A Practice Specialty: Consistently delivering standards of excellence in all aspects of neurosurgery and neurological care for spine and brain related conditions.
By Ellen Paris
Located in the Rancho Mirage Medical Center at Country Club Drive and Monterey Avenue, Desert Spine & Neurosurgical Institute’s (DSNI) team of seven highly experienced medical staff provides complete treatment from diagnostic to surgical care. All four neurological surgeons are board-certified specialists utilizing state-of-the-art technology, providing patients the highest caliber of care. Drs. Bishoy Labib and Indermohan Luthra, two board-certified neurologists, have recently joined the growing practice expanding the scope of comprehensive care. Dr. Ronald Levey, an orthopedic surgeon, provides nonsurgical treatment of spine and joint disorders.
Institute of Excellence Provides Individualized Custom Care
This highly trained group delivers all aspects of care from minimally invasive spine and brain surgery to major reconstructive spine surgery and complex brain tumors. With the addition of the two neurologists, DSNI expands its scope of care to include not only neuromuscular and cerebro-vascular disorders but also epilepsy, headaches, and general neurological disorders often difficult to diagnose and treat. All DSNI physicians are highly motivated to provide the best possible care in their own sub-specialty. With decades of combined neurosurgical experience, Drs. Shahin Etebar, Farhad Limonadi, Alfred Shen, and Ali Tahmouresie are noted for their depth of experience in diagnostics and utilizing the latest treatment techniques.
Dr. Luthra has been in practice in Coachella Valley since 1994 and is fellowship trained in neuromuscular diseases and epilepsy. Dr. Labib is fellowship-trained in cerebro-vascular disease and has been in practice in the valley for six years. He served as associate neurology residency program director at University of Arkansas for Medical Sciences. Their areas of interest include acute stroke management, stroke rehabilitation, musculoskeletal pain, neuromuscular disorders; peripheral neuropathy, epilepsy, headache, and Parkinson’s disease. DSNI neurologists are involved in multiple clinical trials related to stroke and epilepsy.
Dr. Etebar is a specialist in minimally invasive and complex spinal surgery with 15 years of experience. Dr. Shen also specializes in minimally invasive complex spinal surgery and joined the group in 2002. Dr. Limonadi is a specialist in complex brain tumors and diseases of the brain, as well as minimally invasive spine surgery. He joined the group in 2005. Dr. Tahmouresie is former chairman of the Department of Surgery and former president of the medical staff at Eisenhower Medical Center. At DSNI, he is responsible for non-surgical medical management of brain, spinal cord disorders (sciatica, disc herniation, stenosis, osteoporosis, and spinal fractures) and leads the multidisciplinary spine conference. Dr. Ron Levey is an orthopedic surgeon with DSNI who also treats spinal disorders, as well as general orthopedic disorders with nonsurgical measures. If surgery is necessary, Drs. Tahmouresie and Levey will refer patients to the DSNI surgical team for further comprehensive evaluation and treatment.
“Providing tailored patient-care treatment plans and not employing a cookie cutter approach is the way each individual case is handled,” says Dr. Shen. “Once the primary pain source is determined, the odds are higher for successful treatment and excellent outcomes. We’ll see cases where the patient was treated elsewhere with one particular type of injection or one type of therapy and they missed the boat on an effective diagnosis,” Shen adds.
The main reason for DSNI’s successful treatment strategies is taking the time to make the correct diagnosis and tailor the treatment individually for each patient. DSNI physicians search for pain generators when taking care of neck and back pain. “The sources of spinal pain are hard to diagnose, because the spine itself is very complex,” Dr. Tahmouresie says. There are many variables that may be causing pain, including torn and ruptured discs, arthritic joints, or injured muscles around the spine. The most important part in treating back and neck pain is to determine where the pain is coming from. One diagnostic test or scan doesn’t always give a definitive diagnosis. “Treatment of simple and complex spine disorders starts with making a correct diagnosis, understanding the pathophysiology of the disease and biomechanics the spine, employing appropriate sets of conservative measures, and finally, if needed, performing the correct operation using the latest technologies and techniques,” explains Dr. Limonadi.
Excelling in Patient Care from the Start
The experience of excellent patient care begins with the initial phone contact. The friendly staff will help the patients through scheduling appointments, arranging insurance authorizations for various scans. It’s mandated that all team members treat patients as they would want themselves and family members treated.
DSNI’s practice continues to grow as more patients come directly through referral from friends and family who have been successfully treated, often after years of chronic pain and incorrect diagnosis. Prior patients are DSNI’s number one source of new referrals. Over the year’s patients have traveled from across the country and overseas seeking the expertise of DSNI’s medical team. Patients go through rigorous diagnostic testing and examinations before receiving a diagnosis and a treatment plan. Once the patients return home, DSNI closely communicates with their local doctors, who use DSNI’s treatment plans and followup modalities.
Collective Opinions Equal Correct Diagnosis
Like major medical centers, individual cases are presented to DSNI’s Spine Conference and Brain Tumor board. Cases are reviewed and treatment recommendations made. Patients thus receive three and four “second” opinions on their specific case. The Brain Tumor board is a multispecialty conference and it includes neurosurgery, neurology, medical oncology, radiation oncology, radiology, and primary care physicians. This board is chaired by Dr. Limonadi and reviews the neuro-onclogy cases in a multidisciplinary fashion.
DSNI’s Spine Conference meets weekly. Here, a patient’s history, electrodiagnostics, and imaging studies are reviewed. Conservative treatment measures are discussed and consensus is reached whether surgery or another treatment modality is necessary. Cases presented to the Spine Conference are often complex patients that have been treated elsewhere and have not responded to the treatments in the past.
Leading the Way in Technology
DSNI’s surgeons perform less invasive spinal fusions with a hospital stay of less than 23-hours thanks to the latest technology and procedures available. They are one of the leaders utilizing specialized diagnostic SPECT CT Scanning which is not available in many areas of the country. DSNI has the largest volume of spine patients in the world assessed by SPECT CT imaging modality. It was one of the first groups to apply that technology to the treatment of spine disorders.
All DSNI physicians are highly motivated to be the best at what they do. Their main motivation: always excellence.
Desert Spine and Neurosurgical Institute 72780 Country Club Drive, Suite A-104, Rancho Mirage, CA 92270 760-346-8058 • Fax: 760-834-3780 www.desert-spine.com • www.microneurosurgery.org
Left to right: Bishoy Labib,MD; Indermohan Luthra, MD; Shahin Etebar, MD; Alfred C. Shen, MD; Ronald Levey, MD; Farhad M. Limonadi, MD; Ali Tahmouresie, MD; Mick Griswald, CRNFA; Rebecca Hubbs, R.E.E.G.T; Brandi Miller, Administrator Photo by Mark Davidson