Lali Sekhon1-3, Jin Ye Yeo4
1Partner and Board of Directors, Reno Orthopedic Center; 2President, ThinkFirst of Northern Nevada; 3Adjunct Clinical Professor, University of Nevada, Reno, USA; 4JSS Editorial Office, AME Publishing Company
Correspondence to: Jin Ye Yeo. JSS Editorial Office, AME Publishing Company. Email: jss@amegroups.com
Expert introduction
Dr. Lali Sekhon (Figure 1) is an experienced neurosurgeon with expertise in spine trauma, arthroplasty, IP and cervical spine surgery. He has special expertise in the diagnosis and management of many conditions including cervical myelopathy, sciatica, arm pain, back pain, neck pain, degenerative disc disease, spondylolisthesis, spinal tumors, and trauma. He has been dedicated to clinical practice, research and teaching for 24 years with over 100 publications and over 8 patents. He is currently in private practice in Reno, Nevada.
Dr. Sekhon is a member of numerous prestigious organizations including the American College of Surgeons, Congress of Neurological Surgeons (CNS), Joint Section AANS/CNS Spine and Peripheral Nerve, North American Spine Society (NASS), Royal Australasian College of Surgeons, and others.
Figure 1 Dr. Lali Sekhon
Interview
JSS: What inspired you to pursue neurosurgery?
Dr. Sekhon: My dad was a physician, and I just wanted to be a doctor. I think being a physician is the ultimate privilege. When I was in medical school, I liked the challenge of the more difficult specialties including cardiothoracic and neurosurgery. I had a sub internship at Yale New Haven Hospital, and the surgeons there seemed to be happy doing what they were doing and there was a variety of work. I was sold.
JSS: Your research spanned several critical areas in spine surgery. Could you share which of your research projects you consider most groundbreaking, and what led you to pursue it?
Dr. Sekhon: After my internship at Yale New Haven Hospital, I went into Prof. Michael Morgan's laboratory to complete a PhD, at the University of Sydney. Prof. Morgan is a pioneering and world-renowned cerebrovascular neurosurgeon. My PhD defined a new category of cerebral ischemia, chronic cerebral ischemia, which was a noninfarctional reduction in blood flow. I looked at this in an animal model and defined the electrophysiological, histopathological, and behavioral effects of chronic hypoperfusion by maintaining an animal model with a 25-50% reduction in cerebral blood flow for six months. The irony is that this is probably the biggest thing I have ever done, but it is also a sleeper. There is no doubt that reductions in blood flow happen to our brains over time. This may be one of the links to aging and possibly dementia. It is an area that really has not been explored. I loved working in an area where nobody had worked before.
JSS: Research in neurosurgery can be demanding. What challenges have you faced in your research endeavors, and how did you overcome them?
Dr. Sekhon: I think the biggest challenge with research is balancing family life, clinical duties, and research. In my first five years of practice, I was in academic medicine. I then went into private practice. I was still engaged for at least two decades in teaching. My research was more selective. Over time, my research morphed into product development, with the idea being not just changing the life of the next patient you see but also trying to change the lives of the next generation.
JSS: Your work is recognized both clinically and academically. How do you ensure that your research has practical, real-world applications that benefit patient care?
Dr. Sekhon: 99% of what I read in publications is not relevant a year later. I am very selective about what I write now. To me, the most important part of research is solving a problem. There is certainly a role for descriptive research. But you need to ask a question, and you need to solve the problem. I like asking questions that no one else might want to ask.
JSS: How has collaborating with international research institutions, such as those in Australia and North America, influenced the direction and impact of your research?
Dr. Sekhon: Most of the research that I have performed is self-directed. I do have colleagues in Australia and throughout the US, and we have collaborated on work. I think the key here is networking and finding like-minded individuals. With the Internet, the connectivity we all have through so many media is amazing, and distance does not really interfere with research.
JSS: In your view, what are the most pressing research questions currently facing spine surgery, and how do you plan to contribute to addressing them?
Dr. Sekhon: There are so many “whys” in spine surgery. Why did we do what we did? Why does this happen? I think the most pressing research questions for spine surgeons are outlining indications and defining the ideal treatments. Right now, surgical indications are all over the place, with multiple solutions being offered by surgeons depending on training and ability. Answering these questions is crucial because spine surgery has a lot of variability in terms of what individual surgeons will do and when they will intervene.
JSS: How has your experience been as an Editorial Board Member of JSS?
Dr. Sekhon: I am honored to be part of the board. I think it is an outstanding vehicle for surgeons to present their research and clinical data. The journal has done a phenomenal job of providing high quality publications in an open access format.
JSS: As an Editorial Board Member, what are your expectations for JSS?
Dr. Sekhon: To continue to provide high quality peer-reviewed publications in an open access format for spine surgeons throughout the world.