Dr Abdulaziz Al Kuwari

Pushing the frontier of spine surgery in Qatar

In the field of spinal surgery, where precision and expertise are of utmost importance, Dr Abdulaziz Al Kuwari, the CEO of Aspetar Hospital and a Specialist Consultant in Orthopaedic and Spinal Surgery at Al-Ahli Hospital, is a pioneering force. As the first Qatari spine surgeon, he has dedicated his career to addressing the intricate challenges posed by complex spinal disorders, ranging from spinal trauma to degenerative diseases. 

Beyond his clinical contributions, Dr Al Kuwari is equally committed to education and research, enriching the medical landscape in Qatar and beyond. He has chaired prominent spine conferences and is a valued member of AOSpine. Yet, his passion for a holistic approach to health extends beyond the operating room, as he is not only a certified scuba and free diver but also a Co-founder and Director of the Qatar Cyclists Centre. In his belief that sport is a way of life, he has actively contributed to numerous health initiatives, solidifying his status as a health activist with a mission to enhance well-being. 

In this interview, Dr Al Kuwari shares his remarkable journey and insights into the world of spine surgery, offering a glimpse into his multifaceted commitment to health and healing. 

Could you provide us with further insights into your path to becoming an orthopaedic surgeon? What motivated you to choose this field?

I embarked on my journey into the field of medicine at the Royal College of Surgeons in Ireland in 1998 and successfully completed my studies in 2005. Following graduation, during my internship, I found myself uncertain about my career path. However, I soon made a resolute decision to pursue a career in surgery. I initially joined the field of general surgery, with a particular interest in plastic surgery due to its intricate reconstructive aspects.

My fascination with reconstructive work extended to orthopaedics, where I found myself captivated by the intricacies of orthopedic reconstruction, particularly in cases related to the spine. Working alongside a visiting surgeon from France, Dr Michael, who specialized in scoliosis surgery, further fueled my interest in the field. This intricate procedure involved opening the chest, repositioning the lungs and heart, and securing the spine with screws. With my passion for tackling challenges and my commitment to contribute to my nation, I made the determined choice to become Qatar’s first orthopaedic spine surgeon. 

Despite being fully aware of the daunting challenges inherent in this field, my determination remained firm. I completed five years of orthopaedic training at Hamad Hospital, achieving my goal of becoming an orthopaedic surgeon. Subsequently, I embarked on a two-year fellowship and pursued a Master’s in Science of Surgery at the University of Western Ontario, Canada. 

In 2014, my tenure as an orthopaedic consultant commenced at Hamad Hospital. Initially intending to avoid the most challenging cases, fate led me toward complex surgeries that many hesitated to undertake. I embraced these challenges and successfully performed numerous intricate procedures. One case that left a lasting impression was a lumbar corpectomy, necessitating the removal of multiple vertebras to correct a severe deformity in a patient paralyzed since birth. The surgery’s success became even more rewarding when, eight years later, the patient, now a journalist, interviewed me during the FIFA World Cup Qatar 2022.

At the age of 37, I assumed the role of CEO at Aspetar. Despite administrative responsibilities, my passion for surgery and dedication to my patients remained unwavering. The hospital’s higher management supported my commitment to surgical practice, allowing me to continue performing surgeries at HMC, dedicating one day each week to this endeavour. Additionally, I occasionally supported the HMC team with challenging cases.

After four years, I transitioned to private practice at Al Ahli Hospital, now holding clinic sessions there twice a week from 3pm to 8pm.

 You are an expert in both minimally invasive and open complex spine surgery. Can you explain the differences between these methods and when each is best for patients?

Surgical approach depends on the specific problem. Sometimes, a minimally invasive procedure is better, but if a problem recurs, success rates drop for a second surgery. For instance, fusion may be needed initially, as smaller procedures can worsen spinal issues over time. Simple procedures like microdiscectomy can work, but more extensive ones may be necessary. Evaluating each case individually and considering available resources is vital for surgical decisions.

