New UH spine surgeon brings expertise with minimally invasive techniques, advanced technology to the West Side
UH Clinical Update - August 2018
Spine surgery is increasingly becoming a minimally invasive endeavor, with advanced technology playing a pivotal supporting role.
New UH neurosurgeon and spine surgeon Gabriel Smith, MD, is uniquely qualified to put these advancements to work for UH patients.
“New technology like endoscopic techniques and the refining of minimally invasive techniques, creating the least amount of tissue disruption, are the forefront of spine surgery. I hope to advance the field and provide care to the West Side of Cleveland with new minimally invasive and endoscopic techniques. I do also provide service for people with complex spinal problems including adult deformity, scoliosis and patients who need revision spine surgery.”
Advanced technology to support complex spine surgery is a big part of his practice, Dr. Smith says, both in the operating room and in the exam room when talking with patients. For example, he uses the O-arm – a surgeon-directed navigation system, both at UH St. John Medical Center and UH Cleveland Medical Center. The system provides axial, coronal, sagittal and oblique slice data to provide an expanded view of the patient’s anatomy, to assure that surgical goals are being met.
“I’m able to use three-dimensional navigation to register the spine in space and then place screws with pinpoint accuracy where they need to be placed in the spine,” Dr. Smith says.
When talking with patients before surgery, Dr. Smith is beginning to use a virtual reality simulation as a surgical rehearsal platform.
“We have virtual reality simulation where we can take their scans and create a three-dimensional model,” Dr. Smith says. “We can then preview the surgery with them in the office. We’re just rolling that out for spine surgery. I am very excited.”
The use of biologics is another important trend in complex spine surgery, Dr. Smith says.
“There is a lot of research into getting things to heal more extensively at different levels where we perform fusion,” he says. “Currently, the best biologic we can use is the patient’s own bone products from surgery. That will always be the gold standard. But I am using new technology with my interbody fusions using three-dimensional printed cages. These are designed down to the micron to allow bony in-growth into the disc space, through the cage.”
Dr. Smith earned his medical degree at Temple University School of Medicine. He completed neurological surgery residency training at UH Cleveland Medical Center. In addition, he completed fellowship training in complex and minimally invasive spine surgery at Cleveland Clinic. He sees patients and operates at UH St. John Medical Center, Southwest General Medical Center and UH Cleveland Medical Center. Spine surgery makes up the bulk of his practice, although he does perform cranial neurosurgery on call.
The prospect of spine surgery is daunting for many patients, to say the least. Because of that, Dr. Smith says he takes the time with each patient for an in-depth conversation about risks, benefits and expectations.
“With all my patients, I spend an extensive amount of time discussing what to expect before and after surgery,” he says. “I go over all the risks and benefits of surgery to make sure we’re all on the same page. The most important part of my practice is listening and having a true conversation about all options for patients from conservative management strategies to the role of surgery.”
With the implementation of surgical rehearsal in spine surgery and the advancement of minimally invasive approaches in spine surgery, Dr. Smith believes he can offer a new comprehensive practice to the West Side of Cleveland and the UH health system.