Developing a Neurosurgery Destination

Posted on May 01, 2018

Each weekday at 7 a.m., Johns Hopkins All Children’s Hospital’s pediatric neurosurgery team meets to discuss every patient under its care. The collective talent and experience of four neurosurgeons with 80 years of practice among them, as well as six talented and specialized nurse practitioners add up to pediatric neurosurgical care unrivaled in the state.

The team is experienced in all areas of pediatric neurosurgery including brain and spinal cord tumors, tethered cords, congenital malformations, epilepsy, Chiari malformations, craniofacial anomalies, hydrocephalus, brachial plexus and peripheral nerve injuries, traumatic brain injury and congenital and traumatic spine issues.

Each neurosurgeon contributes a specific area of expertise:

  • George Jallo, M.D., director of the Johns Hopkins All Children’s Institute for Brain Protection Sciences, who focuses on epilepsy and tumors of the brain and spinal cord, including using minimally invasive keyhole approaches
  • Gerald F. Tuite, M.D., who specializes in craniosynostosis and other craniofacial anomalies that affect the shape of the skull and face and was the first surgeon in the Tampa Bay area to offer minimally invasive craniofacial surgery
  • Luis F. Rodriguez, M.D., who performs craniocervical junction and spine procedures, particularly on children who are born with complex, often severe problems with the formation of the bones at the base of the skull and in the neck
  • Carolyn M. Carey, M.D., who focuses on Chiari malformations, other spinal cord malformation (dysraphic) conditions and moyamoya disease treatment

“Thanks to our team-centric approach, when a child is admitted, I’m not limited to only my own view of how to manage the child,” Jallo says. “I always have input from the other surgeons. That group discussion allows us to explore more options, and confirm we are choosing the best course of care for each individual child.”

That collaborative approach is critical to resolving the complex cases that prompt patients to travel from across Florida—or across state and international borders—for treatment.

Collaboration is Key 

Being part of the largest pediatric neurosurgery team in Florida allows each surgeon to become so well-practiced that complex procedures—such as removing tumors from the spine or correcting deformities caused by craniosynostosis—become routine.

“The best care is rendered by a team that addresses a multitude of potential issues that can arise in the short and long term,” Tuite says. “I am very proud of the strong multidisciplinary team we have assembled, which allows us to offer a broad range of care that I believe is unrivaled in Florida and in most of the United States.”

The neurosurgery team works closely with the tumor board, led by Stacie Stapleton, M.D., hematologist and oncologist at Johns Hopkins All Children’s, which meets weekly to discuss all cases being operated on that week, as well as any patients who have been seen or are scheduled to be in clinic or follow-up. Neurosurgeons, neurologists, pathologists, radiologists, psychologists and oncologists discuss every step of the treatment process, collaborating on decisions about treatment options.

Pushing Pediatric Neurosurgery Forward

Since 2015, the team also has used robotic treatment for cases of epilepsy.

“It allows us to look at children with refractory epilepsy who we didn’t think were surgical candidates,” Jallo says. “We insert minimally invasive electrodes to pinpoint the specific location of the seizure, allowing us to remove the smallest area of the brain possible. We recently operated on a 20-year-old college student with a history of trauma. Through these electrodes, we found the exact location of the seizures. With a more traditional approach, we would’ve removed more brain, which could potentially cause learning or cognitive effects.”

Each member of the neurosurgery team is also furthering the discipline through research in areas such as Chiari malformations, brain tumors and craniosynostosis, and the surgeons regularly participate in international conferences. Johns Hopkins All Children’s is also in the process of developing an accredited pediatric neurosurgery fellowship program.

“Besides providing the highest level of pediatric neurosurgical care, we are committed to educating residents and fellows in neurosurgery who will carry forth the skills and compassion learned at our institution,” Carey says. “Through our research efforts, we are always pushing the envelope in order to discover and develop the most effective, safe and up to date methods and procedures to offer to our patients.”

“We practice excellent medicine with great outcomes right here in Florida,” Rodriguez says. “We do complex work across all aspects of pediatric neurosurgery, and I think we could put our outcomes up against anyone else in the country and match, or top, theirs.”

To refer patients to the pediatric neurosurgery program at Johns Hopkins All Children’s Institute for Brain Protection Sciences, call 727-767-8181. This story first appeared in Leading Care magazine.

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