In The News Archives - Michigan Head & Spine Institute Blog


MHSI is proud to share the exciting news that Dr. Ratnesh Mehra has received the designation of FACOS; Fellow of the American College of Osteopathic Surgeons. Dr. Mehra has demonstrated a commitment to the practice of surgery, surgical teaching, authorship of professional papers and participation in local, state and national organizations.

The designation was conferred to Dr. Mehra during a ceremonial hooding in Chicago, IL amongst his mentors, peers, students, family and friends last weekend.

Congratulations, Dr. Mehra!!!

If you or a loved one is seeking treatment for neurosurgery, or to schedule an appointment with Dr. Mehra or any of our MHSI experts, visit or call 248-784-3667.


Michigan Head & Spine Institute is proud to share the exciting news that Dr. Holly Gilmer has just been elected Chair of the Michigan Board of Medicine.

She was appointed by Governor Gretchen Whitmer to the Board of Medicine in 2020 and has now been elected as Chair by her colleagues on the Board.

We wish to extend our congratulations to her on such a prestigious accomplishment!

If you or a loved one is seeking treatment for neurosurgery, or to schedule an appointment with Dr. Gilmer or any of our MHSI experts, visit or call 248-784-3667.


Although it’s relatively new, endovascular neurosurgery is being used to treat an increasing number of health problems — with remarkable results. Through research and collaboration, experts from a variety of fields are coming together to innovate a type of surgery that is helping some of the highest risk patients.

What is Endovascular Neurosurgery? 

Endovascular neurosurgery is a subspecialty of neurosurgery that combines multiple types of expertise. Incorporating both neurosurgery, which treats conditions of the brain and nervous system, and interventional radiology, which uses imaging and minimally invasive techniques to diagnose and treat injuries and health conditions, endovascular neurosurgery uses small catheters to diagnose and treat health problems affecting the brain and spinal cord.

What Conditions Endovascular Neurosurgery Treat?

Endovascular neurosurgery can be used to diagnose and treat a variety of injuries, diseases and health conditions including:

  • Strokes
  • Brain aneurysm
  • Cerebrovascular malformations including arteriovenous malformations (AVMs) and dural arteriovenous fistula (dAVF)
  • Carotid artery disease
  • Atherosclerosis (narrowing) of the vessels of the brain
  • Idiopathic intracranial hypertension (formerly pseudotumor cerebri)

This is merely a partial list of the many health concerns that can be addressed with endovascular neurosurgery — a list that will continue to grow as neurosurgeons, interventional radiologists, and interventional neurologists work together to advance the science surrounding these techniques.

What Are the Benefits of Endovascular Neurosurgery?

The blood vessels of the brain are deep within the brain itself, meaning they’re not readily accessible without open surgery. Because it involves the use of catheters to pass through blood vessels, endovascular neurosurgery is a minimally invasive technique that provides an alternative to more invasive options.

Rather than opening the skull to get into the brain, endovascular neurosurgeons often only need to make a tiny puncture to insert the catheters they use in surgery.

The minimally invasive nature of endovascular neurosurgery means that some patients who receive elective (non-emergency) types of this procedure can go home the same day.

Even in cases where recovery takes a little longer, patient outcomes are generally very good. Many people can go home within one day of surgery and are back at work within a week.

Another major benefit of endovascular neurosurgery is that it offers hope for people with diseases or conditions that would have been otherwise untreatable. These are patients who didn't have a different treatment option — or at least a good treatment option — and these endovascular techniques are allowing neurosurgeons to provide life-altering or even life-saving care for them.

Advancing Technology, Saving Lives 

Endovascular neurosurgery is an exciting field that allows surgeons to greatly improve outcomes for patients who were otherwise at the mercy of their disease.

Treatment options that weren’t available only a few decades ago are now saving people’s lives — and will continue to do so as the field grows and expands through continued collaborative research and innovation.

If you or a loved one is seeking treatment for a condition of the spine, or to schedule an appointment with any of our MHSI experts, visit or call 248-784-3667.



Approximately 50 million people in the United States — one in five adults — report struggling with pain on most days or every day. This type of chronic pain can interfere with every aspect of life, making even the simplest of tasks unmanageable.

Fortunately, recent advances in technology have resulted in a new tool for treating chronic pain called neuromodulation. Understanding this treatment, including what it involves and how it works, may help you decide if neuromodulation is right for you.

What is Neuromodulation?

Neuromodulation refers to altering or modulating the function of the nervous system using targeted electrical stimulation or drug delivery. This can be accomplished using non-invasive devices such as transcutaneous electrical nerve stimulation (TENS) units or implantable devices such as spinal cord and deep brain stimulators.

The nervous system can be targeted anywhere along its course, including the brain, spinal cord or peripheral nerves.

How Does Neuromodulation Help With Chronic Pain?

In simple terms, Neuromodulation alters or blocks pain signals as they travel to the brain. Depending on a patient’s pain pattern, the device can be placed at different locations in the spine or on certain nerves to block pain.

Chronic pain can be described as aching, sharp, stabbing or burning sensations. Neuromodulation devices override these sensations, instead providing a soothing or gentle tingling feeling in painful areas.

Can My Pain Be Treated With Neuromodulation?

