By: 2 March 2023
Neurosurgeon in focus with Luke Macyszyn

Dr. Luke Macyszyn is a board-certified, fellowship-trained neurosurgeon specialising in the minimally invasive treatment of complex spinal disorders, such as degenerative disease, disc herniation, scoliosis and spine tumors in both children and adults.

Keenly focused on motion preservation, he uses leading-edge technology to ensure that his patients not only receive the best outcomes, but also return to their normal lives and activities as quickly as possible.

With over 15 years of experience, Dr. Macyszyn joins DISC from the UCLA Heath Spine Center, where he directed the Complex Spinal Disorders and Deformity Research Program and also served as Associate Professor of Neurosurgery, Radiation Oncology and Orthopedics. In this capacity, he led an NIH-funded laboratory aimed at using artificial intelligence to improve the diagnoses and management of patients with spinal disorders.


SSN: What drove you to choose your career in neurosurgery – and spinal disorders in particular?

LM: Neurosurgery is still a very young field. I would state that there are more things that we haven’t yet discovered about the brain and the spine than we understand. I find that this represents a challenging clinical field, as well as an opportunity for research and innovation. Those are the characteristics of the field that have attracted and excited me. 

Likewise, with respect to spine surgery, these prior statements are even more applicable. The field started with the performance of simple decompression surgeries, followed by an explosion of fusion surgeries. We are quickly realising and understanding that the spine has not been designed to be fused from top to bottom, which has brought about the next frontier of motion preservation surgery.


SSN: It is clear that the healthcare industry has been greatly impacted by the pandemic, what has been the greatest impact for you within your research and the industry as a whole? How has your working practice changed over the past two years?

LM: I think there are two changes that have occurred as a result of the pandemic, and both are interrelated. One, I am seeing a much larger proportion of my patients through telehealth. I believe, for certain clinical situations, this is really good, as it enables access to care that patients previously did not have. However, at the same time, medicine and even research is a deeply personal field. Losing that human, physical interaction, I feel, has been quite detrimental at the same time. In the future, I believe we will need to strike the right balance between telehealth an in-person care.


SSN: What is the best part of your job?

LM: As a surgeon, the best part of my job is surgery period. Being able to use some of the latest and greatest technology in the operating room to help someone’s quality of life is not only exciting but also extremely rewarding. Seeing those patients in clinic afterwards, with their symptoms either completely eliminated or significantly reduced, is very heart-warming and motivating.


SSN: … and the worst?

LM: Paperwork and dealing with all the administrative work in medicine. I don’t believe that is the fault of any single person or even organization. Rather, it is a collective mistake on our part by not prioritizing the efficient completion of these tasks.


SSN: What has been the highlight of your career so far?

LM: I believe there have been two highlights in my career that I am extremely proud of. One, building a productive laboratory and securing NIH funding is certainly the first highlight. I have been extremely lucky to work with some of the most talented people in computer science and medicine to achieve these goals. The second highlight has been the opportunity and challenge to take what I have learned and developed while working at large hospital systems, and provide that same level and complexity of care in an outpatient setting at DISC.


SSN: Can you tell us more about the new ambulatory surgery center in Los Angeles, and how you will help redefine the gold standard of minimally invasive surgery?

LM: The goal at DISC in Marina del Rey will be to provide the same level of care that is available at large tertiary centers in an outpatient setting. It is relatively common to perform the standard, bread-and-butter spinal cases in an outpatient setting. However, we will go above and beyond that and provide care that, so far, has not been possible. To that end, we have thought a great deal about the design of the space, the staff and the available technology. Our operating rooms at this new surgery center will be on the leading edge of technology, allowing us to provide more comprehensive, safer and more efficient spinal care.


SSN: What could this mean for the patient experience, management strategies and surgical outcomes looking forward?

LM: I strongly believe that given the combination of surgical expertise, staff experience and technological availability, we will be able to offer patients a level of experience that will be unmatched. By using the latest microscopes, surgical tools and navigation systems, we will be able to perform high-level, complex surgeries in a minimally invasive fashion that has not yet been possible in the outpatient setting. Ultimately, the patient will benefit from not only access to a higher level of care, but care that is also safer, more personalised and more efficient.


SSN: Are you currently involved in any further research? If so, could you tell us more about it?

LM: We are currently using large databases containing clinical informatics data, as well as imaging data, to analyse patient decision making, diagnoses and treatment strategies. The goal of this work is to augment all of these decisions in the future and enable physicians to render care that is more consistent, reproducible and predictable.


SSN: Are you planning to attend any medical events this year?

LM: I will most likely be attending Spine Section this year.


SSN: If you didn’t work in neurosurgery what would you be?

LM: I would be an architect as I love building things. I suppose, in some ways, it’s very similar to spinal deformity surgery where we reconstruct a patient’s spine. However, in architecture, I feel you have more leeway to be creative in ways that medicine does not always allow.


SSN: What would you tell your 21-year-old self?

LM: That’s a great question. I think I would tell my younger self to relax and really focus. There are so many things and obstacles that come about during clinical training and starting in your career, that — when taken too seriously — can really derailed you. I would tell my younger self to ignore all those things and focus on the real important goals that are under my control.


SSN: If you were Health Minister for the day, what changes would you implement?

LM: I would devote a significant amount of resources and engage the IT community to help overcome the administrative burden that is present in medicine today. We now have more administrators working in the medical field than clinical professionals, and I think this represents a very inefficient and wasteful system. This needs to change if we want to provide care to a growing and aging population, as well as render care more equitably.


SSN: Away from the clinic and your research – what do you do to relax?

LM: I love the outdoors. Anything I can do outdoors, I find really invigorating and relaxing. These days, I spend the majority of my time riding a bike and playing on the playground with my kids. I’m seriously looking forward, however, to this year’s ski season!


SSN: How do you think the future looks in the field of spinal surgery and what are your predictions for 2023 and the next decade?

LM: I seriously hope and believe that the field of spinal medicine over the next decade will become more data driven. I think we will slowly move away from individual surgeon or institutional preferences, to an environment where we — as a group of surgeons — use large data, analytics and machine learning to evaluate patients and render care that is more reproducible and predictable.