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Minimizing Invasive Neurosurgery: Colorado Doctor Travels 1,000 Miles for Advanced Technique

Thursday, June 25, 2020 11:37 AM

Psychiatrist Charles Paddack, MD, knows a thing or two about delivering excellent patient care. In practice for more than 50 years and now semi-retired, the 82-year-old Boulder, Colorado resident faced a health challenge of his own recently, one that eventually led him to NorthShore.

Dr. Paddack suffered from potentially dangerous cerebrospinal fluid leakage due to what is called a Tegman defect. A tiny hole at the base of his skull caused spinal fluid to drain into his ear, leading to chronic episodes of vertigo and nausea. Left untreated, it also can put a patient at risk for meningitis and seizures.

Charles Paddack

(Above) Psychiatrist Dr. Charles Paddack went home after a one-night stay following minimally invasive surgery to repair a cerebrospinal fluid leak at the base of the skull

Mind Over Matter
Traditional surgery to repair the fluid leak is long, highly invasive and with a slow recovery. Determined to find a better alternative, Dr. Paddack’s research led him to NorthShore Neurological Institute Neurosurgeon Ricky Wong, MD.

“I came across an article Dr. Wong had written about his own exclusive repair procedure, and I concluded that he would be the best guy to do this,” Dr. Paddack recalled. “So, I reached out and Dr. Wong called me back right away, explained everything and answered all my questions.” Within weeks he was on a flight from Colorado to Chicago.

“Usually, a 3-inch by 3-inch piece of the skull is removed through a large incision to stop the leakage, followed by a lot of pain, discomfort and often a long hospital stay, “explained Dr. Wong, who holds an academic appointment at the University of Chicago Pritzker School of Medicine. “My version involves a much smaller incision that removes only a half-inch square section of the skull. The surgery takes about an hour and a one-night hospital stay.”

Outstanding Outcome
Dr. Paddack’s surgery went flawlessly. Other than some initial tenderness around the incision site, he described his recovery as nearly pain-free. Within a few weeks, he resumed his psychiatry practice in Boulder, and also was back to exercising and long walks with Sampson, his 120-pound Great Pyrenees mix.

“He cured the hole in my head!” joked Dr. Paddack, who is a big Dr. Wong fan. “He’s a very congenial and informative fellow. I had an uneventful recovery and hope his procedure becomes more common.”

“Many surgeons believe that to access the base of the skull they have to open everything up to see clearly,” added Dr. Wong. “I’m comfortable working in tight spaces and using an endoscope if need be to accommodate much smaller openings. If I can get a better outcome through a less invasive, faster surgery and a shorter recovery, I’m going to do it.”