For well over one hundred years, the City of Buffalo has been considered a hub of advanced neurosurgery. In the early 20th century, Buffalo surgeon Dr. Roswell Park (1852-1914) made significant contributions to the development of neurosurgery as a distinct medical specialty. Among other innovations, Dr. Park became the first American to successfully operate for simple partial motor epilepsy in the absence of external scar and was the first to remove an upper cervical spinal cord tumor. Many of his neurosurgical advances served as important precursors to modern practices.
By 1933, Buffalo had its first dedicated neurosurgery practice, founded by Dr. Wallace Hamby. Soon after, Dr. Hamby also established Buffalo’s first neurosurgery residency program, thus beginning a long local tradition of neurosurgical teaching and training. Many of the residents who trained under Dr. Hamby went on to establish successful private neurosurgical practices around the Western New York region. By the 1950s, Buffalo was well-known nationally as a center for neurosurgery and the treatment of cerebral aneurysms and arteriovenous malformations.
In 1961, the University at Buffalo Medical School was integrated into the State University of New York (SUNY) system of schools. Dr. Louis Bakay was recruited from Harvard Medical School to create and chair an academic neurosurgical division within the University. Upon his arrival, Dr. Bakay assumed the task of improving and integrating the existing neurosurgical service, which was divided between three local hospitals: Buffalo General Hospital, Women & Children’s Hospital of Buffalo, and E.J. Meyer Memorial Hospital (now Erie County Medical Center). Dr. Bakay was successful in his task: between 1961 and 1964, the University’s neurosurgical caseload increased by 60%—from 376 cases in 1961 to 591 cases in 1964. Dr. Bakay is also credited with setting new standards of academic neurosurgery for the University at Buffalo by introducing basic research and establishing a neurosurgery laboratory at Buffalo General Hospital.
To further strengthen and grow the division, additional distinguished faculty were recruited. Dr. David M. Klein joined in 1962. He established the first pediatric neurosurgical service in Buffalo at Women & Children’s Hospital. In 1963, Dr. Franz E. Glasauer signed on as clinical director of neurosurgery at E.J. Meyer Memorial Hospital (Erie County Medical Center), a position he filled until 1996.
By 1972, the University at Buffalo Division of Neurosurgery was formally designated the Department of Neurosurgery. Thereafter, in 1974 and 1975 respectively, Drs. Walter Grand and L.N. Hopkins joined the group, having previously served their residency at UB. The two collaborated on the development of a microneurosurgical discipline within the department, focusing their efforts on microneurosurgery of cerebral aneurysms, arteriovenous malformations, transsphenoidal surgery, and cerebral bypass procedures. They also began to perform cutting-edge multiple vessel cerebral angiographies via transfemoral artery approaches (groin access). Their involvement in these early endovascular diagnostic procedures led, in part, to Dr. Hopkins’ role as a pioneer of endovascular treatment techniques for cerebrovascular disease.
In 1979, Dr. Grand left the department to relocate to Jacksonville, Florida (he later rejoined the department when he returned to Buffalo in 1992) and was replaced by Dr. James Budny, a talented neurosurgeon who had recently completed a microcerebrovascular fellowship under the tutelage of the renowned Charles G. Drake MD at the University of Western Ontario. Dr. Drake taught Dr. Budny the nuances of performing carotid endarterectomy, a skill which he mastered and brought with him to Buffalo.
In 1983, Dr. Bakay entered retirement. The chairmanship was gradually transitioned to Dr. Hopkins, who fully assumed the role in 1989. Under Dr. Hopkins’ leadership, the department flourished both clinically and academically. Since his appointment, University at Buffalo Neurosurgery has evolved into a preeminent research institution as well as a renowned regional referral center for the comprehensive and compassionate treatment of neurological disorders.
