Brain Power Baystate’s New Chief Of Neurosurgery Brings A Unique Set Of Skills To The Region

Dr. Paul Kanev says too many young patients from Western Mass. have to travel to Boston to undergo neurosurgery — but that’s changing.

 

Kanev, a neurosurgeon and pediatrician, and one of only two physicians in North America to be both, was recently named chief of Neurosurgery in the Department of Surgery at Baystate Medical Center. And he has no shortage of vision for what he will undertake at New England’s second-largest hospital.

“What brought me here is the opportunity to build a comprehensive neurosurgical program for adults and children, with all the resources to do it right,” said Kanev, who comes to Springfield from Penn State School of Medicine, Hershey Medical Center, where he served as director of Pediatric Neurosurgery and vice chairman of Neurosurgery.

“Historically, there has been very little pediatric neurosurgery done at Baystate, and most people who needed a pediatric neurosurgeon skipped east to Boston.

None of that is necessary anymore,” he said. “The population here supports 150 to 200 cases per year just in children, and now they can keep their care local.”
For parents already struggling with the often devastating impact of their children’s neurological diseases, that’s a small blessing — but a blessing nonetheless.

Natural Fit

Kanev explained that pediatrics was no afterthought as he studied to become a board-certified neurosurgeon. The two disciplines were intertwined in his mind from the start.

“I had always planned a career in pediatric neurosurgery,” Kanev told The Healthcare News. “I was immeasurably influenced by my medical school faculty adviser, who was a pediatric neurosurgeon. And I got it in my mind that the best neurosurgeon for children would also be the best physician for children, and that would mean completing pediatrics training.”

The rewards of those extra years of training have been immense, he continued.

“The biggest single advantage is that I share a common vocabulary with pediatricians — we share a common training, and we understand many medical conditions that children have, which influences how they’re treated surgically,” Kanev said. For example, “I had experience with premature infants extensively during training — much more than I would’ve had in conventional neurosurgical programs.”

And more children require neurosurgery, for a host of conditions, than many people think, he said. Some diseases are as common as one in 1,000 children, while others are a hundred times more rare — but in a region with millions of residents, there’s still plenty of patients.

“One of my thrusts here will be the development of an epilepsy surgery program for adults and children,” Kanev noted. “That’s been a specialty of mine over my whole career — and epilepsy surgery has not been offered at Baystate; patients had to go to Boston.”

Another focus will be the expansion of neurosurgical services in Baystate’s new cancer center. “I look forward to a greater neurosurgical role, especially in the introduction of certain techniques in tumor operations that will have the potential for safer tissue removal and early and aggressive management of spinal metastatic tumors.”

The use of advanced neurosurgical techniques, he explained, minimizes the potential for post-operative weakness and maximizes tissue removal.

“One of the other programs we’re going to expand is functional neurosurgery for both movement disorders and chronic pain and spasticity,” Kanev added. “I’ve done a great number of implantations for pump delivery systems for anti-spasm medication, which is highly effective in spinal cord injuries with spasms.”

In addition, he said, he is helping to incorporate neurosurgery into a comprehensive stroke program which will focus on improved medical and surgical management of strokes of all kinds.

Getting Around

Kanev’s education and profession have brought him from coast to coast. A graduate of Temple University School of Medicine, he completed his internship at the University of Virginia, and a pediatric residency at New England Medical Center in Boston. He went on to complete his neurosurgery residency at the University of Washington, and later completed pediatric neurosurgery fellowship training at Seattle Children’s Hospital.

Before his work in Hershey, Kanev’s other appointments included director of Pediatric Neurosurgery, Henry Ford Hospital in Detroit; surgical director, Comprehensive Epilepsy Center at Temple University School of Medicine in Philadelphia; and chief of Pediatric Neurosurgery and co-director of the Pediatric Epilepsy Center at St. Christopher’s Hospital for Children in Philadelphia.

He also served as an attending neurosurgeon at Children’s Hospital and Medical Center in Seattle, Albert Einstein Medical Center in Philadelphia, and Sinai Hospital in Detroit. Kanev is board-certified in Neurological Surgery and Pediatric Neurological Surgery, and is board-eligible in Pediatrics.

“We are thrilled to have recruited a neurosurgeon of such great quality,” said Dr. Richard Wait, chairman of Surgery at Baystate. “Dr. Kanev will bring new expertise to Western Mass. and will greatly benefit the community.”

Kanev has brought his unique range of skills to bear on various research efforts. For example, he was awarded a three-year grant from the National Institutes of Health in 1999 to study hypothermia in children with severe brain trauma. He has also addressed a number of national conferences on issues such as epilepsy surgery in children and spinal cord malformations, as well as lecturing at neurosurgery and pediatric grand rounds at various teaching hospitals throughout the country.

In addition, he has authored more than 25 book chapters and journal articles. His latest piece, “Reflections on Shunt Infection,” which was published in the Journal of Pediatric Neurosurgery in December, discusses the fact that it is possible to perform shunt implant surgery with substantially lower infection rates than the North American average. Kanev has also served as a manuscript reviewer for Pediatric Neurosurgery since 1998.

His research work has put him on the forefront of what he calls “an explosion of technology” in the past 10 years that has made neurosurgery one of the most challenging, yet exciting, fields of medicine today.

“There has been an integration of imaging and surgery — a spinoff of all the computer hardware and software for MRI scans. There has also been an ever-expanding miniaturization of generators that provide stimulation for tumors and Parkinson’s disease symptoms.”

The other technology that has revolutionized neurosurgery, he said, is the refinement of the endoscope, which has improved surgery of many types in significant ways.

“It allows minimally invasive neurosurgery to be done,” Kanev said, adding that this advancement has dramatically impacted treatment of hydrocephalus, a condition marked by the accumulation of cerebrospinal fluid in the brain.

“Instead of using the traditional shunt for spinal fluid drainage, the endoscope makes an opening at the base of the brain that allows fluids to bypass the blockage.”

Full Speed Ahead

Kanev is a father of three who enjoys sailing and classical guitar in his spare time, but spare time might be difficult to come by for the only pediatric neurosurgeon in the region. Still, he welcomes the fact that there’s plenty on his plate at Baystate.

Kanev received some national attention during his time at St. Christopher’s Hospital for Children when he was interviewed by Paula Zahn on CBS’ The Early Show about his efforts to save a child who had suffered a brain hemorrhage after receiving a heart transplant.

He wants to continue making news in Western Mass. — if not on a national scale, at least for the hundreds of families that now have a valuable neurosurgical resource close to home.