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Dr. Andy Cohen And Don Mattingly Make A Winning Team For Sports Medicine

Cutting edge “sports neurosurgery” is able to return the pro to the game and, for the rest of us, give us back our active lives.

Don Mattingly of the New York Yankees was one of the most widely respected baseball players of the 1980’s and 90’s, considered by many to be one of the greatest in the history of baseball. Like many Americans, he suffered from chronic back problems, which, first, robbed him of much needed power in his game, and then, to the dismay of avid baseball fans everywhere, caused his premature retirement in 1994 from the game he so loved.

Luckily, the world of sports medicine has come a long way since that time when spine surgery was far more complicated and often yielded unpredictable outcomes. Indeed, it was precisely because of the uncertain nature of the result that Mattingly postponed his surgery until after retirement. Had Mattingly’s doctors been able to avail themselves of today’s more sophisticated surgical techniques, it is likely that both his pain could have been adequately addressed and his career could have continued along to its more natural endpoint, allowing him to play for years more.

Today’s Sports Neurosurgery is an exciting new medical subspecialty that borrows from a mosaic of concepts from other specialties. It draws from neurosurgery and spine surgery, addressing the injuries and diagnosis of problems of the brain, spine and peripheral nerves. It includes concepts from minimally invasive surgery, melding existing techniques with new surgical adaptations to address specific requirements of the athlete.

At New York Presbyterian’s Weill Cornell Neurosurgery department, we use the most cutting edge proven advances in surgical technology while we continually hone those standards for the best patient outcomes. The main focus is on soft tissue (skin, muscle, tendon and ligament) preservation to allow for quicker recovery and incorporates cosmetic closure techniques using absorbable stitches under the skin for soft tissue. The latter minimizes scarring.

Traditionally, the surgical sports field has been dominated by Orthopedics. However, spine injuries often involve nerve compression of the spinal cord and exiting nerve roots. Neurosurgeons who focus on these types of injuries have unparalleled training and comprehension of the anatomy, along with the ability to diagnose and treat these disorders.

Athletes today are larger and faster than ever before, and thus the injuries sustained to the head, neck and back are often very serious. In treating the athlete, there are unique demands placed on the physician to effectively treat the injury, preserve the anatomy and return the athlete to competition as quickly as possible.

An accurate diagnosis and treatment plan is only part of the solution. Both non-surgical and surgical options are carefully considered, but when surgery is deemed necessary, repairing the injured site is just one facet of the surgeon’s focus. Just as important is taking into account the lifestyle of the patient and preserving normal anatomy and function to the best degree possible.

Components of a typical sports neurosurgical plan would include:

1. Minimally invasive approaches which allows for: smaller incisions (less than the size of a quarter); no cutting through muscle; the ability to approach the injury from various angles; less time in the operating room; less pain and faster recovery. I see 75% of my patients return home the very next day.
2. Preservation of soft tissue, which includes skin, muscle and ligaments.
3. Preservation of bone which allows for faster healing, less pain and less chance of becoming arthritic down the road.
4. Providing stability, when indicated, using latest fusion or motion preservation technology.
5. Latest imaging techniques, including MRI, CT and functional studies for pre op, intra op, and post operative analysis.
6. Cutting edge energy sources including High Frequency Radiosurgery and LASER for the highest precision and least amount of lateral heat damage.
7. Rehabilitation and “return to play” recommendations.

After surgery, care includes a cohesive team approach to rehabilitation, involving therapists, trainers, coaches and family support. This rehabilitation strategy is usually formulated BEFORE surgery, and is later closely followed by the surgeon in the post operative period.

Common back ailments which we’ve successfully treated in the New York Presbyterian Weill Cornell Neurosurgery Department using this innovative approach include: herniated discs, bulging discs, spinal stenosis, osteophytes, spondylosis, spondylolithesis, scoliosis, facet cysts, spine arthropathy, chiari malformation, tethered spinal cord, sciatica, lumbago, mechanical back pain, spinal instability, post laminectomy syndrome. degenerative disc disease, degenerative spondylosis, degenerative spondylolithesis, degenerative scoliosis, cervical spondylosis, kyphotic deformaty, failed back, pseudoarthrosis.

These same cutting edge treatments used for athletes are also being used to treat the “weekend warrior”, as well as the aging, but still active population. Some of the injuries suffered by those patients are similar to those typically seen in professional athletes, but surgical techniques have been developed and honed specifically to treat their own set of unique problems. While the level of competition that those patients engage in may not be as demanding as the pros, their goals are similar: the return to normal function, the alleviation of pain and the establishment of long term stability. Our patients have come to expect a lot from us, and thankfully, we’re able to deliver.

Dr. Anders Cohen is a full time assistant professor of Neurological Surgery at Weill Cornell Medical Center and a leader in Sports Neurosurgery as an emerging sub-specialty. A former tennis professional, Dr. Cohen maintains an active interest in many sports, and is able to bring to bear his unique perspective as both athlete and accomplished neurosurgeon to better serve his patients. He frequently lectures both nationally and internationally and is a clinical evaluator for many of the latest technological advancements in brain and spine surgery. Dr. Cohen offers the most up-to-date, comprehensive, minimally invasive treatments for a wide variety of neurosurgical conditions. He regularly consults with athletes on the professional, college and high school level. He also specializes in the newest treatments for degenerative spine in the aging athlete.