HAPPY NEW YEAR! It’s time again for our semi-annual newsletter. I know that all of you have had the opportunity to have your patients cared for by us. However, there are strenuous efforts made to maximize the patient outcome, family experience, and minimize complications.

At NEUROSURGEONS for kids, we strive for:

-SAFETY – Primum non nocere. First do no harm. I am very conservative in my surgical decision-making, allowing us to reduce our complication rate to <1%.
-EXPERIENCE – Every full-time employee in our practice has a minimum of 5 years of neurosurgical experience, leading to greater accuracy at every level, from front desk to MD and all in between.
- EMPATHY – Every full-time employee in our practice is a mother or father. We understand that coming to the neurosurgeon’s office is a stressful time.
- DOCTOR ONLY – All patient care is performed by a board-certified pediatric neurosurgeon. No physician extender to open and close cases or screen patients. Each patient knows their MD personally. Each patient gets a personal e-mail from the MD after their visit, for follow-up and to answer any questions that may arise. There is additional time required on my part to do this, but this has allowed me to reduce our infection rate to <1%(historic low in Orlando) and improve patient communication/satisfaction.

These are the SEEDs of our growth.

The following abstract is from an upcoming presentation. Publication is pending.

Since FDA approval of vagus nerve stimulation for the treatment of refractory, multi-focal epilepsy, >16,000 implantation procedures have been performed. The traditional approach has been 2 incisions, one along the lateral margin of the left pectoral muscle(for generator), the other in the anterior, left mid cervical region(for leads). This approach is easier for the surgeon because it allows a direct approach, utilizing anatomy familiar to neurosurgeons comfortable with carotid endarterectomies. However, there is greater discomfort to the patient, more cosmetic evidence, and, recent studies have reported that up to 7% of the left breast tissue may be blocked on mammography. Therefore, an alternate approach has been devised, now used in >50 patients locally. The alternate approach starts with a single left sub-clavicular incision, creating a pocket inferior to the left clavicle(staying medial enough to avoid any breast tissue), followed by superior dissection between the sternal and clavicular heads of the sterno-cleido-mastoid muscle. The vagus nerve is identified lying within the carotid sheath, medial to the jugular vein. Outcomes remain exceptional, with >88% of patients describing a >50% reduction in seizure frequency.