When I was younger I was always interested in science and the human body. When I was an Undergraduate, many people were pre-medical students, so I got my Emergency Medical Technician (EMT) license to make sure I could handle being around sick people or traumatic situations. That led to a job as a Nursing Assistant in the Neurosurgical ICU at our University. I spent a lot of time with the nurses, the residents, and the neurosurgeons, which got me introduced to medicine and also to neurosurgery.
When I ended up going to medical school, I tried to keep an open mind in terms of what field I wanted to go into, but I was already interested in neurosurgery. After I graduated from medical school and got into a residency in neurosurgery, I became very focused on spine surgery in general. I was lucky enough to do a fellowship with Richard Fessler, who is one of the preeminent minimally invasive spinal surgeons in the country, and that led me to my practice that’s focused specifically on complex and minimally invasive spine surgery.
One of the things that set me apart is that I’m one of the few physicians who is fellowship-trained in minimally invasive and complex spine surgery. My goal is to try to avoid surgery when possible and, when surgery is indicated, to try to do the least invasive surgery that gets the best possible result for that patients’ pathology. I try to avoid doing fusions, except for pretty strict criteria, and I try to make sure that the patients have the best outcome in terms of relief of their pain without having to go through unnecessary additional levels or unnecessary surgical interventions.
There are papers published about the advantages of minimally invasive procedures, including decreased narcotics, decreased hospital stay, decreased blood loss and most importantly, decreased infection rates. I have co-authored a paper that shows our infection rate is significantly lower when using minimally invasive techniques.
The key thing to successful outcomes is spending a lot of time talking to the patient, examining them, and getting a real feel for what their specific symptoms are. I show patients their specific MRI. I’ll show them, for example, what a normal spinal level looks like and what their level is at; maybe that L4-5 has horrible stenosis. I want them to understand what the goal of surgery is and make sure that they understand that the goal is to decompress that level. When patients have an understanding of what the imaging shows and how that correlates with their symptoms, then they’ll have realistic expectations about the surgical intervention and the post-operative course.
I spend a lot of time with patients, making sure that they understand what we’re talking about. I explain what’s involved after the procedure, because some symptoms will improve quicker than others. I want to make sure they understand the post-operative course, if they’re having an out-patient procedure or if they’re going to be in the hospital for one, two or three days, and make sure they understand the things that are going to happen during their hospital stay if that’s necessary. I also like to make sure they understand the first few weeks of surgery and their limitations in terms of lifting restrictions or activity restrictions, and then the full recovery course.
I make sure that it’s not just about surgery next week, but understanding the next nine to twelve months, or more, of their recovery from that surgery. It’s important for patients to have appropriate expectations about symptoms and recovery time.