Ideal candidates for neuromodulation for pain are those with chronic (not acute) pain, usually defined as pain lasting more than 3 months. This is typically pain that affects the neck, back or extremities, although there are options for facial pain and other pain patterns as well.

These patients have usually tried different medications or injections and continue to experience pain. Many have had back or neck surgery and continue to have pain, and others don’t qualify for surgery or don’t want to have additional or more invasive surgery.

What Happens During the Procedure?

For spinal cord stimulation, patients require a “trial” before the permanent device is implanted to ensure that the therapy is effective and worthwhile. A trial of spinal cord stimulation typically involves placing thin electrodes through two needles into the back, similar to an epidural injection. These are threaded to the appropriate region that matches the patient’s pain pattern.

These electrodes are then connected to an external device and patient’s “trial” the therapy at home for about a week. If the trial is successful, meaning pain severity is reduced by at least 50%, the temporary electrodes are removed in office and the permanent implant is planned.

This next step involves placement of the same electrodes in the same location, although now they are anchored into the back and connected to a small battery which is also implanted into the back or buttocks through two small incisions in the back. For some patients, a small laminotomy (opening in the spinal vertebra) is necessary to place the electrode.

Deciding which devices are used and where they are implanted requires an individualized approach based on each patient’s unique needs and anatomy.

What Does Recovery Look Like?

These are almost universally outpatient surgeries, and patients tend to experience some slight post-operative discomfort which resolves after a few days.

Patients should limit twisting, bending and lifting more than 5-10 pounds for the first two weeks after implantation to allow for healing, and for the electrodes to scar or “set” into place.

Once patients are seen at their first post-operative visit, we typically discuss a gradual return to activity and lifting of restrictions. Patients also have their devices programmed at that time, during which we map their pain distributions with the stimulation.

Are There Risks Associated With Neuromodulation?

Infection is the most common complication, particularly with implantable devices; on average this risk is 2% for any infection. Important risk factors that can contribute to infection are diabetes, smoking and obesity.

The risk of a spinal fluid or cerebrospinal fluid (CSF) leak is approximately 1%. The risk of a devastating complication such as spinal cord injury is very rare, occurring in much less than 1% of cases.

Although almost all neuromodulation devices currently manufactured and implanted are MRI-compatible, certain precautions must be taken in terms of what type of MRI machine can be used.

Who Else Can Benefit From Neuromodulation?

In addition to chronic pain, neuromodulation devices are often used for movement disorders such as tremors, Parkinson’s disease and dystonia. Additional conditions that can be treated with neuromodulation include obstructive sleep apnea and urinary incontinence.

Neuromodulation also has a long history of use for psychiatric disorders, including obsessive compulsive disorder and depression.

Pain Relief is Possible

Patients with complex regional pain syndrome tend to do very well with spinal cord stimulation, and my last patient was a young woman who went from being unable to walk on her own feet to regaining full strength and having greater than 90% pain relief.

For deep brain stimulation, it’s very gratifying to test the stimulator in the operating room with the patient awake—one of my more recent patients started crying when she realized that her tremor was completely gone for the first time in decades.

If you or a loved one are dealing with chronic pain and feel like you’ve tried everything, talk to a healthcare provider about neuromodulation. You may be only one outpatient procedure away from finally finding relief.


We've added two new physicians who bring new treatment options to better serve our patients and community. Join us in welcoming these new physicians:

John Whapham, M.D., MS, FSNIS, FAAN
Interventional Neurology

Dr. Whapham specializes in neuroendovascular procedures to treat complex vascular abnormalities of the brain and spinal cord. He also specializes in treating stroke and this expertise led the nation’s first integrated telemedicine / air transport stroke network among Michigan hospitals as well as similar programs in Chicago, Alabama and Ohio. Dr. Whapham is also the author of numerous national clinical articles on aneurysm, stroke and endovascular surgery and a surgical textbook section on arteriovenous malformations and their treatment

After several years of practice at Loyola University Medical Center in Chicago, St. Vincent’s Hospital in Toledo and Southeastern Alabama Medical Center in Dothan, Dr. Whapham rejoins MHSI, where he began his neurology practice.

To learn more, click to see how Dr. Whapham describes his treatment options.

Alison LeeDr. Alison Lee, M.D.
Medical Acupuncture

Dr. Alison Lee specializes in medical acupuncture as a part of a program of integrative pain management. Medical acupuncture is defined as acupuncture practiced by a physician using methods grounded in an understanding of both classical Chinese medicine and conventional Western medicine. She is board certified in medical acupuncture and is a Fellow of the American Academy of Medical Acupuncture, which is the highest level of recognized achievement in the profession.

Treatment may include the use of other modalities to enhance the effects of acupuncture to help patients obtain maximal benefit. Dr. Lee provides nutritional and lifestyle counseling and may also recommend evidence-based and time-proven herbal and nutritional supplements. Dr. Lee collaborates with each patient's physician to help patients achieve the best possible results from acupuncture treatment.


If you or a loved one is seeking treatment for a condition of the brain, neck or spine – or in need of a second opinion regarding a diagnosis – schedule an appointment online or contact our MHSI experts at 248-784-3667.

Telehealth or in-person appointments available.