Renaissance Surgeon Seeks Spine Restoration
Q & A With Richard Fessler, MD, PhD, Spine Surgery Pioneer
neurosurgeons don’t start their careers with an MS in psychology, a PhD in
pharmacology and physiology, and fellowships in neurological surgery and psychiatry.
Nor do they earn NASA Space Shuttle certification as both medical specialist
and flight surgeon. And they definitely are not working on a master’s in
theology in their spare time. Most neurosurgeons, however, are not Richard
Fessler, MD, PhD, who joined Rush’s Department of Neurological Surgery last
Describe a patient who benefitted
from your surgical techniques.
nurse came to me with severe scoliosis. She had it for years, but over the past
year it had become excruciatingly painful. She previously had renal cancer and
had her kidney removed, so that made approaching her spine through the side
minimally invasive technique, we were able to do the operation from the side
and get both of her spinal deformities corrected to near perfect. Scoliosis
surgery is of course very big surgery. So I was shocked when six weeks later I
was giving a public lecture on scoliosis, and she showed up. She had to take a
train from Indiana, transferred to a bus and then walked six blocks to show up
at this lecture. And she did that without any pain.
How do your psychology studies inform
your work as a surgeon?
Interestingly enough, I’m doing a study
comparing patients’ expectations and outcomes and seeing if patients'
expectations influence the outcome. If you have a lot of psychological problems
and a lot of unrealistic expectations, you won’t have a good result. Even if
you have a great outcome clinically, you’re not going to think you did.
Could philanthropic support make a
big impact in a particular area of yours?
to my surgical practice at Rush, I am actively involved in research that could
be a major breakthrough. The ability to regenerate damaged tissue in the spine
could alleviate the need for spine surgery altogether and restore mobility to
the 500,000 individuals paralyzed by spinal cord injury each year.
What challenges do
you face in researching better spine surgery methods and techniques?
One challenge with scoliosis is returning lordosis, the
normal curvature of the spine. It’s very important. If they are off balance,
they hurt. One of the hardest things we’ve faced is to accomplish that with
minimal invasion, though the last patients I’ve worked with have fared really
Can you describe your
areas of research at Rush?
My research tends to fall into three areas. The first is
clinical research. I have kept a very thorough database of my patients for the
last 20 years. It allows me to very closely follow how they do after surgery
and over time. It then allows my residents and fellows to go back and use that
database to study and publish. We do a lot of that. Prospective clinical
Secondary research that I focus on is developing new
surgical techniques. That mostly involves minimally-invasive surgical
techniques and that’s done primarily on cadavers in the anatomy laboratory. In
the past, I reserved two days a month where I spend time in the anatomy lab
with whichever residents are available, working on new techniques for surgical
The third area I’ve been doing research is in stem cell
transplantation for spinal cord injuries.
describe aspects of how the stem cell research is conducted?
There will be specific inclusion and exclusion criteria. In
fact, in the last study the exclusion criteria were so extensive it was very
hard to get patients into the study. One of the limitations of that study is
they had to be transplanted within 14 days. Very often a person with a spinal
cord injury goes to an outside hospital. Since a spinal cord injury is usually
associated with a fracture of a spine they would be operated on there to
stabilize it. Well, that takes about a week. Then they need time to be
transferred to this facility to get the stem cell transplant, and then pass all
of the other criteria to get it, so we found it very difficult.
One of the things we’re hoping to do is to extend that
period of time a little bit longer. Perhaps 21 to 28 days. The last time we did
it was in the thoracic spine. Because it was a safety study, that made sense.
But that’s also the area where you’re least likely to see a beneficial effect.
We’re hoping to be able to next do it in the cervical spine. And that’s where
we think we might be able to have a better impact.
in supporting this research or learning more? Contact Deanna Wisthuff, director of development in the Office of Philanthropy, at (312) 942-7246 or at email@example.com.