DR. WHO?
MEMBER SPOTLIGHT
FEATURING DAVID P.
ROUBEN, MD.
Aaron Burch
D
avid P. Rouben, MD, is a native Louisvillian and a pioneering spinal surgeon. Practicing in Louisville for more
than 20 years, Dr. Rouben is the founder of River City
Orthopedic Surgeons PSC, now Norton Spine Specialists. He also
co-developed a revolutionary, minimally invasive spinal fusion
surgery procedure which has been accepted across the U.S. and in
other nations including China and Israel where he has personally
trained other surgeons.
The son of a civil engineer and grandson of a Louisville butcher
who owned his own grocery in the West End, Dr. Rouben learned
about work that requires structure, support and precision from an
early age.
“My father was very encouraging. When I was young I’d work as
a laborer for his firm, and you learn very quickly from the other guys
how to build things and how not to build things,” Dr. Rouben said.
After grade school, he headed to Atlanta’s Emory University for
undergraduate studies before returning home to study medicine at U
of L where he was encouraged to be a surgeon. One of Dr. Rouben’s
mentors, Dr. George Wright, suggested the spine. “He said ‘You need
to be a spinal surgeon. It’s the most complex and we know the least
about it, so you’ll always be on the cutting edge.’ And that’s how I
ended up doing what I did,” Dr. Rouben explained.
What he did is easier said than done. Following general surgery
practice in Dallas, Texas, Dr. Rouben moved quickly to orthopedic
surgery in Atlanta, then to a Fellowship in Boston at New England
Baptist Hospital. From there, he practiced spinal surgery at the University of Toronto under Dr. John Kostuik, the future head of spinal
surgery at Johns Hopkins University, and then taught in Atlanta for
nine years before returning to Louisville to found his own practice
in 1992.
“I became a physician in the era where
spine surgery and
treatment of neck and back pain was evolving from simply treating
scoliosis with an external cast, stretching the spine and inserting
rods and hooks, to more effective ways of locking on to different
spine segments and structurally stabilizing them. I didn’t realize
how lucky I was,” he said.
The most traditional way of accessing the spine during a spine
surgery is to make a midline incision from the top of the spine to
the bottom. “You’d peel off all the muscle and supportive structures
to expose the spine bones, but once you’ve done that you’ve stripped
the blood supply and killed the muscle. So now you’re depending
on the rods, the screws or the hooks to hold things together. But
the muscles are gone. It’d be like planting an oak tree in sand, it
wouldn’t hold,” said Dr. Rouben.
It was in reaction to those limitations that Dr. Rouben was asked
to collaborate with a pair of other physicians to test the possibilities
of performing spinal fusions through a tube in the back. Dr. Kevin
Foley, a Memphis neurosurgeon, started looking at performing
spinal disc removals through a tube in the 1990s. Dr. Rouben came
together with Dr. Foley and the University of Minnesota’s Dr. James
Schwender to streamline the spinal fusion technique through a
tube as small as ¾ of an inch in diameter. The procedure is known
as the Minimal Access Spinal Technology/Transforaminal Lumbar
Interbody Fusion, or MAST-TLIF for short.
“People would understand it’s like a darning needle,” Dr. Rouben
explained. “It starts with a smaller blunt tipped pin and sequentially
Editor’s Note: Welcome to Louisville Medicine’s member spotlight section, Dr. Who? In the interest of simply
getting to know each other as a society of colleagues, we’ll be highlighting random GLMS physicians on a
regular basis. If you would like to recommend any GLMS physician member to the Editorial Board for this
section, please e-mail [email protected] or call him at 736-6338.
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