Robert Ayer, MD, FAANS
Robert Ayer MD
Board Certified with The American Board of Neurological Surgery
I am board certified by The American Board of Neurological Surgery, which represents the highest standard of ethics and safety for neurosurgery in North America. Board certified neurosurgeons have performed a number of surgeries, passed several rigorous tests and have successfully proven to have favorable patient outcomes in order to gain certification.
It is my goal to provide patients with an understanding of their condition and treatment options. I don’t want patients to feel pressured into surgery; and I want them to be comfortable with their providers.
I practice general neurosurgery with a focus on minimally invasive and deformity spinal surgery in adults. I also treat sacroiliac disorders. Neuro-oncology for both brain and spinal tumors is also an area of my practice. Contact our office by visiting Apex Spine and Neurosurgery’s Website.
Undergraduate: 1995 – 1999
Boston University Degree Name: Bachelor of Arts (B.A.) Field Of StudyBiology/Biological Sciences General Grade: Magna Cum Laude
Medical School: 2001 – 2005
Boston University School of Medicine Degree Name: Doctor of Medicine (MD) Field Of Study: Medicine Societies: Alpha Omega Alpha Honor Medical Society
Loma Linda University
Swedish Neuroscience Institute Complex and Minimally Invasive Spine
University of California, Irvine Skull Base Neurosurgery
Back pain is something millions of Americans deal with every day. For one Gwinnett County woman – who is only in her early 30s -- her pain became so bad it brought her normal life to a halt.
The American Board of Neurological Surgery
- Alpha Omega Alpha Medical Honor Society
Loma Linda University
- Awarded for Excellence in Basic Science Research
Loma Linda University
- Recognition for Exceptional Patient Care
Loma Linda University
- Magna Cum Laude
Gill AS, Gill, R, Kaloostian P, Elias D, Roufail JS, Cruz AS, Pelargos PE, Hsu FPK, Kim RC, Ayer RE, Ghostine S. Intracranial myeloid sarcoma metastasis mimicking acute subdural hematoma. Case Rep Surg. 2017.
Ayer RE, Jafarian N, Chen W, Applegate II R.L., Colohan AR, Zhang JH. Pre-operative mucosal tolerance to brain antigens and a neuroprotective immune response following surgical brain injury. J Neurosurg. 2012 Jan;116(1):246-53
Ayer RE, Zouros A. Encephalocraniocutaneous lipomatosis: A review of its clinical pathology and neurosurgical indications. Case Report. J Neurosurg Pediatr. 2011 Sep; 8(3):316-20.
Jafarian N, Neumann M, Applegate II R.L., Ayer RE. Successful labor epidural anesthesia ten days after epidural blood patch. Int J Obstet Anesth. 2011 Apr;20(2):194-5.
Lekic T, Hartman R, Rojas H, Manaenko A, Chen W, Ayer RE, Tang J, Zhang JH. Protective effect of melatonin upon neuropathology, striatal function and memory ability after intracerebral hemorrhage in rats. J Neurotrauma 2010 Mar; 27(3):627-37.
Ayer RE, Chen W, Sugawara T, Suzuki H, Zhang JH. Role of gap junctions in early brain injury following subarachnoid hemorrhage. Brain Research 2010 Feb 22; 1315:150-8.
Suzuki H, Ayer RE, Sugawara T, Chen W, Sozen T, Hasegawa Y, Kanamaru K, Zhang JH. Protective effects of recombinant osteopontin on early brain injury after subarachnoid hemorrhage in rats. Critical Care Medicine 2010 Feb; 38(2):612-8.
Chen W, Hartman R, Ayer RE, Marcantonio S, Kamper J, Tang J, Zhang JH. Matrix metalloproteinases inhibition provides neuroprotection against hypoxia-ischemia in the developing brain. J Neurochem. 2009 Nov; 111(3):726-36.
Sugawara T, Jadhav V, Ayer RE, Chen W, Suzuki H, Zhang JH. Thrombin inhibition by argatroban ameliorates early brain injury and improves neurological outcomes after experimental subarachnoid hemorrhage in rats. Stroke. 2009 Apr; 40(4):1530-2.
Lee S, Jadhav V, Ayer RE, Rojas H, Hyong A, Lekic T, Tang J, Zhang JH. Dual effects of melatonin on oxidative stress after surgical brain injury in rats. J Pineal Res. 2009 Jan; 46(1):43-8.
Sugawara T, Ayer RE, Jadhav V, Chen W, Tsubokawa T, Zhang JH. Simvastatin attenuation of cerebral vasospasm after subarachnoid hemorrhage in rats via increased phosphorylation of Akt and endothelial nitric oxide synthase. J Neurosci Res. 2008 Dec; 86(16):3635-43.
Ayer RE, Sugawara T, Chen W, Tong W, Zhang JH. Melatonin decreases mortality following severe subarachnoid hemorrhage. J Pineal Res. 2008 Mar; 44(2):197-204.
Sugawara T, Ayer RE, JadhavV, Zhang JH. A new grading system evaluating bleeding scale in filament perforation subarachnoid hemorrhage rat model. J Neurosci Methods. 2008 Jan 30; 167(2):327-34.
Zhao X, Ayer RE, Davis SL, Ames SJ, Florence B, Torchinsky C, Liou JS, Shen L, Spanjaard RA. Apoptosis factor EI24/PIG8 is a novel endoplasmic reticulum-localized Bcl-2-binding protein which is associated with suppression of breast cancer invasiveness. Cancer Res. 2005 Mar 15; 65(6):2125-9.
