Hematocrit as a predictor of preoperative transfusion-associated complications in spine surgery: A NSQIP study.

I am a spine surgeon who provides surgical management of cervical, thoracic  and lumbar spine conditions, including cervical myelopathy, herniated discs, deformity, stenosis, tumor and trauma.  I provide both minimally invasive procedures as well as traditional surgical techniques.

I chose to pursue neurosurgery as a career because of my fascination with the human nervous system. In medical school, I developed a keen interest in the diseases that afflict the brain and spine and gravitated towards the only field where I could help treat these diseases with my own hands. I focus on disorders of the spine where my first goal is to help patients avoid surgery if at all possible. If surgery is needed, I treat patients using the most advanced minimally invasive techniques available in order to minimize pain, blood loss, and hospital stay, while maximizing recovery, neurologic function, and quality of life. In my free time, I enjoy spending time with my family and friends. I am an avid sports fan and love to eat. I try to stay physically fit by going to the gym and playing ice hockey.

The overall theme of my research is the application of clinical pharmacology tools to the individualization of the care of high-risk surgical patients, especially those undergoing neurosurgical procedures.  Current research focuses on creating pharmacokinetic-pharmacodynamic models to allow simulation of dose-concentration-effect relationships that will result in reduced toxicity while maximizing efficacy of intravenous opioids and hypnotics. The perioperative period is a time when patients are exposed to a multitude of drugs from a different classes, some of which may attenuate while others may augment the deleterious cascade of events that starts in the operating room and result in worse neuro-oncologic, neurovascular, or pain outcomes, even after the perioperative medication has been discontinued.  Analytical techniques for perioperative “big data” have not been combined with the clinical pharmacology toolbox to create dose-response models that can help optimize perioperative care. Through collaboration with pharmacometricians and informaticians, care paths can be developed in an iterative fashion to expose the innards of the perioperative black box.

As a Neurosurgeon with fellowship training in Spine Surgery, I have dedicated my professional life to treating patients with spine disorders. These include spinal stenosis, spondylolisthesis, scoliosis, herniated discs and spine tumors. I incorporate minimally-invasive spine (MIS) techniques whenever appropriate to minimize pain and length of stay, yet not compromise on achieving the goals of surgery, which is ultimately to get you back to the quality of life you once enjoyed. I was drawn to medicine and neurosurgery for the unique ability to incorporate the latest in technology and neuroscience to making patients better. I will treat you and your loved ones with the same kind of care I would want my loved ones to be treated with. In addition to my clinical practice, I will be working with Duke Bioengineers and Neurobiologists on important basic and translational questions surrounding spinal cord injuries (SCI), which we hope to bring to clinical relevance.

I have more than 25 years of experience treating patients of all ages with spinal disorders. I have had an interest in the management of spinal disorders since starting my medical education. I performed residencies in both orthopaedic surgery and neurosurgery to gain a comprehensive understanding of the entire range of spinal disorders. My goal has been to find innovative ways to manage the range of spinal conditions, straightforward to complex. I have a focus on managing patients with complex spinal disorders. My patient evaluation and management philosophy is to provide engaged, compassionate care that focuses on providing the simplest and least aggressive treatment option for a particular condition. In many cases, non-operative treatment options exist to improve a patient’s symptoms. I have been actively engaged in clinical research to find the best ways to manage spinal disorders in order to achieve better results with fewer complications.