Michael L.J. Apuzzo, MD

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Areas of Treatment:

Specialties:

  • Neurosurgery

Title:

  • Professor, Todd-Wells Professorship in Neurosurgery

Department:

Locations:

Background:


Michael L. J. Apuzzo, Edwin M. Todd/Trent H. Wells, Jr., Professor of Neurological Surgery at the University of Southern California Keck School of Medicine is one of the world's best known and respected neurosurgeons. He has made and been honored for multiple unique contributions to the discipline of neurosurgery over a three decade period. These contributions have played a singular role in the redefinition of the field. As a visionary and innovator, he has been called the disciplines "primary intellectual catalyst" for the past two decades because of his developments and innovative thoughts and has been characterized as representing the epitome of academic substance and achievement.

Background
A native of New Haven, Connecticut, Dr. Apuzzo received his undergraduate education at Yale College, his medical education at Boston University and general surgical training at McGill's Royal Victoria Hospital in Montreal Canada. He then entered neurosurgery residency at the Yale University School of Medicine where he completed additional fellowships in neurophysiology and neuropathology.

He served in the United States Navy's Nuclear Powered Submarine Service for NATO, after completing training in Nuclear Medicine, Submarine and Diving Medicine at the Navy's Groton Postgraduate School Connecticut. Duty included extended patrols to the Arctic, Mediterranean and Black Sea regions. During this period he received special recognition for unusual service from the Surgeon General and Fleet Admiral.

Following a period of faculty appointment at Yale he moved to the University of Southern California.

Principal Interests and Areas of Focus
General Clinical Interests:
Central Nervous System Tumors
Functional Disorders
Epilepsy, Movement Disorders, Pain

Principle Surgical Interests:
Surgery of the Cerebrum
Minimally Invasive Surgery
Functional Restoration

Principle Technical Interests:
Stereotactic Radiosurgery
Virtual Surgery Systems
Operating Room Design

Principle Investigational Interests:
Molecular and Cellular Neurosurgery
Gene Therapies
Stem Cell Biology
NANO Technology



Innovations and Contributions

Working with diverse resources from multiple technical perspectives he had created, developed, and championed multiple new areas in the neurosurgical discipline. These resources have included NASA, the Jet Propulsion Laboratory (JPL), the California Institute of Technology, Northrop Aviation, the John Hopkins Applied Physics Laboratory, USC School of Engineering, USC School of Cinema and Television, USC Institute for Creative Technology (ICT), Apple Computers, Industrial Light and Magic, The Department of Defense, Paramount Studios and multiple bio-technical firms. In addition, he developed and fostered active research and development of programs with major industrial groups.

These contributions have occurred in the following areas:
Microneurosurgery- Beginning in 1973, working with Theodore Kurze, he initiated developments in a then new area dealing with microsurgery of the nervous system focusing upon areas of instrument development, microscopic sterilization and utilization, and applications of these methods to deep cerebral surgeries through new comprehension of functional and anatomical routes. This included focus on the third ventricle with the development of associated retractors and instrumentation devices. These activities lead to the ultimate production of two monumental textbooks Surgery of the Third Ventricle (900 pages 1987, 1,200 pages 1998) and Brain Surgery: Complications Avoidance and Management (3,000 pages 1992) these atlas texts are considered modern classics.

Concurrently, he was an active early participant in the introduction and refinement of the use of the operating microscope in surgery of the spinal column, cord and roots. He participated in prototype testing of the cavitron ultrasonic aspirator, an essential device in modern tumor surgery.

Endoscopy- In the late 1970's, he reintroduced endoscopy to neurosurgery with the concept and practical reality of the methods and application to transsphenoidal, intra-cranial and spinal surgery. This later focused upon intra-ventricular methods of lesion biopsy, excision, and management. This was seminal work for the current popularity of the method in these areas. He initiated and later championed the concept of "minimally invasive" neurosurgery.

