is the power of rewards.
Virtual reality and augmented reality also hold promise in improving neurosurgeons’ performances. They enable us to visualize and simulate complex procedures, enhancing preoperative planning and surgical precision. In the operating room, robotics plays a crucial role by providing enhanced precision, stability, and dexterity, enabling neurosurgeons to perform intricate procedures with greater accuracy, especially in delicate surgeries like deep brain stimulation (DBS).
BCIs have shown remarkable potential in restoring movement and function in patients with paralysis or neurological disorders. They offer individuals the ability to control prosthetic limbs or communicate using their thoughts. When a patient doesn’t have sufficient strength to perform the desired movement, an exoskeleton can provide it. This will allow the patient to regain theirs, limiting the frustration of failure and improving recovery and quality of life..
3D printing is another technology which has found applications in neurosurgery, allowing for the creation of patient-specific models, implants, and surgical guides. These custom-made devices enhance surgical planning, improve accuracy, and optimize outcomes. They can be useful, for example, in dealing with AVMs, since the blood vessels in the human brain can present great variability. 3D printing is also precious in spine surgery, offering a more personalized and efficient tool to treat many degenerative conditions.
For the general public nanotechnology belongs in comics and sci-fi movies, but in neurosurgery, nanoparticles can be used for targeted drug delivery to the brain. Nanotechnology is also a promising field for imaging, diagnostics, and neuroregenerative medicine. It’s the case of the nanosensors that can be implanted to monitor ICP in real time.
This is only a short list, and I’m offering but a glimpse of the potential these technologies have to offer. I’m not trying to teach you something; I’m in a phase of my career in which I have far more to learn than I have to teach. I also won’t deny that new technologies can have their downsides: they can be harder to use for older patients, they are often pricy and delicate, and they need complex engineering, but I think this side of medicine is still a baby moving its first steps, and that we can still barely imagine how far it could bring us. What I want to share with you through this post are my hope and my curiosity – the marvel I feel looking at how far we already went, how far we carried medicine together, my desire to push the limits further, deepen my roots in the knowledge of today and reach out to new questions, new marvels, new magic.
Barbara Buccilli, MD, is an Italian medical doctor and an applicant for US medical residency. She has always had a deep passion for the nervous system and has dedicated her career to this field. Dr. Buccilli obtained her medical degree from Sapienza University of Rome, where she graduated in the top 5% of her class, and she is a cerebrovascular and neurocritical care fellow at Icahn School of Medicine at Mount Sinai. Throughout her academic journey, she consistently achieved scores higher than the national average on the annual progress test, which earned her the corresponding awards.
In 2021, Dr. Buccilli obtained her medical license from the Italian medical board. Since then, she has been actively involved in medical practice while concurrently preparing for and successfully completing all three steps of the United States Medical Licensing Examination (USMLE). Dr. Buccilli is currently engaged in research activities and actively participating in the writing of a comprehensive neuroanatomy book. She is also the CSO of the Global Neurosurgical Alliance.