Dr. Ramin Abdolvahabi Describes a Neurosurgeon's Duties

Well as neurosurgeons, we not only deal with the brain, but we also deal with spines. One of the big questions that comes up-always is being asked is, what is the difference between a neurosurgeon doing a spine? And really at the end of it, it's just a matter of training. Neurosurgeons are trained to do spine from their second year of residency all the way through and I'll tell my patients for example that 4th and 5th year of my residency, we were not doing that much spine anymore because we were done doing spine. We had done so many cases in spine that we would now just switch to brain and aneurisms and the tumors the majority of the time but an orthopedic surgeon has to do 5 years of joints, knee, hip, shoulder, and then one year fellowship in spine. So there is a slight difference in training. Having said that, there are certain things that are done in spine, for example, tumors of the spine. There are very very few orthopedic surgeons that do tumors of the spine. The majority of that is done by neurosurgeons. As far as small cases, such as a simple disc herniation, micro-discectomies, cervical fusions...two big cases such as fusions of the lumbar spine, what they call a trans thoracic approach to the thoracic spine and complex spinal surgery—that's what neurosurgeons do. Basically it's from the simplest to the most difficult and it's done by neurosurgeons.
There are many different minimally invasive procedures that are done. One of the most simple ones that nobody considers minimally invasive would be repair of compression fractures, the fractures of lumbar spine due process before for that repair we used to do a very large operation, now we do it through 2 pin holes and with a cement in about 15 to 20 minutes as opposed to an operation that usually would take 6 to 7 hours and would involve putting a chest tube in the patient or getting 2 surgeons involved, that has gone by the wayside. Nowadays, (prime example) I just did a case today that involved 2 bones in the thoracic spine engulfed by a tumor and with thoracic surgeon, I did the first portion of it; anteriorly replaced the bones and for the posterior portion, going from the back, putting pedicle screws in. I have 4 little incisions and it took me literally 45 minutes to do, whereas before, it used to be a 4 and 1/2 hour operation, lots of blood loss. So there are many ways to do minimally invasive, but not everybody's a candidate for minimally invasive, it should not be done on everybody. It has room and it should be done appropriately.

Dr. Ramin Abdolvahabi Discusses Why He Became A Neurosurgeon

I was always interested in and fascinated by the human body and that's the reason a lot of physicians become physicians- because they are fascinated by the machine we call human so to speak. I was always fascinated by how the mind works and when I was younger I was always fascinated by thought process, how you form a thought. And actually, I was thinking of becoming a psychologist or a psychiatrist. That was because my eyes were not that good when I was younger and I could not be a fighter pilot- that was the first choice, like every boy ever wants to be a pilot. But that went away. So I was thinking of becoming actually a psychiatrist, but my father, whose an electrical engineer, got really sick and had to have a couple of operations. When he was going through that, I found that brilliant mind just shut down completely; he wasn't thinking about the way he was thinking anymore. He was just physical pain that was he was going through and because of that, it was like hmm...maybe I should think more about doing actually a more physical aspect than a psychiatric aspect. So I picked the best of both worlds, says neurosurgery, you know, it's something that you deal with brain and mind, and there's a lot of things we don't know about it and you also help with the physical aspect.
I wanna quote one of the first neurosurgeons that I ever worked with, who was chairman of my medical school. He always used to say, it's the greatest job in the world, and it is the greatest job in the world there is no- you have highs and you have lows but when you have highs there is nothing like it. There is nothing like operating on a 32 year old that was diagnosed with manic schizophrenia nobody bothered to do a CT scan and find out she had a huge frontal lobe tumor and removing that tumor, she went completely back to normal, out of the psychiatric institute. It's just amazing, I mean to see- and then to me my patients that I tell people I think the bravest people you ever see it, not that many days that you can trust the center of your being which is your brain to someone else. That's what makes us us and you trust somebody else to say ok, tinker in it. That to me is great. The patients are the most amazing people to me personally.