UConn Health Comprehensive Spine Center

Unparalleled

By Chris DeFrancesco

Dr. David Choi

Dr. Choi points out spinal tumors needing critical care.


When a man in his sixties recently went to UConn John Dempsey Hospital after four days of severe back pain, an MRI revealed a rapidly growing spinal cord tumor that was placing extreme pressure on his spine.

He was sent straight to the emergency department where Dr. David Choi, the only neurosurgeon in Connecticut with fellowship training in spinal oncology, met him.

But not for the first time.

“Because we’re local, I had been seeing this gentleman for months before this tumor problem arose, so I already knew who he was, I already knew what treatments he was going through, I knew his general attitude about the quality of life that he would want for himself,” Choi recalls. “Now thankfully he did not have any neurologic deficits, but there was just so much compression on the spinal cord that I didn’t want to wait for anything bad to happen.”

Right away — in the middle of the night — Choi operated to decompress the tumor and stabilize the spine with rods and screws.

“The decision to do surgery was a no-brainer for both of us,” says Choi. Before Choi, the product of an elite complex spine surgery fellowship at Brown University, arrived at UConn Health, patients like this one had to travel to Boston or New York City for the same level of fellowship-trained expertise.

Having a comprehensive spine surgery specialist like Choi provides “real-time coverage — you’re getting things done right as they happen, and that gives the best chance for improved outcomes,” he says.

It’s an example of a patient already under the care of familiar providers being able to stay at UConn Health for continuation of that care, including treatment by a spine surgeon with unique subspecialty training in treating spinal tumors.

“In some cases, tumors cannot be entirely removed, requiring further treatments after surgery, such as chemotherapy and/or radiation therapy, coordinated by oncologists and radiation oncologists,” Choi says. “In cases of metastatic tumors, other surgical tumor specialists may continue their involvement in treating the primary tumor.”

Spinal tumors can metastasize to the spine or originate in or around the spinal cord or in the vertebrae. A tumor in the bone can cause fractures and a partial collapse of the spinal cord. In extreme cases, fractured pieces of bone may affect the spinal cord and cause neurologic deficits such as limb weakness or incontinence. Similar neurologic defects can result from a tumor in or around the spinal cord, which can compress the spinal cord or the nerve roots that exit it.

“The possible permanence of these deficits makes surgery necessary,” Choi says. “If you’re not able to walk around, or if you have bowel or bladder issues, that’s a pretty big impact on quality of life for the rest of your life.”

Choi says the opportunity to shape spinal oncology care at UConn Health is what drew him to Farmington.

“Few physicians will have a chance to help develop a new division in a well-established institution,” he says. “UConn Health is poised to become a leading destination center for a wide variety of neurosurgical conditions, and spinal oncology is a field that will serve our community and state well.”

Choi’s addition is a cornerstone of the vision of Dr. Ketan Bulsara, chief of the Division of Neurosurgery, to expand UConn Health’s neurosurgical care offerings and make UConn a world-class destination center.

“Dr. Choi’s expertise adds to the excellent work that was already being done at UConn Health in collaboration between neurosurgery and orthopedic surgery through our comprehensive spine center,” Bulsara says. “His level of training allows him to offer a unique perspective and potential treatment options for spine/spinal cord tumors.”

It also adds to a multidisciplinary team of spine surgeons at UConn Health.

“The recruitment of his talent and clinical expertise buttresses the vision of our comprehensive spine program,” says Dr. Hilary Onyiuke, neurosurgical director of UConn Health’s Comprehensive Spine Center.

The elite skill of the growing neurosurgery program is expanding in other ways as well.

Dr. Kevin Becker recently came from Yale to build a neuro-oncology program in collaboration with the Department of Neurology and the Carole and Ray Neag Comprehensive Cancer Center. Bulsara says the arrival of Becker “continues to build on our collaboration with the Preston Robert Tisch Brain Tumor Center at Duke, bringing an additional dimension to our treatment paradigm.”