Molecular Biology- In 1976, he initiated one of the world's first brain tumor immunology laboratories focusing upon the then novel areas of tumor antigens, immune responses in brain neoplasia, and the application of immunotherapuetic techniques through vaccines, cell infusions, and local cellular therapies in brain neoplasms. This work developed into the more contemporary concept of molecular biology as it is applied to neurosurgical disorders and ultimately stimulated him to introduce the concept and terms "cellular and molecular neurosurgery" and "neurorestoration" two decades ago- areas that are essential to the "new neurosurgery" of the 21st Century. In this regard, he was one of the initial investigators performing neural grafting in the late 1980's, ultimately performing North America's first stereotactically directed bilateral adrendomedullary auto-grafts in Parkinsonian patients. Later, he was one of the initial investigators working with and endorsing studies with stem cells for neuroregeneration. Now, with Charles Liu, M.D., PhD, the California Institute of Technology, Stockholm's Karolinska Institute and Oslo's National Hospital, he is engaged in protein engineering studies for stem cell direction.

Imaging Directed Stereotaxy- In 1978, he performed the first human surgical procedures with the revolutionary Brown Roberts Wells Stereotactic System and went on to develop this concept of imaging directed stereotaxy over a twenty-five year period. These initial efforts were among the world's first application of what would prove to be seminal techniques for relating imagining to operative procedures. He developed the technology with devices and applications innovating and doing initial human testing with the now university applied Cosman Roberts Wells Stereotactic System. He defined methods of use in vascular diseases, neoplasms and functional disorders. He helped in the development of volume related stereotaxy and frameless systems. These applications included biopsy excision, radionuclide introduction, endoscopy and in 1983, stereotactic radiosurgery employing a linear accelerator system a seminal event in modern neurosurgery.

Radio/Brachytherapy and Radiosurgery-With Hosibuchi (UCSF), he introduced European concepts of interstitial brachytherapy to North America in 1976, and went on to develop stereotactic radiosurgery concepts based on European Models in 1979. Working with Biomedical Engineer, Trent Wells for instrumentation, he developed a linear accelerator based system in parallel with Harvard Colleagues that provided the basis for North America's first radiosurgical cases in 1983. The methodology is now globally marketed and employed as the X-Knife. This seminal effort has been carried through a twenty-year period with important work related to Gamma Knife technology, as well as the development of the frameless Cyberknife System. Initial, sophisticated appraisal, and experience has been gained with colleagues Zbignew Petrovich (Radiation Oncology) and Cheng Yu (Radiation Physics) at USC with the Cyber Radiosurgical System and a platform for innovative expansion of the radiosurgical concept established.

Minimal Invasion- He has introduced innovations and has championed this concept bringing it to practical reality in numerous areas of application. The concept of minimally invasive surgery was originally transmitted to him and created by his mentor William Scoville. These methods included microsurgical, endoscopic, stereotactic, radiosurgical, molecular biological and cellular biological methods. He performed one of the world's first surgeries for the introduction of vagal stimulation for the control of epilepsy. In addition, he has introduced the future concept of "nanoneurosurgery" through applications of nanotechnology.

Neurosurgical Operating Environment -He initiated attention and creative focus in the areas of operating room design specific to the field of neurosurgery. This was particularly focused on the demands of the enormous influx of surgical adjuvants to the field and the increasing dependence of the surgeon on advanced techniques to optimize each operative event. There have been numerous ramifications of this focus including intraoperative imaging guidance, real time imaging assessment and the development of on Virtual Reality Environments where he has likewise been an innovator.

These innovations and contributions have been largely directed toward surgery of the cerebrum, but have had ramifications throughout the entire catalogue of neurosurgery and will continue to affect the field for decades to come.

Publications
The contributions are documented in more than 700 individual works in the neurosurgical literature, including 50 individual volumes, which he has (edited dealing with topics of microsurgery, stereotaxy, the future of neurosurgery, central nervous system tumors, trauma, epilepsy and neurosurgical operating room design).

