I can’t remember the last time I woke up without excitement about projects to complete or things to learn. Engineering at Rolla led me to the design and function of humans.
Medical school and residency at the University of Missouri led me to orthopaedics and spine. My fellowship at SIU made me want to study the low back. After the Air Force, when I started private practice, it was common to perform a fusion on a patient and then to have them in a cast for several months. When pedicle screws came out, I designed a plate to make them more efficient and less costly. When threaded cages were popular,
I designed a cage and modified the tooling that would accommodate lordosis. As minimally invasive surgery came along, I invented a retractor and several tools to facilitate the process.
Along the way, I also had other interests. I fly my own plane and enjoy travel. I ski, but not as well as I would like, and have done a marathon. I’ve done wood working from harvesting lumber, to hand tools to machines. When I wanted to build Shaker rockers in quantity, I needed a lathe duplicator. The one I had was not very good, so I got some metal working tools to modify it. That was so much fun that I progressed to bigger machines and then finally computer controlled machines. I added laser scanning and was required to learn computer aided design, CAD, CAM and tried some programming.
3D printing allows me to make prototypes much faster. Presently, I’m exploring the frontiers of how 3D printing can add unique qualities to surgical implants. (The only real chair that I made was done on a shaving horse with a draw knife.)
I began learning before computers so I am mostly self taught. Eight years ago, I started working with a pHD candidate in mechanical engineering. We placed the spine in digital format and then “did surgery” on these spines by computer simulation. Once we had reproducible models, finite element analysis allowed us to predict what type of implants were needed and to determine their ideal placement. Once we could design the implants, we had to figure out how to approach the spine to place those materials. The modification of surgical approaches required different instruments surgical design.
Concept is fascinating but approval with the FDA is difficult. I stopped counting when I could list over 20 companies that I have consulted with. Presently, Nexxt Spine makes the implants that I use for posterior instrumentation. I receive no royalties but am provided with materials that allow me to provide what I feel is the best for my patients.
Although I was trained to install artificial discs, I couldn’t make the case that they were better that what we had. When I understand concepts, I can perform or modify them; but, I only use them if I feel they are best for my patients.
While I operate on patients, I first and foremost deal with people. They are the ones that hurt or don’t function the way they would like. They may carry several diagnoses, often brought on by x-rays or other tests, but my job is to determine which ones cause symptoms or will accelerate deformity. As those patients join ‘my team,’ I expect them to participate in healthy practices so as to maximize their long term health. I teach the person about their pathology and the factors that can affect their long term history. I will guide them as necessary and will perform my functions to the best of my ability. I expect them to do likewise. I have made a mistake or two in my life so I can accept imperfection. I often feel that I care more for my patient’s health than they do. But, I keep trying.
When you come and see Dr. Abernathie, you will also meet Luis R. Visot, NREMT-P, Brenda Grindstaff and Judy Schneider, all part of his team!