ROBERT SPETZLER

OR HOW TO MAKE UNDISTINGUISHABLE NEUROSURGERY AND ART

WFNS Gazette is proud of having interviewed one of the most renowned neurosurgeons of the history of Medicine after successful operations on thousands of incredible difficult cases. Robert Spetzler, a great supporter of Foundation teaching activities, is unveiling some aspects of his exciting and fruitful professional life.

Why are you attracted to aneurysms? 

 They are very challenging lesions and require technical and decision making skills of the highest order. 

How many have you already performed?

6495 aneurysms clipped.

Tell us about Pam Teynolds

It is Pam Reynolds, a patient that underwent cardiac standstill where the body is cooled to 14 degrees centigrade after the heart stops spontaneously the cooling is continued on a heart-lung machine until the 14 degrees are reached, then the pump is turned off so a very difficult aneurysm can be clipped while there is no blood pressure.  During this time there is no pulse, no respiration, obviously no blood pressure and no brain activity.  Pam claimed that despite this she was able to recollect certain activities as if she was watching the surgery while floating above.  Some of these observations were eerily similar to actual events.  That is how she became so popular with many psychologists interested in the near-death experience.

How would you classify your contributions to Neurosurgery?

I was fortunate enough to be surrounded by many talented colleagues from the residents, attendings, nurses and researchers who helped me make contributions in cerebrovascular surgery  including an avm classification, new approaches for cavernous malformationsand the discovery that spinal avms can be treated safely.

Do you consider that good progress is being made in the science of neurological surgery?

The advances in our speciality have paralleled the warp speed of computing. With the introduction of MRI’s, image guidance, etc our speciality has progressed remarkably.  However, much more need to be done to treat brain tumours and degenerative diseases effectively.

You have published over 300 articles in scientific journals. What do you think has been your greatest contribution?

Although not my most cited, my favorite contribution is the classification and new treatment of spinal AVM’s.

You have published over 300 articles in scientific journals. What do you think has been your greatest contribution?

Although not my most cited, my favorite contribution is the classification and new treatment of spinal AVM’s.

After so many years in the profession, what are you afraid of?

I am not afraid for our specialty, when I see the talent and commitment of our residents and young neurosurgeons I am convinced of the bright future and progress that is ahead.

What do you think should be the main function of the WFNS Foundation?

The WFNS and its foundation have made significant contributions to the Third World.  The ability to share knowledge with publications and operative videos as available today allows virtually anyone interested in our specialty to stay current and learn thenewest techniques.  The large number of courses given gratis around the world emphasize the great commitment and altruism of many of my colleagues to share their knowledge and wisdom.

Do you think that first world neurosurgeons are sufficiently aware of the need to help the Third World?

Yes and no, there are many efforts within the WFNS and with other dedicated missions to provide the best care in poverty-stricken areas of the world, yet it is clear that much more needs to be done.

Spetzler played a dominant role in the use of the standstill operation in treating large or dangerous cerebral aneurysms.
 
 One notable application of this method occurred in 1991 when Spetzler successfully removed a large aneurysm in a 35-year-old American woman named Pam Reynolds. Prior to the operation proceeding, Reynolds was placed under general anesthesia, then had her eyes taped shut and a monitoring device placed in both of her ears. She was later induced into clinical death by Spetzler and his team, which was necessary for the operation to take place. Despite being clinically dead and under intense monitoring and medical observation whilst the procedure was ongoing, Reynolds claimed to have had a profound near-death experience in which she was able to accurately recall the sequence of events within the operating theater, the surgical instruments used, and the conversations that had taken place. In an interview that took place for a BBC documentary in 2002, Spetzler affirmed many of the observations that Pam had made and later admitted that he had no explanation for them.
 
 In February 2007, Spetzler performed his 5,000th aneurysm procedure.