Specifically, Dr. Hopkins earned the department a reputation as a leader in endovascular procedures and research. He was among the first neurosurgeons to apply minimally invasive endovascular techniques to the treatment of cerebrovascular disorders. This required adapting existing endovascular technologies, originally designed for cardiology, to suit the more delicate vessels of the brain. Today, University at Buffalo Neurosurgery performs both minimally invasive endovascular procedures and open surgical procedures. Rather than assume the superiority of one treatment approach over another, the physicians of UBNS deliberate as a team to determine the best course of treatment for each individual patient. In addition to the endovascular program, the other neurosurgical disciplines within the department were simultaneously nurtured under Dr. Hopkins’ leadership. In 1990, Dr. Robert Plunkett was brought on as an expert in Parkinson’s disease, neurodegenerative disorders, pain management, and stereotactic neurosurgery. Dr. Plunkett subsequently founded the Comprehensive Movement Disorders Center at Buffalo General Hospital in 1997. Today, Dr. Plunkett specializes in the surgical implantation of intrathecal baclofen pumps to treat spasticity and deep brain stimulators to ameliorate the symptoms of Parkinson’s disease, and focuses his research efforts on the implantation of genetically modified cells as potential therapy for Parkinson’s disease. Aside from his work in Buffalo, Dr. Plunkett has volunteered his time and efforts to modernize neurosurgical services in war-torn Bosnia. For the past decade, Dr. Plunkett has organized and participated in numerous trips to Tuzla to train Bosnian neurosurgeons in stereotaxic and other neurosurgical procedures. Twice he was accompanied by Dr. Budny to train local neurosurgeons in carotid endarterectomy and transsphenoidal surgical procedures. In November 2009, Dr. Plunkett had the pleasure of attending the opening of Tuzla’s newest hospital-a project over 15 years in the making. Moving forward, he will continue to work with Tuzla’s neurosurgeons on establishing even more advanced neurosurgical procedures.
In 1992, upon Dr. Klein’s retirement, pediatric neurosurgeon Dr. Mark Dias was recruited to the department. He was joined by Dr. Veetai Li in 1993 who introduced UBNS to pediatric neuro-endoscopic procedures to treat hydrocephalus and brain tumors. Together, the two developed a multi-disciplinary comprehensive spasticity program to address the needs of children with motor skill deficiencies resulting from cerebral palsy or nervous system trauma. Still in place today, the program unites pediatric neurosurgeons, pediatric rehabilitation medicine specialists, physical and occupational therapists, and pediatric orthopedic surgeons in the evaluation and treatment of spasticity patients, which may include specialized therapy programs, the administration of oral medications, botox injections, and/or one of two neurosurgical procedures: selective dorsal rhizotomy or intrathecal baclofen pump.
In 2001, Dr. Dias left the department to pursue other opportunities; meanwhile, Dr. Li continued improving the department’s pediatric services, moving next to the development of a surgical program to treat both children and adults with intractable epilepsy. For each patient, the program aims to identify where in the brain the seizures originate in hopes of lessening if not completely eradicating the patient’s seizures. It is the only program in the Buffalo area to feature an inpatient epilepsy unit, which allows patients to be monitored 24 hours per day with video and EEG recordings for the most comprehensive seizure data possible. Dr. Li also applied the comprehensive, multidisciplinary concept to pediatric neuro-oncology. Now, pediatric patients can see a team of specialists, including a neurosurgeon, neurologist, and oncologist all in the same afternoon. This aids significantly in coordinating and consolidating care for these children and their families.
In 1993, Dr. Kevin Gibbons, a graduate of the UB Neurosurgery residency program, joined the department as a specialist in spine and cranial base surgery and critical care management. He soon established himself as an accomplished clinician. Presently, Dr. Gibbons directs the neuro-intensive care unit at Buffalo General Medical Center, and serves as director of the neurosurgery residency program.
In 1995, Dr. Robert Fenstermaker joined the department faculty, and was later named director of the neuro-oncology research laboratory at Roswell Park Cancer Institute. Today, he is actively involved in the brain tumor clinics at RPCI and performs advanced Gamma Knife surgery to treat benign and malignant lesions with precise, concentrated doses of controlled radiation.
Research at the department has also flourished in the two decades since Dr. Hopkins assumed the chairmanship. When Buswell Fellow Dr. Ajay Wakhloo, joined the faculty in 1993, he established advanced hemodynamics and neuroendovascular technologies laboratories within the department. Research was given an additional boost when Dr. Lee Guterman joined the faculty in 1996, after serving both his neurosurgical residency and endovascular fellowship at UB Neurosurgery. It was Dr. Guterman who catalyzed the formation of an advanced neuroendovascular research program and multidisciplinary stroke research team at UB.