The Journal NEUROSURGERY- In 1992, he was appointed Editor of the journal NEUROSURGERY by the Congress of Neurological Surgeons (CNS). At that time, he established the first professional office of the publication, initiating changes in the content and design, stressing an "avant-garde" progressive position and internationality. In this regard, global representation was initiated on the editorial board. With this action submissions began to rise and content became more diverse. The digital age was rapidly embraced with the field's first CD-ROM offering and Internet website being established. Innovative sections novel to established medical journalism such as "Concepts and Innovations", Video Driven "Operative Nuances" and "Science Times" met with great interest and with enthusiasm by readers-establishing the publication as a unique entity. The freshness and energy of the publication drew attention as did innovations, content and supplemental offerings. The journals ideas style and spirit was rapidly imitated by other clinical, medical and scientific journals.

Total submissions rose from approximately 650 in 1992 to over 2,500 in 2005; printed paper pages with supplements increased from 2,000 to nearly 4,000 in 2005. Global reader penetration increased astronomically, from 6,000 in 1992 to 13 million in 2005 with the acquisition of content by OVID. In OVID's data platform Neurosurgery was bundled with the New England Journal of Medicine (NEJM) and the Journal of the American Medical Association (JAMA) as a leading surgical journal as part of the elite "A list", which was comprised of only 8% of it's 1,700 offerings. The citation index became the fields highest as the journal became generally regarded as the fields premiere publication.

Advertising pages and revenue lead the field to testify to the industries recognition of the publications singular importance. The journal became the field's most financially successful publication with revenues employed by the CNS to ensure the scope and qualities of its mission-to enhance research and educational opportunities in neurological surgery.

In January 2005, Operative Neurosurgery a regularly quarterly supplement of the journal was initiated expanding publications scope and effort.

His three-volume work Surgery of the Human Cerebrum was published in 2009 as a 1600 page supplement.

He is now Emeritus Editor of the Congress of Neurological Surgeons Publications and Media Consortium. He has been elected Editor-in-Chief and founder of the World Federation of Neurosurgical Societies global journal World Neurosurgery, which publishes its first edition in January 2010.


Education and Scholarship
He has been an ardent advocate for internationalism, education and facilitated global communication.

He has presented more than 60 keynote, named or commemorative lectures including, the Richard C. Schneider, Theodore Kurze, Theodore Rasmussen, Wilder Penfield, Herbert Olivercona, Sixto Oberador, and Nobel Forum Academic Events. He has given more than 600 platform presentations. He has conducted more that 140 invited professorships world wide while holding principle leadership positions in program and educational committees of nearly all-major national and international groups.

The late 1980's and early 1990's he introduced internationalism through the scientific program of the American Association of Neurological Surgeons (AANS) heralding a change toward globalism in organized neurosurgery. In addition, he introduced expansion of the number and intellectual scope of practical course offerings, seminars and special lectures, which have become the hallmark of all national and many international meetings thereafter.

He has held positions of Leadership and Council in virtually all-major national and international neurosurgical societies and has been called upon in advisory positions for four American Presidents.

He has served on more than 25 editorial review boards.

Honors and Awards
Based on these contributions he has received numerous honors and awards. The most significant include:

1. Honored Guest Laureate
Annual Meeting of the Congress of Neurological Surgeons- generally regarded as the principle academic honor in neurosurgery. San Diego, California USA

2. Sixto Obrador Medal
For "unique contributions to neurosurgery", presented by Sophia Queen of Spain and the World Health Organization. El Escorial, Madrid, Spain

3. Herbert Olivercrona Medal
The first of such presented for "innovations in neurosurgery" by the Karolinska Institute. Stockholm, Sweden

4. William Beecher Scoville Prize
For "unique contributions for the art and science of neurosurgery" from the World Federation of Neurosurgical Societies. Sydney, Australia.

5. The GAGNA A. & Ch. VAN HECK Prize
For "work in the development of treatment of untreatable diseases" from the National Foundation for Scientific Research. Brussels, Belgium.

6. Honorary Doctorate "Pro Causa"
"For unusual contributions to the field of medicine" Italian National University System.
Rome, Italy

7. Honorary Society Memberships
He has been awarded Honorary Society Memberships in many of the world's major national and regional neurosurgical societies including Japan, Germany, Brazil, Italy, Austria, Korea, Greece, Norway, Sweden, Scandinavia, China and Turkey.

