One moment, a patient’s head, hands or arms are shaking uncontrollably as he or she lies awake on the operating table. The next moment, as one of the stimulation leads inserted into the brain touches just the right spot inside the thalamus, everything changes.

“It’s amazing when someone’s tremor just stops,” said E. Thomas Cullom III, MD, a Flowood-based neurosurgeon who recently added deep brain stimulation to his practice.

For Cullom, the difference the procedure makes in the lives of his patients is as exciting as the technological advances that have made it feasible for him to add the procedure as a service offering.

“Many of my patients suffering from essential tremor can’t even feed themselves or sign their names,” he said. “A lot of people withdraw and don’t go out in public. They’re afraid of being in line to check out and not being able to get their money out. So it’s just a tremendous lifestyle change when people can go out again.”

The procedure is one Cullom learned to perform during his training years. But in those days, the procedure involved a grueling six- to 12-hour process for patients.

“A lot of our patients are older and frail and are not going to tolerate an operation going that long,” Cullom said. “But with new technology, a lot of the discomfort of patients is significantly abated, and the actual time in the operating room is significantly less.”

The rapid changes in technology Cullom has witnessed in his more than 15 years of practice make the field of neurosurgery both exciting and challenging.

“A lot of things I do, I don’t do them the same way I did them 15 years ago,” he said. “Some of the things I started out doing I just don’t do any more. So it’s an evolving field. There’s always something new or interesting going on.”

Cullom’s practice today includes everything except pediatrics – from removing brain tumors and performing spine surgery, to treating advanced carpal tunnel syndrome.

A native of New Orleans, he received his undergraduate degree in biology from the University of Missouri in Columbia, and went on to earn a medical degree at the University of Missouri School of Medicine.

He completed his internship in general surgery and residency in neurosurgery at the University of Mississippi Medical Center. He is certified by the American Board of Neurological Surgery.

During his training, Cullom was attracted by the variety of procedures he would be able to perform as a neurosurgeon.

“Some say neurosurgery is the last generalized specialty,” he said. “Some areas are becoming so sub-specialized. But with neurosurgery, I can do back, neck and brain surgery, stereotactic radiosurgery — there’s just a lot of variety to it.”

A neurosurgery practice also suited his desire to stay on the cutting edge of medical technology.

“It seems to be a specialty that needs to and does embrace technological advances when they occur, which keeps it interesting,” he said.

“I expect there to continue to be a lot of innovation. In the next 10 years, who knows? Procedures we never even thought about will be pretty routine, and a lot of the procedures that are pretty routine now, we won’t really be doing anymore.”

One such advance that’s made a dramatic difference for brain-tumor patients over the past few years has been the introduction of Gamma Knife radiosurgery. Instead of an open cranial operation with a several-day stay in the hospital, the focused radiation procedure is typically done on an outpatient basis, Cullom said. Similarly, many of the spine surgeries he performs today are minimally invasive rather than open procedures.

“You have to blend the old and new and find out what works the best,” he said. “There are so many new things out there, you have to evaluate them.

“It’s a constantly changing and evolving field, with different ideas for how to treat conditions. Sometimes those new ideas lead us to a dead end, and sometimes they lead to something bigger and better.”

With deep brain stimulation, Cullom is making use of frameless navigation technology. It’s an alternative to having patients wear a bulky headframe for an entire day while their CT or MRI scan is run, the surgery plan is finalized and the procedure at last gets underway.

“With frameless navigation, we can do the MRI or CT any time within a week or two of the procedure,” Cullom said. “There’s none of this running around trying to get everything done on the same day.

“Anytime you have to take a patient from one place to another in a hospital, it really slows everything down, and that’s what kept this out of a lot of private practice for many years. It just wasn’t feasible.”

Before Cullom reintroduced the procedure, many Mississippi patients were having to drive to centers in Nashville, Tenn., Birmingham, Ala., or Houston, Texas, for deep brain stimulation, Cullom said. Patients are now coming to him for the procedure from all over the state.

Cullom sees patients in his Flowood clinic adjacent to River Oaks Hospital, where he performs most of his surgical procedures. He also holds satellite clinics twice a month in Magee, and once a month in Kosciusko and Brookhaven.

Cullom’s wife, Mary Beth, helps run his clinic office and cares for their three children: Thomas, 15, Alexandra, 11, and Connor, 9.

Outside of his practice, Cullom enjoys running and reading.

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