In 1997, thanks to Dr. Guterman’s vision and a $3.6 million donation from Toshiba America Medical Systems, the neuroendovascular and hemodynamics laboratories converged and were relocated to the new Biomedical Research Building at UB South campus. The lab, subsequently renamed the Toshiba Stroke Research Center, still stands as a quintessential example of multidisciplinary cooperation and partnership. Within the facility, basic science as well as diverse clinical specialties, including radiation physics, biomedical and aerospace engineering, polymer chemistry, neuroradiology, neurology, and neurosurgery, all contribute to the advancement of knowledge in the field of stroke prevention and treatment. Dr. Guterman served as co-director of the TSRC until he ultimately left the faculty to open a private practice.
In addition to a stellar research program, the residency program at UB Neurosurgery has also become one of the best of its kind in the country. Under Dr. Hopkins’ chairmanship, Millard Fillmore Gates Hospital was officially designated a teaching hospital and the administrative seat of UB Neurosurgery. Today, residents rotate through each neurosurgical sub-specialty-including neurology, general neurosurgery, pediatric neurosurgery, neuro-oncology, endovascular neurosurgery, and neurosurgical research—and at each of the department’s affiliated hospitals, to obtain a truly comprehensive training experience.
In 1991, the department expanded its educational program to include endovascular fellowship training, and later expanded again to include clinical spine and spine research fellowships. The department’s academic programs collectively attract an international cadre of the best and brightest neurosurgeons, who go on to apply the skills and knowledge they gain to improve neurosurgical services in communities around the world. Some of the department’s former endovascular fellows continue to practice locally, including Lee Guterman PhD MD, Gregory J. Bennett MD, James G. Egnatchik MD, John Pollina Jr. MD, Michael Landi MD, Douglas B. Moreland MD, and Gregory J. Castiglia MD.
As a result of these improvements, UB Neurosurgery’s domestic and international reputation flourished. In 2000, the department was invited for the first time to transmit live cases to an audience at the Annual Scientific Symposium of Transcatheter Cardiovascular Therapeutics (TCT). The department was invited to back to TCT in 2001, 2002, 2006 and 2007, and presented live cases to the Endovascular Neuroradiology Workshop and Live Cases course in Houston, Texas in 2002, 2006, and 2008. In 2008 and again in 2009, UB Neurosurgery broadcast live cases to the International Course on Carotid Angioplasty (ICCA) in Frankfurt, Germany, becoming the only American institution to be asked to participate both years.
Simultaneously, UB Neurosurgery has continued to expand its talented faculty. In 2003, Dr. Elad Levy was brought on as associate professor of neurosurgery and radiology, followed by Dr. Adnan Siddiqui in 2007. Together with Dr. Hopkins, the two have strengthened the department’s endovascular program. Not only have they bolstered the department’s reputation for excellence in stroke care and research, but have helped establish Kaleida Health System’s Millard Fillmore Gates Hospital as a designated regional stroke center. In 2004, Millard Fillmore Gates Hospital received Primary Stroke Center Certification and Disease-Specific Care Certification for Acute Stroke from the Joint Commission on Accreditation of Healthcare Organizations, and from the New York State Department of Health in 2005. Between 2004 and 2006, more than 1500 patients with acute ischemic and hemorrhagic stroke were treated by the University at Buffalo neurointerventional team of attending staff, fellows, nurses, and technicians all highly trained in acute stroke care.
In January 2009, former resident Dr. Jody Leonardo joined the faculty after completing a minimally invasive endoscopic intracranial fellowship in Nijmegen, the Netherlands. Currently, she and seasoned veteran Dr. Grand (back from his stint in Jacksonville) serve as co-directors of the University at Buffalo Neurosurgery Brain Endoscopy Center, where they specialize in endoscopic surgery of intracranial pathology, specifically pituitary, and intraventricular tumor resections and hydrocephalus.
Moving forward, UB Neurosurgery will continue to grow to meet the demands of neurosurgery locally and nationally. In August 2009, UB Neurosurgery expanded its clinical facilities and renewed its commitment to patient comfort and convenience with the opening of a new, easily accessible northtowns office in Amherst, NY. 2010 saw the arrival of Dr. Kenneth Snyder, MD PhD, whose expertise in neuroendovascular rounds out our world-class minimally invasive stroke team. In early 2012, with the closing of Millard Fillmore Gates Circle Hospital, UBNS’ home for 22 years, two new office locations emerged. The first, in Orchard Park, NY serves the growing Southtowns population and is home to our Comprehensive Movement Disorders Center and in March we opened our latest office at the newly-renamed Buffalo General Medical Center (formerly Buffalo General Hospital).