Spine Services Division

The Neurosurgical Spine Services Division at the University of Pittsburgh is a multidisciplinary organization composed of specialists in the fields of physical therapy, physical medicine and rehabilitation, interventional neuroradiology and neurological spine surgery. Specialists from these fields work together as a unified group to provide the highest quality care for patients and athletes who have spine injuries, painful disc conditions, neck, arm, back or leg pain. 

D. Kojo Hamilton, MD, is the director of the Neurosurgical Spine Services Division and chief of spine at UPMC Presbyterian. David O. Okonkwo, MD, PhD, leads the spine trauma and spinal deformity program and Dr. Hamilton provides specialty care in the treatment of cervical misalignment and spinal deformity. Peter C. Gerszten, MD, MPH, leads the percutaneous and spine radiosurgery programs. Thomas J. Buell, MD, joined the division in 2022 with an expertise in complex open and minimally invasive spinal deformity surgery. Nitin Agarwal, MD, joined the division in 2023 and leads the division's minimally invasive spine and robotics surgery program.

The Neurosurgical Spine Services Division offers comprehensive care for all types of spinal disorders, including degenerative, traumatic, and oncologic conditions. The initial treatment approach is typically non-surgical, with surgical options reserved for patients with recurrent or disabling symptoms and/or progressive deficits. Complete diagnostic testing of all spinal and nerve disorders is available through the center.

The minimally invasive spine and robotics surgery program, led by Dr. Agarwal, offers quick recovery and the latest innovative techniques for a variety of spinal conditions including artificial disc replacement, robotic spine surgery, navigation-assisted surgery, endoscopic spine surgery and awake outpatient surgery. With advances in surgical technology, less invasive surgical options are employed while maintaining unparalleled precision and accuracy. 

The spinal deformity program, led by Dr. Okonkwo, offers full-scale analysis, longitudinal tracking and treatment interventions for patients with scoliosis and thoracolumbar spinal deformity. The team of deformity practitioners continues to push the surgical envelope and combines unique skill sets to provide each and every patient with the least invasive yet maximally effective treatment options.

Dr. Hamilton correspondingly treats complex cervical deformity, such as swan neck and chin-on-chest disorders, in addition to thoracolumbar scoliosis, oncologic and degenerative spine conditions. Dr. Buell, who completed advanced training in complex spine surgery at the University of Virginia and Duke University, is a prolific academician poised to make significant contributions to this subspecialty. 

The spine radiosurgery program, led by Dr. Gerszten, is one of the most experienced centers in the world in treating a wide variety of benign and malignant spine and paraspinal tumors that has proven highly effective, safe, and painless, and avoids many of the risks associated with open surgery.

Within the division is the Center for Surgical Pain Management led by John J. Moossy, MD. This program provides a variety of surgical options for the management of medically intractable pain syndromes. The range of treatment varies from neuroaugmentation (i.e., spinal cord stimulation and intrathecal opioids) to surgical decompression (with or without spinal fusion) to ablative neurosurgery.

The Neurosurgical Spine Services Division works together as a unified team, utilizing a multidisciplinary approach to maximize patient care and outcomes. An array of research studies and protocols are employed to deliver unsurpassed treatment strategies, ensuring that patients receive the best state-of-the-art care in the country.

The Spine Division supports two distinct fellowship tracks under the leadership of Dr. Hamilton. One track is for those interested in spine and neurotrauma, under the co-direction of Dr. Okonkwo. The other track is for those interested in complex and minimally invasive spine deformity, under the co-direction of Dr. Agarwal.