Ayer RE, Sugawara T, Ostrowski R, Ma Q, Jafarian N, Tang J, Zhang JH. Statin induced T-lymphocyte modulation and neuroprotection following experimental subarachnoid hemorrhage. Acta Neurochir Suppl. 2013;115:259-66
Ayer RE, Jadhav V, Sugawara T, Zhang JH. The neuroprotective effects of cyclooxygenase-2 inhibition in a mouse model of aneurysmal subarachnoid hemorrhage. Acta Neurochir Suppl. 2011;111:145-9.
Suzuki H, Hasegawa Y, Ayer R, Sugawara T, Chen W, Sozen T, Kanamaru K, Taki W, and Zhang J.H. Effects of recombinant osteopontin on blood-brain barrier disruption after subarachnoid hemorrhage in rats. Acta Neurochir Suppl. 2011;111:231-6.
Jafarian N, Ayer RE, Eckermann J, Tong W, Jafarian N, Applegate II R.L., Stier G, Martin R, Tang J, Zhang JH. Mucosal tolerance to brain antigens preserves endogenous TGFβ-1 and improves neurological outcomes following experimental craniotomy. Acta Neurochir Suppl. 2011;111:283-7
Suzuki H, Ayer RE, Sugawara T, Chen W, Sozen T, Hasegawa Y, Kanamaru K, Zhang JH. Role of osteopontin in early brain injury after subarachnoid hemorrhage in rats. Acta Neurochir Suppl. 2011; 110:75-9.
Hartman RE, Rojas HA, Lekic T, Ayer RE, Lee S, Jadhav V, Titova E, Tang J, Zhang JH. Long-term effects of melatonin after intracerebral hemorrhage in rats. Acta Neurochir Suppl. 2008; 105:99-100.
Sugawara T, Jadhav V, Ayer RE, Zhang JH. Simvastatin attenuates cerebral vasospasm and improves outcomes by upregulation of PI3K/Akt pathway in a rat model of subarachnoid hemorrhage. Acta Neurochir Suppl. 2008; 102:391-4.
Ayer RE, Sugawara T, Zhang JH. Effects of melatonin in early brain injury following subarachnoid hemorrhage. Acta Neurochir Suppl. 2008; 102:327-30.
Lee S, Jadhav V, Ayer RE, Rojas H, Hyong A, Lekic T, Stier G, Martin R, Zhang JH. The antioxidant effects of melatonin in surgically induced brain injury in rats. Acta Neurochir Suppl. 2008; 102:367-71.
Sugawara T, Ayer RE, Jadhav V, Chen W, Tsubokawa T, Zhang JH. Mechanisms of statin treatment in cerebral vasospasm. Acta Neurochir Suppl. 2011; 110(2):9-11.
Ayer RE, Zhang JH. Connecting the early brain injury of aneurysmal subarachnoid hemorrhage to clinical practice. Turkish Neurosurgery 2010; April; 20(2):159-66.
Ayer RE, Zhang JH. The clinical significance of acute brain injury in subarachnoid hemorrhage and opportunity for intervention. Acta Neurochir Suppl. 2008; 105:179-84.
Ayer RE, Zhang JH. Oxidative stress in SAH: significance in acute brain injury and vasospasm. Acta Neurochir Suppl. 2008; 104:33-41
Sugawara T, Ayer RE, Zhang JH. Role of statins in cerebral vasospasm. Acta Neurochir Suppl. 2008; 104:287-90.
Ayer RE, Sugawara T, Zhang JH. Aneurysmal subarachnoid hemorrhage grading in animal models. Animal Models of Acute Neurological Injuries II: Injury and Mechanistic Assessments. Ed: J. Chen, X. Xu, J. Xu, J. Zhang. Humana 2012.
Ayer RE, Cahill J, Sugawara T, Jadhav V, Zhang JH. Rodent surgical procedures and tissue collection. Animal Models of Acute Neurological Injury. Ed: J. Chen, X. Xu, J. Xu, J. Zhang. Humana 2008.
Ayer RE, Azgarzadie F. The Incomplete Picture of Incomplete Spinal Cord Injury. Transl. Stroke Res. 2011 Dec 2 (4):430-32.
Ayer RE, Zhang JH. Comment on: Neural stem cell markers, nestin and musashi proteins, in progression of human glioma: Correlation of nestin with prognosis of patient survival. Surgical Neurology 2007 Aug;68(2): 143-4.
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"Dr. Robert E. Ayer is an excellent doctor. I had two back surgeries for back pain, the first one was done by another doctor in another town who did damage. The second one was done by Dr. Ayers partner who is in another state. He corrected the wrongs the first doctor did. After about 6 mos. I was still having back pain. The first time I saw Dr. Ayer he diagnosed my back pain as Si joint which is many times diagnosed as back pain. 2 weeks ago Dr. Ayer did SI Fusion and I am PAIN Free."
"On Nov. 2nd of 2026 I was operated on for spinal stenosis by DR Ayer. My decision was prompted by a couple of years of treating the crippling symptoms that continued to get worse. I did therapy then pain shots then deciding who I would trust to open up my back to end my pain. When I awoke in recovery I was not in pain but still filled with pain killer. I was released the next day at about noon and was able to walk. I soon switched to Tylenol. Today, no pain at all and am walking easily.”