24 Spine Surgeon Leaders on Why They Chose Spine Surgery FeaturedWritten by Laura Dyrda | Monday, 04 February 2013 09:34
Here are 24 spine surgeons discussing why they chose the spine specialty.
Howard An, MD, Midwest Orthopaedics at Rush: When I was choosing a specialty within orthopaedic surgery in the 1980s, the field of spine surgery was not straight-forward in making common diagnoses and treatment recommendations for the patients. I felt that spine surgery needs to further develop, and I [could] become part of this progress and make a difference for so many patients suffering with spinal disorders. I was also attracted to the intricate anatomy of the spine and neural structures and the technically challenging aspect of spine surgery.
Neel Anand, MD, Cedars-Sinai Medical Center: Spine surgery to me was always and remains the most intriguing, complex and challenging field. Besides the technical challenges of surgery itself, the clinical challenges of making the right diagnosis was also very appealing to me.
Gunnar Andersson, MD, Midwest Orthopaedics at Rush: I actually initially trained to be a joint replacement surgeon. What happened however was that my research interest was primarily in spine and as a consequence my colleagues starting sending me more and more spine cases. I tried to do both for a while, but it became difficult to go to scientific meetings in both areas and to follow the new developments and techniques in two areas. Looking back I'm really happy with my choice. Spine has been an area with tremendous development and although we still struggle with patients who have chronic back pain it's been a very rewarding experience.
Scott Blumenthal, MD, Texas Back Institute: As an ex-athlete orthopedics was a no-brainer for me. I choose to focus on spine surgery because I found the anatomy of the spine the most interesting of the whole body.
Scott Boden, MD, Emory Healthcare: I made my decision to become a spine surgeon in 1990. At the time, there were many academic spine positions available, spine meshed well with my research interest of enhancing bone healing, and since most of the focus at the time was on biomechanical research and internal fixation, I felt the opportunity to utilize molecular biologic techniques and drive research into the biology of spine fusion would be a great opportunity to contribute to the field.
Charles Branch, MD, Wake Forest Baptist Health: I chose to become a spine surgeon as the result of the great influences of David Kelly, my neurosurgery professor, and Charles Branch Sr., my neurosurgery father. Both of these men were dedicated spine surgeons, with different approaches and philosophy. I benefited from both and participated in the transition era where Neurosurgery embraced spinal stabilization.
John Paul Dormans, MD, Children's Hospital of Philadelphia: My practice is 50 percent pediatric spine deformity and 50 percent pediatric tumor surgery here at CHOP/Penn. Spine surgery, while challenging intellectually and technically is rewarding in that one can make a huge difference in the life of a child or young adult. Often the benefit is preventative in the sense that the deformity surgery correction prevents progressive deformity and associated conditions that would ultimately affect the quality of a patient's life.
Thomas Errico, MD, NYU Langone Medical Center Hospital for Joint Diseases: When I was a Chief Resident at Bellevue hospital in July a 16-year-old boy sustained an L1 fracture with bilateral footdrops. I called my spine attending who came in the middle of the night and we placed bilateral Harrington rods reducing the fracture. The boy woke up in the recovery room moving his feet. I became enamored with the ability of a spine surgeon to be able to affect a patient's life so positively. It initiated a burning lifelong interest in spinal disorders.
Steven Garfin, MD, UCSD Medical Center: During residency (1975-79) I did a fair amount of basic and clinical research studies. I decided I really liked academics. At that time my Chairman, Wayne Akeson, MD, felt there were two burgeoning academic areas — spine and oncology. I did not like the thought of oncology as a career. During residency and two years in the military I never had a problem seeing patients with spine problems, though my exposure to spine surgery during residency was limited. I had the fortune to be selected by Dick Rothman, MD, and Fred Simeone, MD, for their spine fellowship program. That year, with Dick as my primary mentor, and then returning to Wayne Akeson at UCSD, cemented, as well as jump started, my career as a spine surgeon.
Jeffrey Goldstein, MD, NYU Langone Medical Center Hospital for Joint Diseases: For the properly selected patient spine surgery provides the opportunity to dramatically improve a person's quality of life by applying innovative surgical techniques.
