NeuroLogic
Winter 2017

Like many neurosurgeons, Nicholas Theodore  says that it’s the intriguing anatomy of the brain that drew him into the specialty. But, during his residency, the spine caught his interest and has held it ever since. Now the new director of the Johns Hopkins Neurosurgical Spine Program, Theodore adds that it’s the incredible outcomes of spine surgery that have kept him fulfilled over decades of practice. For the patients he cares for, which include all ages with conditions including trauma, infections, fractures, herniated discs, degeneration and stenosis, he notes that spine surgery frequently has the possibility of completely resolving their complaints.

“Through surgery,” he says, “we can often completely cure a patient’s spine problem and get them back to fully living their lives.”

It’s also a subspecialty in which many of the encompassed conditions stand poised for a revolution in care. Much of Theodore’s research focuses on spinal cord injury, a devastating problem that still largely remains an enigma. By gaining a better understanding of this mysterious condition, he and his colleagues are striving to improve outcomes.

In one ongoing project, started in Theodore’s former position as director of spinal neurosurgery at the Barrow Neurological Institute in Phoenix, Arizona, and continuing at Johns Hopkins, Theodore and his colleagues are studying how to get the greatest blood flow to the spinal cord after an acute injury. Rather than raise a patient’s blood pressure, the current standard of care, the team’s work suggested that draining spinal fluid to decrease pressure instead brought more blood to the spinal cord. Based on these findings, they recently launched a three-year, multisite trial funded by the Department of Defense to evaluate this intervention in human patients.

Theodore’s research also extends from the genetics of spine disorders to robotic tools to improve surgeries. He’s currently working on a robot that can precisely place screws in a patient’s spine at the touch of a screen displaying their anatomy.

On a more operational level, Theodore is working to improve the field overall by improving patients’ experiences. In his new role, he plans on working to streamline care at the Johns Hopkins Spine Center by coordinating it among multiple specialists who take care of spine patients. By making the center a “one-stop shop,” he says, patients will receive better care while also saving time and effort.

“Dr. Theodore is not only a phenomenal physician and extraordinary surgeon; he’s also wonderfully compassionate,” says Henry Brem, director of the Johns Hopkins Department of Neurosurgery. “He doesn’t just take patients into surgery but really takes care of them.”

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