James R. Rappaport, M.D.

Headshot of Dr. James R. Rappaport
Head shot of Dr. James R. Rappaport

James R. Rappaport, M.D.

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Biography

Dr. Rappaport has been in practice, academic and private since 1986. He believes in conservative approach to spine problems. Dr. Rappaport is a strong proponent of education and participates as a clinic instructor of the University of Nevada Reno Family practice and fellowship training programs. Dr. Rappaport also invites residents and medical students to intern with Sierra Regional Spine for educational purposes.

Dr Rappaport believes in a conservative approach. He prefers to exhaust all non surgical treatment before performing surgery. Providing High Tech care with old fashioned caring.

Medical Licensure

Professional Memberships

logo of the University of Nevada
US Ski Team Logo
Personal Affiliation
stanford university logo

Education

Spinal Surgery Fellowship

7/87 – 12/87

John O’Brien, Ph.D., F.R.C.S., F.A.C.S.
London Clinic 20 Devonshire Place,London, W1G 6BW
T: +44(0)20 7935 4444

Spinal Surgery Fellowship

7/1/86 – 6/30/1987

Spinal Surgery Fellowship, Texas Institute for Spinal Disorders
Director: Alexander E. Brodsky, M.D., Baylor University
St. Luke’s Episcopal Hospital, Texas Medical Center
2450 Holcombe Blvd, Ste 1, Houston, Texas 77021
T: 713-791-6161

Orthopaedic Surgery Residency

8/1982 – 6/1986

University of California
55 Laguna Street, San Francisco, California 94102-6232
T: 415-252-3016

Medicine
1976 – 1980

University of California School of Medicine, (M.D.)
55 Laguna Street, San Francisco, California 94102-6232
T: 415-252-3016

Bachelor of Science
1972 – 1976

Stanford University, Bachelor of Science – Biology
Stanford, California 94305
T: (650) 723 2300

High School
1970 – 1972

Ed Modena High School, Orange, California

High School
1969 – 1970

Villa Park High School, Villa Park, California

Honors & Awards

Appointments

Northern Nevada Representative

Nevada State Medical Association

Principal Investigator

Medtronic Evolve Study

Principal Investigator (2005 - present)

Kineflex™ Lumbar and Cervical Disc Replacement, Clinical Trials, St Mary’s
Regional Medical Center, Reno, NV., 2005 to present

Principal Investigator

Benvenue “KIVA” Study

Team Physician (1998 to present)

U.S. Ski and Snowboard Association

Assistant Clinical Professor

University of Nevada, Reno 2002 – Current
Assistant Clinical Professor, University of California, San Francisco 1987 – 1996

Chairman

American Back Society (Annual Meeting 1998, 1999)

Commander

U.S. Navy Reserve – Retired

Attending Physician

Spine Center, University of California,
San Francisco General Hospital, 1986 – 1993

Assistant Clinical Instructor

Orthopaedic Surgery, Baylor College of Medicine
Houston, Texas, July 1986

Spinal Surgery Representative

United States Department of Defense
Spine Center of Excellence Project, 1999 – 2000, Washington, D.C.

Courtesy Staff Physician

San Francisco State University Football, 1983

Staff Physician & Surgical Consultant

Sequoia Hospital, 1988

Surgical Consultant
Sequoia Pain Treatment Center, 1988

Presentations

Northeastern Nevada Regional Hospital. “Treating Vetebral Compression Fractures and Improving Quality of Life.” Elko, NV. October 10, 2013.

American Back Society Annual Meeting. “Minimally Invasive Lumbar Disc Surgery” Las Vegas, NV June 18-20, 2008

20th Contemporary Update on Spinal Disorders. “Sacroiliac Dysfunction after Lumbar Fusion,” Whistler, British Columbia, Canada January 19-23, 2008.

American Back Society Annual Meeting. “Return to Sport After Cervical Spine Injury,” Las Vegas, NV May 2007.

