Dr. Peter Derman, a minimally invasive and endoscopic spine surgeon at Texas Back Institute, graduated with honors from Stanford University after completing a Bachelor of Science in Biological Sciences. Dr. Derman attended the Hospital for Special Surgery in New York for his residency and completed his Fellowship in Spine Surgery at Rush University Medical Center in Chicago, Illinois.
Dr. Derman is actively involved with spine surgery research and exploring ways to better medicine for future generations. He has served in leadership roles in multiple national and international spine societies and was a founding member of both the Endoscopic Spine Research Group and the International Spinal Endoscopy Research Foundation.
SSN: What encouraged you to choose surgery as a career – and minimally invasive and endoscopic spinal surgery in particular?
PD: I have always been fascinated by science. Spine surgery in particular involves elements of biology, physics and chemistry. Every patient is a unique puzzle, and I get to combine elements of these scientific fields to diagnose their issues and develop treatment plans, whether they be surgical or not.
I have chosen a career completely dedicated to minimally invasive and endoscopic surgery, as these approaches allow for rapid symptom relief without the prolonged recovery associated with more traditional spine surgeries. It is unbelievably gratifying to see patients who have struggled for months and even years wake up from surgery already with dramatic pain relief. They are often comfortably home within hours and rapidly back to the activities they enjoy.
SSN: You recently shared insight addressing the generational shift in spine care. Could you tell us more about what your practical experience and your research about the trend toward minimally invasive spine surgery?
PD: Minimally invasive spine surgery is performed through small incisions, but this is actually not the most important differentiating factor. Instead, what happens under the skin is the key — and that is never cutting or damaging the muscles and other important soft tissue stabilizing structures around the spine. These tissues are extremely important for supporting the spine and promoting physical function. Regardless of patient age, minimally invasive techniques can be beneficial, allowing for a smaller surgery with more rapid recovery. Some of our research has focused on the impact of age on outcomes of endoscopic spine surgery, and we have found that young and old alike benefit from this technique with low complication rates.
SSN: What could your experience in the operating room and post-operative care mean to help support spinal surgery, and what will be the effect on patient experience and their long-lasting healing?
PD: Spine surgery is increasingly moving to the outpatient environment, which means patients get to go home the same day rather than having to stay in the hospital. I am particularly passionate about endoscopic techniques, which involves placement of a narrow camera through a dime sized incision, allowing me to “scope” the spine. I watch the whole thing on a high-definition screen and can remove pressure from nerves, alleviating sciatica. Patients often take no medication whatsoever after surgery. This is a total paradigm shift in the way that spinal care is provided, and I am optimistic that it will become more widespread in the future as additional surgeons incorporate this technique and patients become aware of it.
SSN: Does there need to be a shift in educating patients and society regarding the prevention of spinal injuries and diseases?
PD: Prevention is the best medication. Maintaining a healthy weight, keeping your core strong, and avoiding nicotine containing products are all important for overall health as well as out of the spine. I impart this information on all of my patients, whether surgical or not; and more widespread focus on these factors would likely reduce the burden of spinal issues overall.
SSN: Do you have any more research in the pipeline?
PD: There is no shortage of interesting research questions to investigate. We have a strong research department at Texas Back Institute, where we critically assess our outcomes in order to optimize patient care. I am also an active member of the Endoscopic Spine Research Group (ESRG), a multi-institution conglomerate dedicated to advancing the field of endoscopic spine surgery through scientific research. We have been very active in evaluating patient recovery after endoscopic spine surgery and publishing our results so that others can see the benefit of these ultra minimally invasive techniques.
SSN: How does the future look with the advancing involvement of 3D technology in patient care?
PD: There are a variety of uses for 3D navigation and printing and spine surgery. Currently, the most common use of 3D printing in spine surgery is to create interbody cages, which are spacers that are placed between the spinal bones to provide support and encourage bone growth during fusion operations. Most of the 3D printing cages presently on the market are of standard sizes, but the next frontier is truly patient-specific implants. The data from a preoperative scan can be used to help design implants that more closely conform to an individual patient’s anatomy. These are then 3D-printed, sterilized, and inserted during surgery, providing a talar made construct that I am optimistic will improve surgical outcomes such as better spinal correction, fewer fractures of the adjacent vertebral bones, and higher fusion rates.
SSN: What’s the best part of your job?
PD: I am blessed to have a profession that I enjoy. The most rewarding part of my job is seeing patients back after surgery and witnessing the transformation they have undergone. Many of these patients have been sidelined by severe nerve pain, which was seemingly inescapable before surgery. I get to tinker around in the operating room, and they emerge often feeling dramatically better immediately. When minimally invasive and endoscopic techniques are employed, these patients have minimal surgical pain. The smiles, handshakes, and hugs I get in the office reinforce my dedication to helping patients regain their lives.
SSN: … and the worst?
PD: The worst part about my job is dealing with insurance companies that are increasingly making it difficult for patients to obtain the care they need. As physicians, we spend a significant amount of our time arguing with the insurers in order to advocate for our patients. It is frustrating to patients and their doctors.
SSN: What has been the highlight of your career so far?
PD: I am proud of the fact that I have developed a busy minimally invasive and endoscopic practice while also being active in research, teaching, and product development, despite the fact that I just turned 40 this year. I am grateful to practice in the setting such as Texas Back Institute, where I have the resources and support to make this dream a reality.
SSN: Are you planning to attend or speak at any medical conferences or events in 2026?
PD: Haha… yes! Between teaching other surgeons and speaking at conferences in the United States and abroad, I travel most weekends of the year. I try to keep these work trips as short and efficient as possible so that I still have time to dedicate to my wife and two young boys at home.
SSN: If you didn’t work in the health industry, what would you be?
PD: One of my creative outlets outside of the traditional bounds of my job is creating educational and informative spine-related social media content. I post routinely to Facebook, Instagram, LinkedIn, YouTube, and TikTok (check me out @PeterDermanMD). This allows me to reach an even broader audience with the goal of providing reliable information about spinal conditions. Over time, I have created a bit of a video recording studio in my house, complete with green screen, teleprompter, lighting, and high-quality sound recording devices. I enjoy editing content and interacting with those who consume it. So I suppose in a different life I would work in the field of online marketing. Fortunately, my current position allows me scratch this itch while also providing clinical care to patients in need.
SSN: How do you think the future looks within the field of spinal surgery and its treatments and what are your predictions for 2026 and the next decade?
PD: The future is bright. Traditional spine surgery is often perceived negatively by patients and with good reason. I would not personally be excited to sign up for extensive procedures with prolonged recoveries. Fusion surgeries, while occasionally still necessary in the current day and age, will hopefully become less and less prevalent with the increasing use of disc replacement and other non-fusion techniques. Ultimately, I predict that ultra-minimally invasive endoscopic techniques will become the norm for treating many spinal conditions, similar to how arthroscopy is now the standard of care for many shoulder, knee, and hip conditions.
Image: submitted by the author
