Dr. Michael Seiff’s path to neurosurgery came by way of research—a “gene jockey” as he calls himself. He eventually became a clinician, now at the Spine & Brain Institute, specializing in cranial and spinal work. He was a fellow of the American College of Surgeons and serves as the chief of Neurosurgery at Sunrise Hospital. A Las Vegas resident since 2001, Dr. Seiff also holds posts as the director and chairperson of the Nevada Neurosciences Institute, is the neurosurgeon representative for the Trauma Medical Audit Committee of the Southern Nevada Health District, a vice president of the Rocky Mountain Neurosurgical Society and an honorary medical commander at Nellis Air Force Base. Here are the highlights of his recent interview with Jessi C. Acuña.
There was a push about 10 years ago through our governing body to disseminate to the public that neurosurgeons are spine surgeons. The lay public mostly viewed orthopedic surgeons as spine surgeons. There are a lot of really good orthopedic spine surgeons. But orthopedic residency is five years, with a spine rotation and then a one-year spine fellowship. Neurosurgery is a seven-year training program, and you do spine all seven years from Day One.
There are different types of medicine: Western, Occidental, traditional. They all have their place and merits. I send plenty of patients out for acupuncture, and I never see them back. Either they didn’t like me or it worked. I give my patients videos on juicing, plant-based diets—even though I don’t eat a plant-based diet. I send patients to chiropractors on a weekly basis. I see the utility of a chiropractor in my practice for those who’ve lost the normal curvature of their spine. Aligning the spine is important for your biomechanical well-being. I find that to be very beneficial.
The trends right now are in how fusions are being done. If you take a general case that walks in the door: 35-, 45-year-old guy, L4-L5 degenerative problem. He’s having pain in his back and in his leg. You take that basic case and present it to six different spine surgeons, you’re going to get four or five different answers on what to do: fuse it; don’t fuse it. Fuse it from the front, from the back. Both. The side. There are different ways to approach it.
You have to feel comfortable with your surgeon. If you voice the desire to get another opinion, the surgeon should help you facilitate that. Never feel talked into surgery. It should always be the last resort, but, having said that, I do surgery all the time. And problems occur no matter how good your surgeon is. If you want to find a neurosurgeon that nobody has anything bad to say about, find one that just completed their training and hasn’t started practice yet.
The biggest challenge right now is getting insurance to pay for what the patients need. Insurance companies are playing doctor. You can take pretty much any issue and they’ll say, “Nope, not indicated for these reasons.” It’s a weekly battle with insurance companies that has geared up more in the last few years.