Richard Guyer, MD, Texas Back Institute: I chose spine surgery because the surgery is challenging and "high risk" compared to other specialties in orthopedics. I also enjoy the cognitive aspects of spine as it is rarely black and white with regard to the decision making of what you think is best for the patient. I also felt that it was one of the last frontiers of all the orthopedic specialties in which I could make a difference through research, publishing, training fellows and lecturing.
Andrew Hecht, MD, Mount Sinai Medical Center: I was drawn to spine surgery as it is one of the most rewarding and technically demanding fields within orthopedic surgery. I like the diversity of the clinical problems that interface between the musculoskeletal and the nervous system. The variety of degenerative, traumatic, deformity and neoplastic diseases that effect the spine and the numerous surgical approaches and treatment options have provided great career satisfaction. The emphasis on making an accurate diagnosis has always been paramount in achieving an excellent surgical outcome. To be a great spine surgeon you need excellent clinical diagnostic skills, decision making as well as superb surgical ability and technique. Spine surgery also is performed on patients of all age groups and activity levels.
Harry Herkowitz, MD, William Beaumont Hospital: My decision to pursue a spinal surgery career occurred during my third year of orthopedic surgery residency. I was greatly influenced by Carl Samberg, MD, an orthopedic surgeon who specialized in children's orthopedics and surgery of the spine. He was one of only a few orthopedic surgeons doing spinal surgery at the time. Spinal surgery as a subspecialty in orthopedic surgery was really in its infancy.
The types of procedures done and instrumentation available for cervical, thoracic and lumbar surgery were limited to spinal rods, hooks and wires. I was fascinated with the ability to correct spinal curvatures and fix unstable spine fractures and remove ruptured discs to get patients out of pain. The surgical procedures were very intriguing and "special." I felt this specialty was the one I wanted to embrace and I pursued a post graduate spine fellowship, one of only a handful in the country with Dr. Richard H. Rothman in Philadelphia, for which I completed and returned to Michigan and Beaumont Hospital in 1980 to begin my practice.
Stephen Hochschuler, MD, Texas Back Institute: I became a spine surgeon because when in the Air Force as a general surgeon (1971-1973) I realized there weren't any real answers to patients who presented with neck, back and leg pain. The state of the art was similar to general surgery 100 to 150 years ago where "belly pain was belly pain was belly pain." There was no real differential diagnosis as to etiologies. I found this to be a challenge which needed to be addressed. Since I was already a surgeon I decided to change my focus to orthopedics and then spinal disorders.
A. Jay Khanna, MD, Johns Hopkins Medical Group: I chose to become a spine surgeon because spine it is one of the few areas in orthopaedic surgery and neurosurgery that hasn't already been "figured out." The spectrum of pathologies and treatment options are diverse and we are still trying to determine which treatment options are best for which patients; I find this intellectually interesting and challenging. In addition, I had the opportunity to train with a few surgeons during my residency, including Dr. John Kostuik, who were leaders in the field and thus inspired me and many of my colleagues to try to follow in their footsteps as we were deciding on which subspecialty fellowship to pursue.
Kamal Ibrahim, MD, M&M Orthopaedics: When I was completing my residency training and fellowship, it was a significant time for scoliosis surgery and the management of spinal deformity. New knowledge about natural history of the disease was appearing in the literature. The long term results and problems with the traditional surgery of Harrington rods started to be recognized. Emerging of new procedures such as Cotrel-Debousset segmental system was revolutionary in the surgical correction of scoliosis, the new development in anesthesia such as hypotension during surgery which significantly decreased blood loss, the new experience in the management of adult complex spine problems were just starting to be discussed, which was almost ignored in the past for the lack of knowledge.
These are some of the exciting development in spine surgery which occurred in the late '70s, early '80s which made scoliosis and spine deformity field are very exciting and enjoyable to chose and to get involved in the research in that evolving field. Personally, I felt the pleasure of treating children with spine deformity and experiencing their joy with the successful outcome.
Stephen Parazin, MD, New England Orthopaedic & Spine Surgery: As I was finishing my orthopedics training, I looked around at the subspecialties available to an orthopedist. Most of the subspecialties had a good handle on where the future was going to go with them and how things were going to be treated, but spine was different. Spine was still in its infancy. Spine was still trying to figure out where it was going to go, how it could help people, and in what manner it could. To that end, spine continues to evolve.