Spine Network of California “Less Invasive Lumbar Discectomy,” Las Vegas, NV October 19-20 2007

Spine Specialist Advanced Training Course. Lecture, “Anatomy and Physiology of Spinal Disc and Bone,”
San Diego, California, February 13, 2006.

Washoe Medical Center CME Committee, Lecture, “High Tech Care Old Fashioned Caring,” November 16, 2005.

University of South Florida Annual Spine Conference. Moderator: Artificial Disc Replacement Panel and Instructor: Hands on Laboratory Skills for Coblation Technology. Whistler, B.C. January 17-22, 2005.

Nevada Chiropractic Association. Lecturer: “Spinal Cord Injury Update”. Reno, NV December 4, 2004

Surgeon Training course. “Kyphoplasty”. Minneapolis, MN. November 5, 2004.

7th Annual Spine Conference. “Spine Pathology: An Update”. Spinal Cord Injuries South Lake Tahoe, California. September 25, 2004.

4th Annual Complex Case Spine Symposium: Less Invasive Microdiscectomy. Olympic Valley, CA., April 4, 2004

Advanced Concepts in Minimally Invasive Vertebral Compression Fracture Management. Texas Medical Center, Houston, TX. February 28, 2004

Symposium Moderator. “Update on Spinal Cord Injury”

16th Annual Update on Disorders of the Spine. “Minimally Invasive Lumbar Discectomy” -lecture and lab. Whistler, BC January 17-23, 2004

Kyphoplasty, Surgeons Training Course – Faculty. Minneapolis, Minnesota, November 7, 2003

Neurosurgical & Orthopedic – Faculty. Graduating Spine Surgery Fellows Course “Current Concepts in Vertebral Fracture Management”, Memphis, Tennessee September 5, 2003

Kyphoplasty, Surgeons Training Course – Faculty. Stanford University, California August 15, 2003

World Spine Congress – Faculty. “Minimally Invasive Spine Symposium”
Chicago, Illinois, August 10, 2003

American Academy of Orthopedic Surgeons – Learning Center Lecturer, Rosemont, Illinois Coblation Assisted Microdiscectomy, November 11, 2003

Percutaneous Discectomy, Lecture and lab. November 11, 2003

48th Annual Visiting Professorship, Leroy C. Abbott Society
“Coblation Assisted Microdiscectomy “University of California, San Francisco, May 2, 2003

Kyphoplasty
Reno, NV March 2003

15th Annual Contemporary Update on Disorders of the Spine. University of South Florida, January 18-24, 2003 “Minimally Invasive Lumbar Discectomy.” Whistler, BC

15th Annual Contemporary Update on Disorders of the Spine.
“The Future of Spinal Cord Injury Treatment” Whistler, B.C. January 2003.

North American Spine Society Annual Meeting “Axial Cage: A New Device for Treatment of Spondylolisthesis” Scientific Poster Exhibit – Seattle, Washington 2003

“Axial Cage: A new device for an old procedure” Poster Presentation, American Academy of Orthopedic Surgeons, 2004.

Emerging Technologies in Spinal Surgery Conference. “Coblation Assisted Minimally Invasive Microdiscectomy” Washington, D.C. October 2002.

14th Annual Contemporary Update on Disorders of the Spine
“Future Treatment of Spinal Cord Injury” University of South Florida, January 2002.

The American Back Society. “Kyphoplasty – Technique and Results”
Vancouver, Canada December 2001

Sierra Valley Spine Society. “A History of Anterior Lumbar Surgery”
Squaw Valley USA, April 2001

Surgical Consideration in the Osteoporitic Spine, January 2001
University of South Florida

University of Southern Florida – Spine Center Course
Axial Cage for Spondylolisthesis – A New Technique, January 2001

“Anterior Lumbar Fusion” – Advances and Techniques
University Medical School, Bialystok, Poland March 1998

American Back Society. “Anterior Lumbar Fusions – Concepts and Advances.” Las Vegas, Nevada 1998

