March 21, 2019
Dr. Lawrence Lenke ’82 is a world-renowned spinal surgeon. He is often the last resort for patients from around the globe in need of his life-changing and, in some cases, life-saving abilities. But his interior decorating skills could use some work.
Walk into Lenke’s office at the Och Spine Hospital at NewYork-Presbyterian, and your eyes are drawn to the window behind his desk. It’s not the view of the northernmost tip of Manhattan that grabs your attention. Occupying roughly the bottom third of the large, wall-to-wall window is a collection of three-dimensional models of severely deformed human spines stacked on top of each other in a tenuous balancing act.
These models, which are exact replicas of the spines of patients Lenke has performed surgeries on, are bent and mangled in different directions. In the weeks leading up to his operations, Lenke studies them exhaustively, numbering the vertebrae and memorizing every bump and detail. They serve as his navigation tools during surgeries, and years later, he can pick a model from the pile and quickly identify its owner.
“Every patient is important,” Lenke explains when asked why he adds each new model to the ever-expanding pile. “So I don’t want to throw anything away. No matter if it’s a simple case or a more complicated case, that’s my life’s work.”
His life’s work rarely involves simple cases. In his 27 years of practice, Lenke has established himself as perhaps the world’s most respected and sought-after surgeon specializing in complex spinal deformities. Fellow surgeons often refer their most difficult cases to him, and his research and techniques have driven industry-wide innovations. Now, as surgeon-in-chief at the groundbreaking Och Spine Hospital, he hopes his influence will be even more wide-reaching.
Lenke’s move to New York in 2015 didn’t come without risk. In St. Louis, he had built the country’s leading practice in his specialty. He served on the faculty at Washington University Medical School for nearly 25 years. His wife, Beth, is a St. Louis native, and together they had raised their three children there.
But the opportunity to lead the newly launched Och Spine Hospital in New York City was tantalizing in its potential impact. The facility is unprecedented in terms of the resources devoted to spinal cases. Four of the five operating rooms at the hospital are dedicated to treating spine disease. (The fifth is mainly used for trauma surgeries that come in through the hospital’s emergency room.) By 2022, five more operating rooms reserved for spinal surgeries will be added. The staff, from doctors and nurses to technicians and therapists, only work on spinal patients, raising their expertise and ensuring the highest quality of care.
Similar facilities exist for other specialties, like heart surgery or neonatal intensive care, but the Och Spine Hospital is the first of its kind, and Lenke believes it will play a critical role in advancing the field.
“That’s really why I came,” Lenke explains. “Honestly, for our profession as spinal surgeons more than individual accolades.”
Lenke already has accumulated a lifetime’s worth of accolades. The first in his family to graduate from college, Lenke credits his time at Notre Dame with instilling in him a desire to help those in need. He went on to medical school at Northwestern University, gravitated toward orthopedic surgery, and ultimately chose to specialize on the spine because it was so challenging.
In St. Louis, Lenke became a master of complex surgeries thanks to his tireless work ethic. While most spinal surgeons operate two or three days per week, Lenke performed surgeries five days per week most weeks for 15 years. As he saw more and more cases, he grew more and more comfortable tackling the most difficult ones.
“I wasn’t really better than anybody,” Lenke says. “I just had more experience.”
The patients who visit Lenke suffer from severe scoliosis and other spinal deformities that can cause a wide range of serious health issues, from heart and lung problems to the loss of the ability to walk or use the bathroom normally. The father of three—two of his children also attended Notre Dame—strives to approach each surgery as if his own child is on the operating table.
In one of his most memorable cases, a 14-year-old named Svetlana who traveled from Moscow had such severe scoliosis that her spine was putting pressure on her heart and lungs, dangerously restricting her ability to breathe. Lenke performed a vertebral column resection (VCR), a procedure that involves removing one or several vertebrae, separating the spinal column into two pieces, and then realigning the spine to make it straighter without overstretching the spinal cord. After the surgery, Svetlana, who had been severely hunched over, gained 13 inches in height. She moved back to Russia and eventually became a model.
“I’m very, very privileged to be able to take care of people like that who are very desperate,” Lenke says. “Often I’m the end of the line for them. If I can’t help them, really they can’t be helped. Fortunately, that rarely happens.”
Lenke helped popularize the VCR technique he performed on Svetlana. He also was an early advocate for most spinal surgeries being performed by entering from the back, which is easier on patients, rather than from the side or front, which used to be the standard. Perhaps his most ubiquitous legacy is the creation of the Lenke Classification System, a new method for categorizing scoliosis into certain types that Lenke introduced in 2001. It remains the worldwide standard used by most spinal surgeons.
Lenke shrugs off invitations to reflect on his achievements. “I don’t really have time to dwell on it,” he says, “because, honestly, if the next case of mine goes sour, it doesn’t really matter.”
What matters to Lenke, more than anything, is changing the lives of his patients. It’s why he became a doctor in the first place. It’s why he focuses on the most complex spinal disorders. And it’s why he obsessively studies those three-dimensional models and prepares so thoroughly for each surgery.
“I make the sign of the cross before I go in the O.R., and basically I do my best,” Lenke says. “And usually that’s good enough, thankfully.”