Neurosurgeon recommendations in Austin/central Texas area Neurosurgeon recommendations in Austin/central Texas area

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Thread: Neurosurgeon recommendations in Austin/central Texas area

  1. #1
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    Mar 2019
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    Default Neurosurgeon recommendations in Austin/central Texas area

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    This may be a bit wordy, but here is the "back" story.

    A friend and trainee was in a wreck several years ago that left her with several severe disc problems. She had two separate lumbar microdiscectomies on her L5/S1, after which she still had sciatica and numbness in her right foot. The surgeon who performed these operations also tested for nerve damage/impingement in the t11/t12 area, because that disc was severely herniated, but she showed no symptoms.

    She's been training for a little over two years and she's four years out after her initial accident and subsequent surgeries. Training has been a massive success in terms of taking her from frail to athletic again and changing her mindset to not worry about her back so much. She was afraid to bend over and reach past her knees without any weight in her hands when we first met and now she can currently squat ~160 for 3s and pull 185 for 3. Her sciatica has gone away and she's back to living like an athlete, but she still has some numbness in her right foot.

    Sometime over the summer she had an incident breaking up a dog fight and tweaked her back. This was diagnosed as a facet joint injury and she consulted a pain management clinic to treat it. the pain would come and go and typically training would leave her feeling better for a few days before it would come back again (she only trains 1x/week). She decided to have a procedure done to cauterize the nerves that were symptomatic as a result of the facet joint issue. An MRI was done, after which her doctor explained that he would not do the procedure because her t11/t12 herniation was so severe that she "could be paralyzed if she gets bumped at a stoplight."

    My initial reaction was anger that this alarmist doctor would put this kind of shit in her head, but then she showed me the MRI. It doesn't take a doctor to notice that her t11/t12 disc is quite fucked. She sent the imagines to her original neuro in Jersey who stated that the herniation has progressed and she should talk to a neuro in Texas. This surgeon was surprised that she never showed symptoms from this herniation that occurred over 4 years ago, but I'm thinking that her foot numbness is related to that disc.

    She has had one doctor's opinion thus far and the recommendation is t11-12 fusion with a laminectomy. My advice to her was to get multiple opinions, but not to hesitate if surgical intervention is the best option. She's been of the mindset that she will avoid another back surgery for as long as possible, but I told her that in this particular scenario she should get it done and over with while she's still strong and relatively asymptomatic. I've attached her recent MRI images and I'd be interested to hear any expert opinion: Rip, Dr. Sullivan, Dr. Morris, Dr. Bradford, et al.

    This is a healthy, athletic 25 year old woman. She understands the benefits and therapeutic applications of strength training and she wants to continue training. She's looking for the kind of neurosurgeon that we like, who also understands what we know about strength training.
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  2. #2
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    Aug 2010
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    Olympia, WA
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    Of all places, there is a phenomenal neurosurgeon in Lubbock, Texas that works out of University Medical Center. His name is Mark David D'Alise, and I would trust his recommendation over all but two other neurosurgeons I have met. If she were into taking a much longer road trip, David C Wang in El Paso is one of those two neurosurgeons I would recommend. Both are extremely skilled, extremely conservative, and they are fairly exceptional with their bedside manner.

  3. #3
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    Quote Originally Posted by Will Morris View Post
    Of all places, there is a phenomenal neurosurgeon in Lubbock, Texas that works out of University Medical Center. His name is Mark David D'Alise, and I would trust his recommendation over all but two other neurosurgeons I have met. If she were into taking a much longer road trip, David C Wang in El Paso is one of those two neurosurgeons I would recommend. Both are extremely skilled, extremely conservative, and they are fairly exceptional with their bedside manner.
    Thanks Will, much appreciated.

  4. #4
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    Mar 2019
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    She had a consultation with a local neuro this week. He told her disc replacement on t11/t12 and fusion on her l5/s1. I had sent her the reply here from Doc Morris. Hopefully sheíll decide to get another opinion.

    The appointment with the neuro on Wednesday has left her pretty shaken. I donít know what to think about all of this. The l5/s1 fusion seems unnecessary, but Iím not a doctor.

  5. #5
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    Aug 2010
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    Olympia, WA
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    You have here the recommendation. If she does not seek a second opinion, this is likely the result she actually wanted.

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