University of California. “Anterior Cervical Discectomy and Fusions – Technical Aspects.” San Francisco, California October 1997

SPINETECH BAK Surgical Course
Faculty, Sacramento, California, November 1997

“Current Concepts of European Spine Practice”
Baylor University, April 1988

Stanford University of Orthopaedic Grand Rounds, “Pathogenesis and Treatment of the Degenerative Lumbar Disc” November 1988

American Academy of Orthopaedic Surgeons. “Treatment of Proximal Humerus Fractures” San Francisco, California 1987

University of California Rounds “Locating the Offending Disc,” Rappaport, J. Weitz, E. November 1983

Publications

Rappaport, James R. MD. Site Investigator and member of research team. “KAST Study: The Kiva System As a Vertebral Augmentation Treatment- A Safety and Effectiveness Trial.” SPINE, VOL 40, No 12 June 2015.

Rappaport, J.: “Kineflex/C Cervical Artificial Disc” Motion Preservation Surgery of the Spine, Advanced Techniques and Controversies, Chapter 31, pages 258-268. Yue, James, J. et al. Saunders Elsevier 2008

Alamin, T., Rappaport, J.: “Coblation-Assisted Microdisc (CAM) Improving a Gold Standard”
Research Outcomes in Spine Surgery, January 2003

Rappaport, J.: “Less Invasive Microdiscectomy Improving a Gold Standard”
Research Outcomes in Spine Surgery, October 2002

Rappaport, J., Weitz, E.: “Locating the Offending Lumbar Disc.” Videotape
University of California Publications, 1983

Rappaport, J., Maurer, R., Nicholar, R.: “Surgical Treatment of Bone Infection”
Abbott Society Proceedings, June, 1985

Rappaport, J., Day, L.: “Conservative vs. Surgical Treatment of Long Bone Fracture.”
Abbott Society Proceedings, June 1985

Rappaport, J. Weitz, E.: “Locating the Offending Disc,” Video, University of California San Francisco Medical Library, November 1983

Rappaport, I., Rappaport, J.: “Congenital Arteriovenous Fistula of the Maxillofacial Region”
American Journal of Surgery, Vol. 134, July, 1977

FDA Clinical Trials

Patents Owned or Pending
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Artificial Disc Replacement

At Sierra Regional Spine Institute, we believe that the future is restoration of anatomy and function through motion. The artificial disc replacement is the answer to that problem. Sierra Regional Spine Institute continues to be a leader in Nevada when disc replacement surgery is needed.
It is a surgical procedure in which degenerated intervertebral discs in the spinal column are replaced with artificial disc implants in the lumbar or cervical spine.

The procedure is used to treat chronic, severe low back pain and cervical pain resulting from degenerative disc disease.

Artificial disc replacement has been developed as an alternative to spinal fusion, with the goal of pain reduction or elimination, while still allowing motion throughout the spine. Another possible benefit is the prevention of premature breakdown in adjacent levels of the spine, a potential risk in fusion surgeries.

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Revision Spine Surgery

Revision spine surgery is a surgery procedure performed in certain patients to correct the problems of earlier spine surgery. Revision surgery is only when working with patients who experience chronic pain or any worsening symptoms even after the initial surgery.
Other factors that can indicate the need for revision spine surgery include:

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Decompression

At Sierra Regional Spine Institute we use Decompression in a few ways to treat and make the process of recovery smoother for people with fractures: Microdiscectomy, Microendoscopic Laminectomy, Minimally Invasive Cervical Foraminotomy (MICF), Vertebroplasty and Kyphoplasty.

Microdiscectomy

Microdiscectomy, also called microlumbar discectomy (MLD), is a very common MIS decompression procedure performed in patients with a symptomatic lumbar herniated disc. The operation consists of removing the portion of the intervertebral disc that is herniated and compressing a spinal nerve root.

