Dr Andrew Cannestra is a fellowship-trained neurosurgeon with a focus on spine surgery and spinal cord injury. Over the course of his career, he has built a reputation as both a skilled surgeon and a leader in advancing minimally invasive approaches to spinal care.
He served as Director of the Baptist Robotic Spine Surgery programme, where he helped shape one of the leading clinical teams in the field.
As a founding member of the Society for Minimally Invasive Spinal Surgery, Dr Cannestra has been at the forefront of surgical innovation. He is a Diplomate of the American Board of Neurologic Surgery and an active member of the American Association of Neurologic Surgeons, the Congress of Neurologic Surgeons, and the National Association of Spine Surgeons. His professional involvement reflects a commitment to advancing best practice and sharing knowledge across the field.
What sets Dr Cannestra apart is his clear philosophy of care. He believes in responsible surgical intervention, tailored precisely to each patient’s needs. He focuses on the smallest incision and least disruptive approach, recognising that a faster recovery leads to a better quality of life. “Life tasks such as walking and going to work, once lost to chronic pain, can be regained,” he explains.
By combining technical expertise with a patient-first mindset, Dr Cannestra has helped countless individuals return to the activities they enjoy. His work highlights the powerful impact that thoughtful, minimally invasive surgery can have on restoring independence and confidence.
Q&A:
Q: Let’s start at the beginning. What led you into medicine and, eventually, neurosurgery?
Andrew Cannestra: I was always fascinated by how the nervous system works. During medical school, I became interested in spinal injuries and the way they limit everyday life. A fellowship in spine surgery and spinal cord injury gave me a chance to focus. I saw first-hand how restoring movement—something as simple as walking to the mailbox—could transform a person’s confidence. That confirmed my path.
Q: How did you first get involved in minimally invasive surgery?
Cannestra: Early in my training, I worked on cases where the surgical approach required large incisions and long recovery periods. Patients often spent weeks in hospital. I remember one man who wanted nothing more than to get back to his job as a mechanic. His recovery was slow, and he worried about losing his livelihood. That experience stayed with me. I began seeking methods that reduced trauma. Minimally invasive surgery promised exactly that—smaller incisions, less blood loss, faster recovery.
Q: You were a founding member of the Society for Minimally Invasive Spinal Surgery. How did that come about?
Cannestra: A group of us were exploring new approaches in the early 2000s. There wasn’t a formal space to share findings or refine techniques. We created the society as a way to pool knowledge. It wasn’t about grand statements; it was about building a community of surgeons committed to improving patient recovery. Today, that society continues to shape best practice across the field.
Q: You later became Director of the Baptist Robotic Spine Surgery programme. What was that experience like?
Cannestra: It was both exciting and daunting. Robotics were just beginning to find a place in spine surgery. We started with a handful of procedures, working closely with engineers and nurses. I recall our first robotic case: a straightforward stabilisation. The precision was impressive, but what struck me most was how quickly the patient was able to walk afterwards. Seeing that kind of recovery made us confident to expand the programme.
Q: How do you decide when surgery is the right option?
Cannestra: Surgery is never the first step. My philosophy has always been to reserve it for appropriate candidates. I look at each case individually. A person with chronic pain may have tried physiotherapy, medication, and other treatments. Only when those fail do we discuss surgery. And when we do, I tailor the procedure to the patient’s needs. No two spines are identical.
Q: What does a typical day look like for you now?
Cannestra: My mornings usually begin with surgery. The operating theatre demands absolute focus, so I try to block that time. Afternoons are spent in clinic, meeting patients, reviewing imaging, and planning future cases. Evenings often involve research or teaching. It’s a long day, but medicine is a field where preparation is everything.
Q: What challenges has your field faced in recent years?
Cannestra: Access to care remains a big challenge. Not every hospital has the resources for robotic systems or advanced minimally invasive tools. Training is also a hurdle. These techniques require a different skill set than traditional approaches. Building programmes that train surgeons safely and effectively takes time.
Q: Have you faced setbacks in your own career?
Cannestra: Certainly. Early on, I performed a complex reconstruction that didn’t go as planned. The patient required a second operation. It was humbling. I spent weeks reviewing every step, speaking with mentors, and examining what I could have done differently. The lesson was to stay cautious, no matter how confident you feel. That experience shaped the way I approach risk.
Q: Where do you see spine surgery heading in the next decade?
Cannestra: I expect to see even less invasive approaches. Imaging will improve, robotics will advance, and artificial intelligence may help with surgical planning. But I also think we’ll see more personalised care—tailoring surgery and recovery plans to each individual’s anatomy and lifestyle. The tools are changing, but the aim remains the same: get people back to their lives as quickly as possible.
Q: What advice would you give to medical students considering neurosurgery?
Cannestra: Patience. It’s a long road and it’s easy to feel overwhelmed by the years of training. Focus on mastering the basics and learning from every case. Find mentors who push you to think critically, not just follow routines. And remember that each patient you meet has their own story. Surgery isn’t just technical—it’s deeply personal work.
Read more:
In Conversation with Andrew Cannestra: Spine Surgery, Innovation and Lessons from the Operating Room
