A New Spine of Steel

For Denetra Dale, back issues have been part of her daily life for years.  The Army Veteran spent years ruck sacking her way through military exercises, ultimately returning home after a tour in Germany with chronic back pain.  

Dale carried the burden of back pain quietly for years. But a week ago, at the Michael E. DeBakey VA Medical Center, something changed. She had surgery. And the instrument that helped change everything wasn’t only a scalpel or a set of trained hands, although those were essential.  It was a robot.  

Dale became the first Veteran to receive care using Houston VA’s newly acquired MAKO spine robot.  The procedure, the first of its kind at any VA hospital in the country, was performed by VA surgeons, using the MAKO Spine Robotic System. The results, even just a few days later, are already speaking for themselves. Dale said she is already getting up easier, which is half the battle.  She describes her experience at the Houston VA as nothing short of great….and said she feels genuinely hopeful about the future.  

The MAKO Spine Robot is not a surgeon, but according to Houston VA’s Chief of Neurosurgery, Dr. Alfonso Fuentes, it’s a remarkable partner.  The platform integrates robotic assistance with advanced navigation technology in a way that, as Fuentes describes it, improves surgical precision.  At the heart of the system is a real-time CT imaging capability that gives the surgical team a live window into the patient’s anatomy as the procedure unfolds. The navigation technology works together with haptic (touch)  technology to ensure precise execution at every step. Most critically, it assists in the precise placement of screws in the lumbar region of the spine.  

“In spinal surgery, millimeters matter,” Fuentes said.  “The difference between a screw being placed perfectly and one being placed slightly off can mean a dramatic difference in a Veteran’s quality of life.” 

Beyond precision, the MAKO system enables smaller incisions, which means less trauma to surrounding tissues, Fuentes said.  “The enhanced surgical precision offered by this robot translates directly into greater safety margins, especially for the Veterans who often present with complex and challenging cases.” 

Those challenges aren’t incidental. Military service often puts extraordinary demands on the body…demands that accumulate over deployments, time and years.  The Veterans walking into the Houston VA often carry spinal, knee and shoulder conditions that are shaped by their military service.  For these Veterans, having access to cutting-edge technology isn’t just a luxury…it’s a meaningful advantage.  

“Technological advances like the new MAKO robot are particularly valuable when treating the challenging conditions that Veterans often face,” said Dr. David Green, Houston VA’s chief of orthopedic surgery.  “In addition to using our new robot on the spine, we will be able to use it for some of the hundreds of knee and shoulder surgeries we perform at the Houston VA every year.” 

Houston VA being the first VA in the nation to deploy this technology is not an accident. It is the product of a culture that views surgical innovation as part of its obligation to the Veterans.  “Houston VA surgeons pride themselves on being leaders in innovation,” said Dr. Samir Awad, Chief of Surgery.  “Our Veterans deserve the best and we are here to give it to them.” 

The culture extends beyond any single procedure or technology. As new tools emerge, the Michael E. DeBakey VA has made a standing commitment: to implement innovations that can improve patient outcomes. Not every new technology earns its place in the operating room, but when it does, thanks to evidence showing a clear benefit to Veterans…Houston VA embraces the opportunity.   

For all the enthusiasm about what the MAKO system has to offer, Fuentes is quick to remind everyone that every advanced tool and technological leap at the VA exist for the Veterans. The robot guides the screws. The navigation maps the spine.  But at the center of every procedure is a person….a Veteran with a history, a body shaped by service and a life they want to return to.  

“Every advanced tool and technique is there to provide our patients with the safest, most effective treatment tailored to their specific conditions and goals,” Fuentes said. “It really is all about the Veteran at the Houston VA.”