My Areas Of Expertise
Robert Ayer MD
The Expert in Minimally Invasive Spinal Surgery Techniques
Minimally invasive surgery is an approach to spine surgery that aims to minimize tissue disruption, reduce blood loss, and in some instances reduce surgical pain associated with the procedure. It has also been associated with shorter hospital stays. Minimally invasive techniques have been developed for many spine and cranial surgeries, but have mostly been developed for spinal surgery. It is not applicable for all patients and/or all conditions. However, I apply these techniques when possible.
Some of the most common surgical procedures I have both open and minimally invasive expertise in are:
Spinal fusion can be done through a number of techniques and approaches. My practice includes the following techniques and approaches:
What Is Unique About Dr. Ayer?
Throughout his education and training, the over-arching concept behind every procedure can be defined by two words- minimally invasive.
Next, our patients have access to something few other private practices have access to- a tumor board. This is a monthly meeting with oncology specialists from all around the state where cases are reviewed for treatment protocols. This defines treatment excellence.
I spent an additional year of training to gain experience in complex brain tumor surgery. I also spearheaded the organization of a Multidisciplinary Brain Tumor Board at Gwinnett Medical Center, the only one of its kind in Gwinnett County. This is where physicians from different specialties (Neurosurgery, Radiation Oncology, Oncology, and Radiology) meet on a regular basis to discuss brain tumor patients. This allows for comprehensive care in an organized manner and allows for access to clinical trials. I have experience in the treatment meningiomas, gliomas, and skull base tumors.
Cerebrospinal Fluid Shunting: I have experteise in shunting patients for obstructive hydrocephalus, normal pressure hydrocephalus (NPH) and pseudotumor cerebri.
Chiari Decompression: I provide Chiari decompression surgery to patients with symptomatic Chiari malformations.
Motion Preservation Spinal Surgery
I employ motion preservation techniques when applicable. These techniques inlcude:
Cervical Disc Arthroplasty and Lumbar Disc Arthroplasty: The removal of a degenerated disc and its replacement with an artificial disc that preserves motion and simulates the motion of the natural disc. This technology is relatively new with 10-15 years’ worth of data showing advantages over fusion surgery when applied to the correct patients.
Links for extra info:
Coflex: The coflex® device is a titanium metal implant that helps keep your spine stable after surgical decompression and helps maintain the normal foraminal height and motion in your spine. It provides and alternative to spinal fusion for some patients.
Links for extra info:
Neurosurgeons spend 7 years training in brain and spinal disorders with about half of their time focused on the treatment of spinal disorders. When a Neurosurgeon completes their training they are able to treat a majority of spinal disorders, except for those that may require specialty centers. Orthopedic Surgeons complete training in the treatment of bones and joints that exclude the head and spine, and require at least one year additional training if they wish to treat spinal disorders.
Neurosurgeons and Orthopedic Spinal Surgeons have the ability to treat disorders of the bones, joints, and discs of the spine. However, Neurosurgeons are trained to operate on the nervous system itself, and are able to treat disorders of the spinal cord and nerves themselves. If these types of disorders are encountered by an Orthopedic Spine Surgeon they must seek the assistance of a Neurosurgeon. Today, most spinal surgeries are performed by Neurosurgeons.
As part of my Neurosurgery residency, I chose to pursue additional experience in complicated spinal disorders. During this time I had the unique opportunity to operate with ORTHOPEDIC SPINE SURGEONS specializing in degenerative deformity. This experience provides me the perspective of both specialties.
I Use Advance Imaging Technologies During Spine Surgery
Computer-assisted image guidance allows surgeons to view operative targets with far greater detail and accuracy than traditional visualization techniques. These techniques have been shown to be more accurate placement of hardware into the spine.
* Mason A1, Paulsen R, Babuska JM, Rajpal S, Burneikiene S, Nelson EL, Villavicencio AT. The accuracy of pedicle screw placement using intraoperative image guidance systems.J Neurosurg Spine. 2014 Feb;20(2):196-203.