Pedro Coutinho, MD, is a neurosurgeon who specializes in treating complex spine diseases, such as Chiari malformations and spine tumors, with minimally invasive spine surgery. “The prevalence of spine disease leans toward degenerative conditions, especially as the population ages,” Dr. Coutinho says. As such, Dr. Coutinho routinely sees patients with degenerative conditions, including disk herniations, spinal stenosis, spondylolisthesis, and compression of the spinal cord.
“What attracts me to spine surgery is the fact that it’s changed tremendously over the past two decades,” Dr. Coutinho says. “Now, we use intraoperative navigation tools, robotics, and newer minimally invasive surgical techniques, all of which result in much better outcomes for the patient.”
For patients who worry about undergoing surgery, Dr. Coutinho offers reassurance through his personal philosophy that surgery should be a last resort. Except for a few conditions, the first step toward treating spinal conditions is trying nonsurgical options such as physical therapy, core strengthening exercises, and medications, says Dr. Coutinho. “We work with pain management doctors, physiatrists, and physical therapists, in addition to orthopedic surgeons, to discuss cases and find better ways to treat our patients,” he says.
If patients do require surgery, Dr. Coutinho stresses the importance of first understanding what a patient hopes to achieve with the procedure. “We help manage expectations, but we also want to make sure we are addressing the clinical symptoms of the patient, and not just correcting a deformity in an X-ray, MRI, or CT scan image,” he says.
While he’s accessing a patient’s condition and mapping out next steps, Dr. Coutinho keeps this in mind: “The goal of treatment is to give the best care using the latest technology and procedures, and to weigh that against the human aspect of practicing medicine. I ask myself, ‘What would I chose for myself or my wife or family members?’”