Ira Fedder, MD
Image provided by Dr. Fedder
What first brought you to NASS, and what do you remember about the early years?
The meeting was very small. My first meeting was in the early 1990s in Washington, DC. One Hotel, two rooms for presentations.
What was spine care like when you entered the field and how did it evolve throughout your career?
Spine care was much more centralized. There many fewer spine surgeons. Very few neurosurgeons did disciplines, laminectomies, and some cervical surgery, but no fusions and no instrumentation. Sometimes there would be a ortho spine/neuro team. Conservative care was primarily directed by the ortho spine surgeons. There were not many fellowships. Incisions were large. Bed rest and inactivity was common. Rigid bracing was common. Anterior surgery was a big operation. Thoracoabdominal approaches included dividing the diaphragm and everyone had a chest tube! Then came VAT and laparoscopic fusions. We did the early work including retroperitoneal endoscopic approaches using a balloon device to develop the potential apace (original balloon). We helped develop these techniques operating on pigs and sheep. I remember working with the early neuromonitoring that would eventually finds its way to market by Nuvasive as part of the XLIF
Was there a particular project, committee, or initiative you were proud to be a part of? What made it memorable?
Helping develop the VAT and endoscopic procedures. Also teaching disc arthroplasty.
If you could preserve one lesson or philosophy for future generations of spine care providers, what would it be?
Think about what you are doing. Anyone can do most of our surgeries. In fact, in the near future robots may replace our hands on the patient but robots cannot hold your patient’s hand or discuss the impact of the diagnosis and surgery to them and their family. Talk to your patients and listen to them. Not just their words but their tone, their body language, and their families.
What did you learn from patients that changed how you approached your work or saw your role in the field?
Have relationships. In 30 years of practice I was sued once and it was dismissed. I was never named in a malpractice action again. No settlements.
What do you see as the most important challenge or opportunity facing the future of spine care?
Maintain relationships with patients. Groups have gotten big. Using call centers. Very impersonal for such a stressful environment.
What emerging innovations do you think will have the most impact on patient care?
Regenerative approaches including the development of small molecules to enhance bone growth and heal injured nerves.
If you were entering the field today, what area would you be most excited to pursue?
Endoscopic surgery. Also focus on wellness and overall health
What would you most like to be remembered for in your career?
I was a really good physician. I listened to patients and took care of them and their families. Anyone can be a technician but not every can be a healer
If someone finds your message in this time capsule decades from now, what would you want them to know about the people who built NASS?
They were very dedicated to advance the science and the art of spine care.