My research efforts document the ground-breaking clinical advances I have achieved as a leader of cross-functional treatment teams that are changing care locally and nationally.
In craniofacial surgery, we have developed and documented multiple novel approaches. We have pioneered the use of particulate skull autograph to fill in cranial defects, markedly reducing the dependence on allografts and allowing for normal skull development. Our work with this has been ongoing for a decade, with both clinical and research components. This has been published for both primary and secondary skull defects, and currently its usage is being expanded internationally.
I am one of the leading surgeons internationally performing minimally invasive endoscopic correction of craniosynostosis. Many aspects of this work have been published, including the marked effect endoscopic surgery has on ocular disorders in coronal synostosis. My work with anesthesiologists and the Craniofacial team validating the efficacy of transexamic acid in craniosyntosis surgery helped established a new standard of care that reduces bleeding in craniosynostosis surgery.
In spinal surgery, orthopedic surgeons and I have published the largest series of modern spinal instrumentation for the cervical spine in children, defining its use for surgeons across the country and setting the standard of care. We have developed a posterior lateral trans-pedicular approach for correction of congenital spinal deformity in children with hemivertebrae, changing the correction from two surgeries to a single procedure. Many surgeons have now adopted this technique, although many consider it too technically challenging and we are therefore referred patients nationally and internationally.
We see over 400 concussion patients each month in the Sports Medicine and Neurology clinics, and I have published the world’s largest surgical series on herniated disks in the pediatric population, identifying several new concepts, including its marked predilection for female athletes.
We have also described a novel approach to dermoid tumors at the skull base, involving removal of the nasal bones to achieve complete resection of the lesion with almost no risk of recurrence. Together with colleagues, I have described the use of intraoperative bone scan for the resection of spinal osteoid osteoma. I have published the largest series on the surgical treatment of intrasacral meningoceles, standardizing the indications for surgery and type of surgical repair.
My clinical work has led to many publications that are defining new standards of care. These include:
Proctor, M. Spinal Cord Injury. Crit Care Med, 2002, 30(11), 489-499.
Rogers GF, Proctor MR, Greene AK, Mulliken JB. Frontonasal osteotomy to facilitate removal of an intracranial nasal dermoid. J Craniofac Surg. 2005 Jul;16(4):731-6.
Greene AK, Mulliken JB, Proctor MR, Rogers GF. Primary grafting with autologous cranial particulate bone prevents osseous defects following fronto-orbital advancement. Plast Reconstr Surg. 2007 Nov;120(6):1603-11.
Hedequist D, Hresko T, Proctor MR. Modern Cervical Spine Instrumentation in Children. Spine. 2008;33(4): 379-383.
Greene AK, Mulliken JB, Proctor MR, Rogers GF. Pediatric cranioplasty using particulate calvarial bone graft. Plast Reconstr Surg. 2008 Aug;122(2):563-71
Hedequist D, Proctor MR. Screw fixation to C2 in children: a case series and technical report. J Pediatr Orthop. 2009 Jan-Feb; 29(1): 21-5
Robinson, S, Proctor, MR. Diagnosis and Management of Deformational Plagiocephaly: A Review. J. Neurosurg Peds., 2009;3(4): 284-295
Blaskiewicz DJ, Sure DR, Hedequist DJ, Emans JB, Grant F, Proctor MR. Osteoid Osteomas: Intra-operative Bone Scan Assisted Resection. J Neurosurg Peds. 2009;4(3):237-244.
Hedequist D, Emans J, Proctor MR. Three rod technique facilitates hemivertebrae wedge excision in young children through a posterior only approach. Spine. 2009; 34(6): E 225-9.
Cahill K, Dunn I, Gunnarsson T, Proctor MR. Lumbar Microdiscectomy in pediatric patients: a large single-institution series. J Neurosurg Spine. 2010;12(2): 165-170
Goobie S, Meier P, Pereira L, McGowan F, Priscilla R, Scharp L, Rogers G, Proctor MR, Meara J, Soriano S, Zurakowski D, Sethna N. Efficacy of transexamic acid in pediatric craniosynostosis surgery: A double blinded placebo controlled study. Anesthesiology. V, 114(4). 2011 (in press).
Ridgway EB, Berry-Candelario J, Grondin RT, Rogers G, Proctor MR. The management of sagittal synostosis using endoscopic suturectomy and postoperative helmet therapy. J Neurosurg Pediatr. 2011, June; 7(6) 620-626.
McCarthy JG, Warren SM, Bernstein JM, Burnett W, Cunningham ML, Edmond JC, Figueroa AA, Kapp-Simon KA, Labow B, Peterson-Falzone S, Proctor M, Rubin M, Sze RW, Yemen T. Parameters of Care for Craniosynostosis Cleft Palate Craniofac J. 2011 Aug 17.
Warren SM, Proctor MR, Bartlett SP, Blount JP, Buchman SR, Burnett W, Fearon JA, Keating R, Muraszko KM, Rogers GF, Rubin MS, McCarthy JG. Parameters of care for craniosynostosis: craniofacial and neurologic surgery perspectives. Plast Reconstr Surg. 2012 Mar;129(3):731-7
Hennelly KE, Mannix R, Nigrovic LE, Lee LK, Thompson KM, Monuteaux MC, Proctor M, Schutzman S. Pediatric Traumatic Brain Injury and Radiation Risks: A Clinical Decision Analysis. J Pediatrics. Aug 22, 2012
Lohani S, Rodriguez DP, Lidov HG, Scott RM, Proctor MR. Intrasacral meningocele in the pediatric population. J. Neurosurg Peds 2013 Apr 19.
Meehan WP 3rd, Jordaan M, Prabhu SP, Carew L, Mannix RC, Proctor MR Risk of Athletes With Chiari Malformations Suffering Catas
Nigrovic LE, Stack, AM, Mannix, RC, Lyons, TW, Samnaliev, M, Bachur, RG, Proctor, MR. Quality Improvement Effort to Reduce Cranial CTs for Children With Minor Blunt Head Trauma Pediatrics Volume 136, number 1, June 2015.