At Saint Louis University-SSM Health, spinal neurosurgeon Mauricio Avila, MD, has spent his time building bridges between orthopedic spine and neurosurgeons.
Interdisciplinary collaboration has become more and more of a priority in the spine world, especially with overlapping care needs and technologies.
Dr. Avila, director of the neurosurgery spine program, discussed how he deepened collaborations across spine teams, along with tips for adopting endoscopic spine on Becker’s “Spine and Orthopedic Podcast.”
Note: This is an edited excerpt. Listen to the full conversation here.
Question: How do you want to grow SSM’s neurosurgery spine program over the next 12 to 24 months?
Dr. Mauricio Avila: We’ve been able to achieve something that has always been in my mind: creating a bridge between neurosurgery and orthopedic spine. As we all evolve, we’ve now come to understand that the spine specialty is a shared world, and besides very few procedures, we basically can do the same thing.
Personally, I’m growing the endoscopic spine program, which has been very interesting for me because I was not exposed to that during my residency or fellowship. But because I’m a big believer in minimally invasive surgery, it was very easy for me to understand the value of endoscopic spine.
Q: I want to home in on what you’re saying about bridging between orthopedic spine and neurosurgery spine. What does that look like in practice? What kinds of actions and strategies are you thinking about?
MA: What I did here is my orthopedic colleagues had basically some spine conference, so I asked if I could join them. As surgeons, the way you show humility is to start showing your cases. I started showing my own cases, my successes and my not-as-perfect cases. That showed them that I was willing to do that, and it really helped get us all in the same room.
It has helped tremendously to some of our C-suite leaders and in the hospital to go as two departments and say, “Hey this is something we both want.” That helps tremendously because now we have lines for communication. For patient care, if I’m on call and one of their patients comes in, I can take care of them. There’s none of that “not my problem” attitude, which provides more peace of mind and also some quality of life.
Q: What advice do you have for surgeons who want to learn endoscopic spine but may be daunted by the learning curve?
MA: The first thing is, you have to believe in it. For me, because I’m a big tubular decompression and minimally invasive person. It makes sense. All the companies have done a great job in getting surgeons into cadaver labs and practicing.
The microscope is more useful for us in neurosurgery, but with the endoscope my orthopedic colleagues are probably more comfortable with it. In neurosurgery we do some brain endoscopy, but it’s not the same, so you have to get familiar with the instruments.
Then you just have to find that perfect case to start. But it’s not going to be easy because if your one-level micro discectomy takes you an hour and a half, this may take three. You just have to have that commitment. Don’t give up, and keep doing them. It is truly amazing to see the visualization through the endoscope and have patients going home the same day.