8. Apuzzo Society for Clinical and Laboratory Research
Established at Yale University School of Medicine.

9. Apuzzo Lecture on Creativity and Innovation
Established by the Congress of Neurological Surgeons as Keynote Lecture of Annual Meeting (in perpetuity).

10. University Medal, Boston University
For unusual contributions to the field of medicine and the advancement of surgery of the central nervous system.

11. Recipient Gold Medal, University of Messina
Leadership and Academic Internationalization in Medicine, Science and Humanities

12. The Michael L.J. Apuzzo Professorship for Advanced Neurological Surgery
Established at The University of Southern California Keck School of Medicine.

13. Recipient Vihelm Magnus Medal, Oslo, Norway
To honor distinguished neurosurgeons of our time who have influenced modern neurosurgery.

14. Recipient Designation Francesco Durante International Prize, Messina, Italy
For extraordinary contributions to the field of neurosurgery. (Recipient Designate
April 2010)


Additional Activities
Sports

Having a background and interest in sports, he is principle Neurosurgical Consult for the University of Southern California Trojans Athletic Department and the New York Football Giants. Additionally, he is advisor to the National Football Leagues Committee on Head Injury. He serves as consultant to the activities of teams and clubs of the National Football League, Major League Baseball, the National Hockey League and the National Basketball Association.



Featured Articles:




Editorials:



WORLD NEUROSURGERY, Editor-in-Chief, 2009-
WORLD NEUROSURGERY Online, Editor-in-Chief, 2009-

Neurosurgery, Editor Emeritus 1991-2009
Neurosurgery's Operative Nuances, Editor-in-Chief, 2002-2009
Neurosurgery's Science Times, Editor-in-Chief, 2002-2009
Neurosurgery-Online, Editor-in-Chief 1999-2009

Education:

  • Boston University School of Medicine, MD, 1965

Internships:

  • Royal Victoria Hospital, McGill University Montreal, Surgery, 1965 - 1966

Residencies:

  • Yale University Health Services Center, Neurological Surgery, 1966 - 1973

Fellowships:

  • Yale School of Medicine, Post-Doctoral Fellow - Neuropathology, 1967
  • Yale School of Medicine, Post-Doctoral Fellow - Neurophysiology, 1971

Board Certification:

  • American Board of Neurological Surgery
  • American Association of Neurosurgery
  • Congress of Neurosurgery
  • Academy of Neurosurgery

Professional Society Memberships:

  • American Association of Neurosurgery
  • Congress of Neurosurgery
  • Academy of Neurosurgery

Awards:

  • Honored Guest Laureate--Annual meeting of the Congress of Neurological Surgeons generally regarded as the principle academic honor in neurosurgery. San Diego, CA.
  • Sixto Obrador Medtal--For Herbert Olivercrona Medical--the first of such presented for William Beecher Scoville Prize--for the GAGNA A. & Ch. VAN HECK Prize.
  • Achievement Award, World Health Organization and World Federation of Neurological Surgery at Continental Congress “Neurosurgery and Public Health”, Madrid, Spain, March 1996
  • Sixto Obrador Gold Medal by Queen Sophia of Spain, World Health Organization (WHO), World Federation of Neurological Surgery, El Escorial, Madrid, Spain, March 1996
  • Herbert Olivecrona Award (Medal) presented by American Ambassador’s Office upon selection by the Karolinska Institute, Stockholm, Sweden, December 1998
  • William Beecher Scoville Prize, World Federation of Neurological Societies, Sydney, Australia, September 2001
  • GAGA A. + Ch Van Heck Prize, The National Foundation For Scientific Research, Brussels, Belgium, May, 2003/Awarded September 2003
  • Francesco Durante International Prize, European Society of Neurosurgery 2010 Medal for Achievement, Society of University Neurosurgeons, Naples/Capri Italy April 2010

Languages:

  • English