A measured approach

The least invasive surgery is no surgery at all. Conservative measures are essential first steps in the spine care journey. Physical therapy, judicious use of non-narcotic medications and targeted injections often successfully alleviate symptoms and should typically be exhausted first.

If these fail to provide sufficient relief, surgery may be beneficial; and the smaller the surgery, the better. Dr. Derman utilizes the least invasive techniques to rapidly get patients back to the activities they enjoy.

Data-driven decision making

Dr. Derman is a data-oriented surgeon. His clinical decisions are informed by scientific literature and evidence-based pathways rather than medical fads.

As a founding member of the Endoscopic Spine Research Group, a highly productive research collective, Dr. Derman has authored numerous scientific papers demonstrating the benefits of endoscopic spine surgery. In addition to employing these advanced techniques in his everyday practice, he is actively shaping the future of the field. He views the endoscope as a platform — a paradigm shift in the treatment of spinal conditions that will continue to expand our ability to treat patients using ultra-minimally invasive means.

Pinpointing the source

Imaging is a powerful tool, but it can be misleading. Beyond the actual source of symptoms, most scans reveal incidental findings that are completely asymptomatic and require no intervention. Patients often end up being offered unnecessarily large or multi-level surgeries that treat the imaging rather than the person.

Dr. Derman views every patient's condition as a unique puzzle and is passionate about identifying the exact pain generator. He invests the time and effort to meticulously correlate the symptoms and physical examination findings with imaging results. This rigorous diagnostic process ensures a targeted plan that treats only what is necessary, sparing healthy anatomy and avoiding the pitfalls of overtreatment. Because every patient’s situation is unique, every surgical plan is tailored specifically to the individual.

Ultra-minimally invasive surgery

The true advantage of endoscopy isn't just tiny incisions. The key to a rapid recovery is preserving the anatomy that matters: the muscle and spinal stabilizing structures.

In these procedures, Dr. Derman maintains the integrity of the soft tissues and leaves the structural bone undisturbed. He utilizes the endoscope to navigate to the problem area with precision, avoiding the collateral damage associated with traditional "open" or even "microscopic" surgery. This approach results in less physical trauma, minimal pain and a faster return to an active lifestyle.

The value of a second opinion

Dr. Derman frequently serves as another opinion for patients who have been told they require traditional spinal surgery. In many cases, a more targeted, endoscopic alternative exists that preserves the natural anatomy, maintains motion and offers a more efficient path to recovery. These ultra-minimally invasive techniques often help patients avoid the need for instrumented procedures, such as fusions or disc replacements, by addressing the underlying issue without necessitating implanted hardware.

Precision over volume

In the traditional medical system, patients find themselves in a model of care that rewards high volume and extensive surgeries. Dr. Derman founded this practice to realign incentives and restore the fundamental doctor-patient relationship.

By adopting a boutique, private-pay structure, Dr. Derman is free to dedicate the time necessary for comprehensive evaluation, meticulous surgical execution and personalized post-operative care. This ensures that the focus remains entirely on the quality of the individual outcome rather than the quantity of cases.