We still don't have all the answers. We are still working forward. I think this is what appeals to me the most: the dynamics of the field, the ability to see change, to try to affect patients' lives in a positive way while trying to improve upon those on a daily basis. Spine can give some of the most rewarding results and it can also deal with some of the most complex issues that we face as orthopedist. I think those are some of the main reasons why I chose spine.
Rick Sasso, MD, Indiana Spine Group: Making people better — the ability to impact someone's life in such a positive fashion is the most fulfilling sensation any human can feel. We are so fortunate in our work as spine surgeons to be able to profoundly and overwhelmingly improve another's existence. The emotional awareness of a patient I operated on years ago thanking me when I run into them in the grocery store, recounting their intense pain and suffering before I met them and their quick return to a full functioning life after their operation-is unmatched in any career.
Thomas Schuler, MD, Virginia Spine Institute: I didn't choose to become a spine surgeon through a defined plan. I followed my heart at major decision points in my life and fortunately fell in love with spinal surgery. I had limited knowledge of the different medical fields upon matriculating into medical school. I spent my medical school years and my residency years sorting out what fascinated me and what didn't. Through a process of elimination spinal surgery won on all levels. I didn't even know the specialty existed when I started my medical education and feel extremely fortunate to have found such a challenging and stimulating field. Spinal surgery is the hardest surgical field to learn, and to perfect. It is the most challenging and demanding specialty that I know. It requires great skill and greater intellect. Decision making is paramount, and when paired with excellence in technical ability, patients' lives are truly improved. The ability to help an individual recover his or her life through knowledge and skills that required decades to acquire is the reward. Improving the lives of people is the most fulfilling aspect of my career.
Paul Slosar, MD, The SpineCare Medical Group: I chose spine surgery as I made the most direct and meaningful connection with that subspecialty and those surgeons during my training. At that time, spine surgery mainly consisted of deformity and scoliosis surgery. I had great mentors during my residency at Loyola who encouraged me to do a fellowship. This was a time when our discipline first began to understand and effectively treat the degenerative spine. This is has become my primary area of focus in both practice and scientific research.
William Taylor, MD, UCSD Health System: I chose spine surgery for the various options that were available to me. As a neurosurgeon, not a lot of people wanted to go into spine surgery back when I started it. It seemed to be a really growing field with lots of new things to do that I felt was going to change and become very vibrant over the next decade.
Alexander Vaccaro, MD, Rothman Institute: I became a spinal surgeon because I developed a fascination for spinal cord injury care after working closely with Jerome Cotler, my mentor, at Thomas Jefferson University. He began and headed the largest spinal cord injury center in America. Our clinical volume during my residency was approximately one to three spinal injuries/spinal cord injuries a day and through that experience I developed a love for the management of patients with spinal cord injury and subsequently with any type of spinal pathology.
Robert G. Watkins III, MD, Marina Del Rey Hospital: My choice in spinal surgery is predominantly because I realized that most contemporary orthopedic surgeons had no interest in spine. Too complicated, too many high risk complications, to much involving pain and paralysis. Ironically that is what appealed to me about it. A combination of neurological tissue as well as musculoskeletal tissue, the severity of the injury to the patient both in terms of disability, loss of function, pain, and neurological loss, presented a challenge that I felt could be dealt with through hard work, dedication and compassion.
James Yue, MD, Yale Medicine: My decision was based on a number influences. First, the dynamic synergism of the neuroanatomical and biomechanical functional components of the spine is intellectually intriguing to me, in particular, how spinal motion as well as spinal stability influence neurologic physiology and function. By restoring the neuroanatomical and biomechanical components of the spine, the spinal surgeon can positively influence the neurologic and functional capacity of a patient. Second, spine surgery encompasses all age groups as well as a broad spectrum of disease processes such as trauma, tumor, degenerative and deformity. Lastly, the scholarly activities which continue to evolve such as disc replacement surgery, spinal cord injury and deformity correction are intellectually satisfying for me to study and explore.
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