The controversial Dr. Rosner
by Jason Sandford in Vol. 14 / Iss. 51 on 07/16/2008
Depending on whom you ask, Fletcher-based neurosurgeon Michael J. Rosner is either a skull-shaving savior or a shameless opportunist who’s needlessly operating on patients desperate for a cure.

Dr. Michael J. Rosner has operated on hundreds of patients to remove bits of bone at the base of the skull and along the spinal cord — a surgery that remains controversial. The North Carolina Medical Board suspended Rosner’s license in 2002. Two years later, the board approved a restricted license for Rosner, who continues to perform surgeries at Park Ridge Hospital in Fletcher. A number of his patients who complained of a variety of neurological symptoms say Rosner dramatically improved their lives, while others have sued him, alleging that he performed unnecessary surgeries. Photo By Jason Sandford

For about a decade, Rosner’s work has gone in a direction pursued by only a handful of neurosurgeons in the United States: snipping away bits of the spine and the back of the skull to treat neurological conditions found in patients diagnosed with chronic fatigue syndrome or fibromyalgia.
Rosner’s work caught the attention of the North Carolina Medical Board, which summarily suspended his medical license in 2002, concluding that he’d performed eight unnecessary surgeries on patients. Brian Blankenship, the board’s attorney, said the agency, which is charged with looking after patients’ welfare, found that Rosner’s surgeries were “deviating from the accepted and prevailing standard of care.”
“If you look at the board’s actions, they’re very case-specific and very fact-specific,” said Blankenship. Summary suspensions are rare—the medical board issued four in 2007 and three in 2006.
Rosner wasn’t allowed to reapply for his license for six months, and when he did, his application was denied. Rosner appealed. Following a June 2004 hearing, the medical board did reinstate his license—but with certain conditions.
As for Rosner’s patients, some have reported improvement that’s little short of miraculous; others say the treatment made only a minor difference, and still others report worsening conditions. But Rosner has also been sued at least 48 times in the past six years by people alleging unnecessary surgery. Fifteen of those suits have been dismissed, he says, and eight more have been withdrawn. According to Henderson County court records, however, 32 lawsuits against Rosner remain unresolved.
Rosner maintains that over his entire career, only one malpractice claim has been paid on his behalf: a $50,000 settlement in 1987 for operating on the wrong level of a patient’s back. Rosner also contends that the medical board’s actions may actually have encouraged some suits. Four months after the suspension of his license, he notes, a single law firm filed eight cases.
A confident man with a salt-and-pepper goatee, Rosner seems unbowed by the controversy that continues to dog him. He’s still seeing patients, most of whom are referred to him either by other doctors who believe in his work, or by passionate supporters who network via the Internet.
In Rosner’s eyes, the real question is how long it will take to change what he believes is faulty science.
“It’s a long process to change anything in the world ... and the same is true in medicine, particularly with the egos and intellect involved,” he observes. “Because if you believe something and you’ve got an IQ of 140, that’s a difficult process to unlodge, because you’ve got all your intellect behind maintaining what you believe in.”
A minority view

Rosner and other proponents of the surgery believe that many of the patients they see suffer from one of two conditions: a skull that’s too small for the brain, or a compressed spinal column. Sometimes they have both.
In medical terminology, “hypoplastic posterior fossa,” also known as a “Chiari I malformation,” essentially means that the back of the skull and upper spinal column are too small to contain the lower part of the brain and the upper spinal cord. This condition has long been known to cause some neurological difficulties—such as tremors, sleep apnea, headaches and poor coordination—in some sufferers.
Rosner wants to be clear: He’s not operating to treat fibromyalgia or chronic fatigue. Rather, he’s using surgery to correct what he calls a “neurological deficit” in his patients. He also emphasizes some fundamental differences in the way he examines patients and determines a course of treatment.