Director, Vanderbilt Minimally Invasive Spine Center

Richard A. Davis, M.D. Director, Vanderbilt Minimally Invasive Spine Center

Clinical Interests: Leg and Low Back Pain (disc herniations, spinal stenosis, discogenic pain) using microsurgical techniques. Has special interest in evaluating and treating cervical spine problems. Treats non-operative and operative adult spine patients. MD Degree: Georgetown University School of Medicine, Washington, D.C.

Post Graduate Training: University of Wisconsin, Madison, WI

Fellowship Training: Cervical and Lumbar Spine Surgery, University of Pittsburgh Medical Center

Interview with Dr. Davis

1. What type of symptoms would indicate a referral to your office?  Arm pain/weakness and leg pain/weakness  Back pain not responsive to non-operative treatment 2. What would you consider an average length of time for conservative treatment prior to initiating surgery?

Depending on the condition I like to wait at least 2 months before performing disc surgery in the neck or back as most of these problems will resolve non-operatively

3. What treatment measures are normally indicated during the conservative treatment period?

Physical Therapy focused on the specific condition along with NSAID’s are usually quite helpful. Epidural steroid injections or oral steroids can benefit patients that need additional treatment

4. Is surgery always necessary?

No. As a cervical and lumbar spine surgeon most of my patients actually never require surgery. It is quite gratifying to make a significant improvement in someone’s quality of life by directing the appropriate treatment.

5. If surgery is indicated, at what point do your patients normally return to work with restrictions?

Early return to work is my goal as long as the environment is safe, as it re-integrates the patient to a more normal lifestyle. For decompression surgery most patients can return when off narcotics, usually 3 weeks post-operatively. Fusion surgery in the neck is 3 weeks and for the back approximately 4-5 weeks.

6. How do you feel about returning patients to modified duty if it is possible?

I encourage modified duty. My goal is to minimize the time a person spends as a “patient” by getting them to begin rehabilitation in a real world scenario.

7. How open are you to direct communication with the case management community?

Open communication is the only way to optimize the patient’s care. I appreciate and rely on the case manager’s experience to rehabilitate my non-operative and operative patients.

8. In what types of situations would you order a Functional Capacity Evaluation (FCE)

I use FCE’s to educate my patient and their employer regarding the level of work that can be expected after surgery or a significant non-operative rehabilitation (spine fracture, etc.) process.