The North American Spine Society (NASS) is celebrating the work of surgeon and biomedical pioneer Nicholas Theodore, M.D., M.S., at its upcoming annual meeting. Theodore is being honored with the Leon Wiltse Award for his visionary approach to spine and brain surgery as he explored the best ways to marry robotics with imaging.
A True Visionary
Theodore co-founded Excelsius Surgical which developed the first real-time image-guided robotic system for spine, brain, and orthopedic trauma surgery.
The Leon Wiltse Award honors excellence in leadership and clinical research in spine care as a tribute to the visionary work of Dr. Leon Wiltse, one of the most influential orthopedic surgeons of our time. He founded the Wiltse Spine Institute and was a true innovator when it came to patient care.
On receiving the award, Theodore told Orthopedics This Week, “It is humbling for sure and exciting. It came as a surprise.”
Theodore has been a member of NASS since 1998 and is the Donlin M. Long Professor at Johns Hopkins University in Baltimore. He is director of the Johns Hopkins Neurosurgical Spine Center and recognized worldwide for his groundbreaking work in brain and spinal cord injury, robotic surgery, and advocacy.
Theodore said his personal journey to become a spine surgeon had some help from fate. As a medical student, he was interested in everything, and it wasn’t until he had his neurosurgical residency in his third year that he found his calling.
What attracted him to neurosurgery he said was making the diagnosis, taking care of the patients, and the technology.
“Even at that time, neurosurgery had all the greatest toys,” he explained.
Theodore earned his medical degree from Georgetown University and then completed his military service. He interned at Bethesda Naval Hospital now called the Walter Reed National Military Medical Center and then served as a Marine Corps doctor in Okinawa, Japan. He completed both a residency in neurosurgery and a fellowship in spinal surgery at the very prestigious Barrow Neurological Institute in Phoenix, Arizona.
Following his training, Theodore served as Chief of the Division of Neurosurgery at the Naval Medical Center San Diego and then Director of the Neurotrauma Program and Associate Director of the Neurosurgery Residency Program. In 2009, he became Chief of the Spine Section and Director of the Spine Fellowship at Barrow Neurological Institute.
Theodore left Phoenix in 2016 to join the legendary Johns Hopkins Medicine system in Baltimore, Maryland.
Looking back at his career milestones so far, Theodore said, “I am most proud of bringing imaging guidance and robotics into neurosurgery and spine surgery.”
Pioneering Work
While using imaging technology in Phoenix, Theodore began asking a very basic question: how can robotics improve brain and spine surgery accuracy?
That question turned into a 17-year proposition for him and his best friend and inventor Neil Crawford. The robotic system they created vastly improved the accuracy and speed of surgical access, implant sizing, positioning, and placement.
“We could have given up, but we didn’t. It is my proudest accomplishment, Now, everyone wants robots because they are easier to use and safer for patients. Today over 75,000 of cases using the image-guided robotic system are performed globally.”
Theodore and Crawford sold their company to Globus Medical, Inc., in 2013.
Theodore said the other big passion in his life is sports. He is heavily involved with ThinkFirst which was founded by fellow neurosurgeons. The mission of the organization, where he served as National President from 2013 to 2015, is to prevent brain, spinal cord and other traumatic injuries through education, research and advocacy.
“ThinkFirst focuses on how to prevent injuries by wearing helmets, not jumping into the shallow end of the pool, and other preventative measures,” he explained.
“People share their experiences getting injured and teach how these injuries can be prevented. It is pretty impactful.”
“This led to my work with the National Football League,” he added. “I am Chairman of the NFL’s Head, Neck, and Spine Committee which aims to protect football players from concussions and spinal injury. It is a great opportunity and great visibility, a fun job, but there are a lot of moving parts.”
Thoedore is also the co-holder of 10 patents for medical devices and procedures and is a prolific author of book chapters and peer-reviewed journal articles.
At Johns Hopkins Outpatient Center and the Johns Hopkins Bayview Medical Center, he treats patients with spinal disorders including trauma, Chiari malformations, spinal deformities, degenerative spine conditions, and spinal cord tumors.
HEPIUS, GOD of Healing
His lifelong passion, however, has been spinal cord injury, especially the concept of draining spinal cord fluid after an injury to the spine. That is what he is working on at his lab HEPIUS named for the Greek god of medicine and healing. HEPIUS is short for Holistic Electrical, ultrasonic and Physiological Interventions Unburdening those with Spinal cord injury.
“At my lab in Baltimore, we have a big grant from the Defense Advanced Research Projects Agency to develop an ultrasound patch that can be put on the spinal cord right at the time of injury to monitor the fluid. The hope is that it can help us better understand if blood flow to the spine is adequate enough.
It can also monitor the spinal cord for swelling and the risk for the development of hematoma.
The patch called the MUSIC device has already been given FDA Breakthrough Device Designation.
Even with all these accomplishments though, Theodore says his marriage to his wife of 30 years and their two boys will always be the most important part of his life.
The North American Spine Society is a medical society for health care professionals who specialize in spine care. The mission of the society, which was founded in 1985, is to promote evidence-based and ethical spine care.
The 2024 NASS 39th Annual Meeting will take place September 25 through September 28 in Chicago at the McCormick Place, West Building.
