January 18, 2018

Radiant blog: St. Vincent Charity Surgeon Dr. John Collis revolutionized spinal surgery

A nationally noted leader in his field, St. Vincent Charity surgeon John Collis, M.D., revolutionized treatment for patients suffering from back pain. Dr. Collis, who is co-director of the Spine & Orthopedic Institute at St. Vincent Charity Medical Center, was the first doctor to establish spinal surgery as a sub-specialty in neurosurgery. He has also developed a number of groundbreaking standards over his more than 60 years in medicine.

The hospital’s blog, radiant, published an article about Dr. Collis’ background and his many achievements. The full text of the article is below.

Physician profile: St. Vincent Charity Surgeon Dr. John Collis Revolutionized Spinal Surgery

January 11, 2018

St. Vincent Charity Surgeon, Dr. John Collis, has revolutionized the treatment for patients suffering with back pain.  His leadership has led to innovative treatments and surgical options for millions of Americans living with chronic back pain. Through his foresight, Dr. Collis was the first to establish spinal surgery as a sub-specialty in neurosurgery. He developed groundbreaking standards, such as the use of pre-surgical antibiotics to prevent operative infections.
When Dr. Collis began his neurosurgical career more than 61 years ago, there were no neurosurgeons focusing on treatments of the spine.  Rather, the focus in his field was related to brain and head injuries “No one knew much about the spine and there was no management plan to help those suffering with back pain.  People looked at cranial surgery as exciting,” Dr. Collis said.  “I, however, saw that back injuries were far more common, but also more complex: there was a tremendous need for specialists to help these patients with back problems.”
As a result, Dr. Collis became the first neurosurgeon in the country to specialize in the spine.  He helped   to establish residency and fellowship programs to train other surgeons for spinal surgery.  His efforts were not immediately embraced by the established medical community; some doubted the need for spinal specialists.  However, today, Dr. Collis is recognized as the “father of the spinal surgery.”
Through Dr. Collis’ leadership, spine surgery is now a respected sub-specialty, and is now the largest subspecialty in neurosurgery.  Many of today’s neurosurgeons and orthopedists specialize in the spine, with more than 800,000 major spinal surgeries performed each year.  A two-year spinal surgery fellowship is a virtual requirement for many neurosurgeons and orthopedic surgeons. 
Dr. Collis’ eagerness to learn more about the causes of back pain has led to expanded, effective treatment options for patients.  Initially, the common perception was that back pain was caused by compression, motion and biomechanical dysfunction, with disc removal as the primary treatment.  However, Dr. Collis understood that back pain was much more complex than these three factors alone, and worked to emphasize accurate identification of the cause of pain before treating each patient. 
“Dr. Collis started practicing before the development of advanced imaging, so he had to take the time to listen to each patient’s description of their pain: he would correlate that with the findings on the x-ray,” said Mark Janack.  Janack has worked alongside Dr. Collis as a CRNFA since 1980. “It is that attention to the patient’s experience that has led to one of the most impressive careers in medicine.” 
The Cleveland Spine and Arthritis Center, and also the Spine and Orthopedic Institute at St. Vincent Charity Hospital, were developed by Dr. John Collis, Dr. Arthur Steffee and Dr. Lou Keppler.  This was one of the first cooperative efforts between Neurosurgery and Orthopedics.  This provided training for physicians headed for a spinal surgery career. 
Dr. Collis developed an appreciation for the multiple causes of back pain. He then developed a variety of treatments, including non-surgical options that would provide relief for patients.
“Dr. Collis was the earliest to say you don’t have to operate on everyone,” said Dr. Donlin Long, who worked with Dr. Collis to help establish spinal surgery residency programs.  Dr. Long retired from Johns Hopkins as the Director of Neurosurgery in 2010.  Dr. Long further stated, “Dr. Collis was the first to use steroid injections to treat spinal pain, which is now the most common interventional treatment.” 
Dr. Collis worked as a military surgeon for two years in Hawaii treating soldiers with spinal problems and injuries.  Dr. Collis noted a growing risk from post-surgical infection.  Infections became so rampant that, at one point, the military hospital Tripler had to be closed to prevent further spread.  He recorded that the majority of post-operative complications were the result of infections. Believing that the infection rate should be lower, Dr. Collis learned everything he could about causes and prevention of infection for patients after surgery.  It was that experience that led him to begin to prescribe antiseptic baths, the night before surgery and the morning of surgery. He later, in the 1950s, initiated pre-surgical use of antibiotics to prevent these life-threatening infections.  
Once again, his innovation was met with widespread skepticism from the established medical community.  At that time, it was unheard of to use antibiotics before surgery. “Everyone believed ‘this was bad’,” Dr. Collis said.  “Everyone used antibiotics once a patient had an infection, but at that point, it was often very difficult to treat.  I wanted to stop any infection before it started.”
Dr. Collis has performed 17,000 major spinal surgeries.  This includes 5,000 fusions; and not one of the 5,000 patients has developed a post-surgical infection.  Once again, it took the medical community decades to catch up.  Pre-surgical baths finally became protocol for spinal surgery in the late 1970s, and pre-surgical use of antibiotics became a standard of care in the 1990s. 
In the end, Dr. Collis says his commitment to innovation – including developing new surgical retractors in his friends’ machine shop and becoming the first to provide patients with a complete copy of all doctor’s notes, tests and history – are the result of his obligation to his patients and the Golden Rule.  
“I look at patients like they are family.  I believe we must treat others the way we want to be treated,” Dr. Collis said.  “That is why in my operating room environment is church-like, and I mean the old fashioned church, when it was quiet. At a Catholic Mass, the attention is on the Eucharist, on God; in my operating room I want my team quiet, focused only on the patient.”
Dr. Collis was honored recently at a Lifetime Achievement Celebration.  The celebration outlined 60 years of devotion to more than 400,000 patient examinations.  Dr. Collis has no intention of retirement. He continues to forge a path toward more effective care.   He is Co-Director of Spine & Orthopedic Institute at St. Vincent Charity Medical Center.

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