Minimally Invasive Cervical Foraminotomy

This is a MIS cervical foraminotomy decompression procedure that enlarges the space in which a spinal nerve root exits the cervical spinal canal (intervertebral foramen). This narrowing can be caused by a herniated disc, bone spurs, thickened ligaments or joints, which may result in pinched nerves.

Vertebroplasty

Vertebroplasty for the treatment of vertebral compression fractures (VCFs) was introduced in the United States in the early 1990s. The procedure is usually done on an outpatient basis, although some patients stay in the hospital overnight. The procedure may be performed with a local anesthetic and intravenous sedation or general anesthesia.

Using x-ray guidance, a small needle containing specially formulated acrylic bone cement is injected into the collapsed vertebra. The cement hardens within minutes, strengthening and stabilizing the fractured vertebra. Most experts believe that pain relief is achieved through mechanical support and stability provided by the bone cement.
Kyphoplasty
Kyphoplasty involves an added procedure performed before the cement is injected into the vertebra. First, two small incisions are made and a probe is placed into the vertebral space where the fracture is located.

The bone is drilled and one balloon (called a bone tamp) is inserted on each side. The two balloons are then inflated with contrast medium (which are visualized using image guidance x-rays) until they expand to the desired height and removed. The spaces created by the balloons are then filled with the cement. Kyphoplasty has the added benefit of restoring height to the spine.

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Cervical Fusion

Cervical Fusion is an operation that creates a solid union between two or more vertebrae in the upper spine (neck) area. This procedure may assist in strengthening and stabilizing the spine and may thereby help to alleviate severe and chronic back pain.
The best clinical results are generally achieved in single-level fusion, although fusion at two levels may be performed in properly selected patients.

Bone grafts may be taken from the hip or from another bone in the same patient (autograft) or from a bone bank (allograft). Bone graft extenders and bone morphogenetic proteins (hormones that cause bone to grow inside the body) can also be used to reduce or eliminate the need for bone grafts.

Fusion sometimes involves the use of supplemental hardware (instrumentation) such as plates, screws, and cages. This fusing of the bone graft with the bones of the spine will provide a permanent union between those bones. Once that occurs, the hardware is no longer needed, but most patients prefer to leave the hardware in place rather than go through another surgery to remove it.

Fusion can sometimes be performed via smaller incisions through MIS techniques. The use of advanced fluoroscopy and endoscopy has improved the accuracy of incisions and hardware placement, minimizing tissue trauma while enabling an MIS approach.

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Lumbar Fusion

This is a MIS technique that is performed in patients with refractory mechanical low back and radicular pain associated with spondylolisthesis, degenerative disc disease, and recurrent disc herniation. The procedure is performed from the back (posterior) with the patient on his or her stomach.

Using x-ray guidance, two 2.5-cm incisions are made on either side of the lower back. The muscles are gradually dilated and tubular retractors inserted to allow access to the affected area of the lumbar spine.

The lamina is removed to allow visualization of the nerve roots. The disc material is removed from the spine and replaced with a bone graft and structural support from a cage made of bone, titanium, carbon-fiber, or a polymer, followed by rod and screw placement.

The tubular retractors are removed, allowing the dilated muscles to come back together, and the incisions are closed. This procedure typically takes about 3 to 3 1/2 hours to perform.

Outcome & Benefits

Pioneers of both surgical and non-surgical techniques

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Minimally Invasive Spine Surgery

MIS was first performed in the 80s but has recently seen rapid advances. Technological advances have enabled surgeons to expand patient selection and treat an array of spinal disorders, such as degenerative disc disease, herniated disc, fractures, tumors, infections, instability, and deformity.
This can result in quicker recovery, decreased operative blood loss, and speedier patient return to normal function. In some MIS approaches, also called, “keyhole surgeries,” surgeons use a tiny endoscope with a camera on the end, which is inserted through a small incision in the skin. The camera provides surgeons with an inside view, enabling surgical access to the affected area of the spine.

Benefits of Minimally Invasive Surgery

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