The beginning.
Begins performing endoscopic spine surgery.
ENDOSCOPIC SPINE SURGERY · CAPE COD
What would you like
to get back to?
For many of my patients, it’s golf, tennis, or simply moving comfortably again. My approach begins with understanding what is getting in the way—and explaining the options clearly.
Several thousand endoscopic spine procedures since 2014.
The story behind my approachPaul Houle, MD, FAANS
Board-certified neurosurgeon
EXPERIENCE IN PRACTICE
A practice centered
on endoscopic spine care.
Endoscopic spine surgery is a major part of Dr. Houle’s practice on Cape Cod. He also teaches other surgeons how to perform these procedures, drawing on years of operating, studying abroad and developing a systematic way to teach the technique.
For patients, the conversation starts with what is causing the symptoms, whether an endoscopic approach fits, and what other options deserve consideration.
A PRACTICE IN CONTEXT
Learning abroad.
Teaching at home.
Explaining clearly.
Study in Europe and South Korea, alongside the work of teaching other surgeons, has helped shape Dr. Houle’s approach to endoscopic spine care.
Hear the story in his own words ↓A wider perspective.
Travels to Germany and the Netherlands to learn from surgeons with established endoscopic practices.
Making the steps teachable.
Helps develop an eight-step transforaminal teaching approach with joimax to make instruction consistent across courses.
Learning in South Korea.
Travels to Wooridul Spine Hospital to study endoscopic techniques for the neck and mid-back, building on his experience treating the lower back.
Wooridul’s training recordIN HIS OWN WORDS · SOUTH KOREA
Why I went
to Korea.
In this short interview, Dr. Houle explains what drew him to Wooridul Spine Hospital and what he hoped to bring back to his practice.
What he went to learn.
In this interview, Paul Houle, MD, explains why he traveled to Wooridul Spine Hospital in South Korea to study endoscopic spine surgery. He describes the operating team’s coordination and the opportunity to observe an endoscopic approach to cervical disc surgery that was new to him. His purpose was to learn from experienced teams and consider what he could bring back to his own practice.
A summary of the recorded interview, published in 2022.
EXPLORE THE PRACTICE
Different problems.
Considered approaches.
Clear explanations of the work and the questions behind it.
01Persistent back pain.
0203
Persistent back pain.
Could the facet joints be involved?
A closer look at medial branch transection and the importance of identifying the pain source.
Understand medial branch transectionA closer view of nerve compression.
How I connect your symptoms, examination and imaging with the treatment choices.
Explore endoscopic surgeryGetting back to the game.
How my patients, my own golf and TPI training shaped the way I think about recovery.
Read about returning to activityA FOCUS OF THE PRACTICE · MEDIAL BRANCH TRANSECTION
When back pain
comes from
the facet joints.
The facet joints can be a source of persistent back pain. Medial branch transection is an endoscopic approach to interrupting pain signals from targeted joints.
The starting point is understanding whether these joints are contributing to the symptoms. The explanation covers assessment, alternatives and the limits of treatment.
Explore medial branch transection
MEET DR. HOULE
Learning, teaching
and patient care.
Paul Houle, MD, FAANS
Board-certified neurosurgeon
Cape Cod Healthcare Neurosurgery · Hyannis
He trained at Boston University School of Medicine and completed his neurosurgical residency at the Medical College of Georgia. His work brings together patient care on Cape Cod, international study and teaching other surgeons.
A LITTLE MORE CONTEXT
Care. Teaching. Community.
Endoscopic care,
closer to home.
A hospital feature on Dr. Houle’s endoscopic spine work.
Read the hospital story“Like father,
like daughter.”
A story about family, mentorship and the next generation in medicine.
Go beyond the operating roomPRACTICE INFORMATION
Cape Cod Healthcare Neurosurgery
Paul Houle, MD, FAANS · Hyannis, Massachusetts
508.771.0006 ↗46 North Street
Hyannis, MA 02601
Call to discuss an evaluation. Find questions to ask about referrals, imaging and records on the appointments page.
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Practice contact information