How do you diagnose a patient’s condition? What methods do you use to monitor their recovery post-surgery?

The process starts with a thorough patient history and clinical exam, as imaging can sometimes mislead. For instance, lumbar stenosis, involving spinal canal compression, can manifest symptoms resembling peripheral vascular disease in the leg. Without a thorough examination and history-taking, there’s a risk of misdiagnosis, with the focus on the spine while the real problem lies elsewhere. 

Following a comprehensive clinical history and examination, a plan for investigations is made, including blood tests and X-rays or MRIs as needed. Choosing the right X-ray depends on the issue; standing X-rays can show spinal alignment. In cases of spinal instability, fusion surgery with screws for stabilization is essential to prevent worsening. Skipping fusion in unstable cases can lead to dissatisfaction.

Can you share your most successful medical case so far? What factors do you believe played a crucial role in achieving that success?

It’s the journalist’s case I mentioned earlier. When it comes to the factors contributing to its success, I believe it can be attributed to a meticulous examination and in-depth analysis of the case, along with a well-structured post-operative plan coupled with thorough patient education. The significance of physiotherapy cannot be overstated in ensuring the success of any surgical procedure. Even if the surgery is flawlessly executed, without a clear post-operative plan and a competent support team, an orthopaedic surgeon’s success is jeopardized. This is why it forms a complete and essential cycle. At Al Ahli Hospital, I take immense satisfaction in entrusting my patients to my team. The reason I chose Al Ahli over other centers is because of the dependable team that can step in to care for my patients in my absence. Furthermore, the comprehensive physiotherapy and rehabilitation services provided at Al Ahli are pivotal in ensuring a patient’s safe recovery journey and the achievement of the surgical objectives.

 How do you stay updated with the latest treatments and advancements in orthopaedic surgery?

Development is ongoing in our field, but we should stick to the standard of care. New advancements come and go; caution is needed when choosing treatments. For example, lumbar disc replacement gained popularity, but after a few years, studies showed no advantages over fusion with cages and screws. We must be prudent and wait for long-term results before changing our practice. 

There are well-known conferences that every surgeon should attend to stay updated on recent developments. Additionally, engaging in day-to-day education and discussions with colleagues holds great importance. Discussing cases with peers is a valuable practice because they may present challenges or offer alternative perspectives that one may not have considered. These discussions can lead to new discoveries and foster continual learning and self-improvement.

You’ve chaired and participated in various local and international spine conferences. Could you share some key takeaways or insights from these experiences that have influenced your approach to patient care?

I’m a member of AOSpine, and I recently assumed the role of Education Officer Chair for GCC AOSpine. AOSpine is a highly esteemed organization in the field of orthopaedics. Being a part of such associations provides numerous opportunities. I’m also on the AFC Medical Committee representing the Qatar Football Association. I have treated many footballers for spine injuries, and when such injuries occur in athletes, they can be catastrophic and potentially career-ending. Therefore, it is crucial to provide prompt and proper management for these patients. 

Furthermore, we are currently collaborating with AOSpine to organize the inaugural Athlete Spine Symposium, scheduled to take place at Aspetar on November 4th. During this symposium, we will discuss recent updates and the best practices for managing spine injuries in athletes.

You are also the Co-founder and Director of Qatar Cyclists Centre. How do you balance your medical career with your passion for cycling?

I believe our responsibilities as physicians extend beyond the clinic. We should serve as role models for our patients. I make a conscious effort to demonstrate that, despite my busy schedule, I still find time for physical activity. A significant portion of my time in the clinic is dedicated to encouraging people to engage in sports. When individuals suffer orthopaedic injuries, the most effective treatment often involves physiotherapy, which typically lasts for six to ten sessions. However, it’s crucial to emphasize that if they don’t continue with regular exercise, the problem may recur. The human body possesses an incredible capacity to adapt to challenges, but this adaptation requires encouragement, which is achieved through physical activity. This not only helps prevent injuries but also serves as a highly effective approach to treating them, even when they occur.