STATE COLLEGE, Pa. — Precision is crucial for James Fick, an esteemed neurosurgeon from the nationally ranked Penn State Hershey Neuroscience Institute. Fick frequently operates within millimeters of the delicate nerves in his patient’s brains and spinal cords.
To combat the inherent risks associated with brain and spinal column surgeries, such as paralysis and loss of functionality, Fick employs a unique combination of specialized technology to safeguard his patients during surgery. These technical procedures are the centerpiece of neurosurgery today, he explained, and are leveraged in the hundreds of procedures his team performs every year.
“The level of patient care I received from the neurosurgery staff, both before and after the operation, was something I wasn’t used to at the time,” said Patti Fantaske, a former patient who underwent two spinal surgeries with the neurosurgeon. “Dr. Fick’s team knows you’re scared and upset. They are very reassuring and comforting — and the technology they employ just makes the whole process easier.”
Collaboratively recruited by Penn State Milton S. Hershey Medical Center and Mount Nittany Medical Center in 2004, Fick is a board certified neurosurgeon who, today, heads up the only neurosurgery practice in State College, Pa. His neurological practice has been an inspiration within this community of 40,000 people — while introducing technology into the operating room has resulted in increased confidence, precision and safety, even allowing operations to be done that would have been judged inoperable years prior.
Electrophysiological monitoring is one such technology. According to Fick’s team members, the monitoring works by placing electrodes within the muscles of the scalp, neck, arms, hands, legs and feet to activate the sensory and motor pathways and report on the neurological functioning of patients under anesthesia.
The role of the on-hand monitoring technician is to study the patient’s vitals and alert the surgeon as to whether they are operating too aggressively or if the spinal cord or nerves are showing signs of trouble, based on second-to-second readings that appear on a laptop screen. During the operation, the technician also communicates with an off-site neurologist, via a secure form of instant messaging, who is available to answer questions, discuss the patient’s drug levels and consult regarding any concerns.
“When we’re so close to the nerves in the face responsible for movement and hearing, we want to monitor our progress very carefully,” observed Fick. “There can be 18 reasons why the surgical neurophysiologist sees a change in the patient’s readings, which can ultimately change the way I do the surgery. So there’s constant interaction between us.”