For Sarah Thompson, a future with less pain felt like distant hope. Suffering from spondylolisthesis, a painful slippage of a vertebral body, Thompson endured chronic back pain, severe radiating leg pain, and weakness in her foot.

Thompson's hope for less pain became a reality after an L5-S1 (spinal) fusion at Walter Reed National Military Medical Center. “I now have less pain post-operatively than pre-operatively. I am so relieved the surgery is over and excited for what my future brings me,” she wrote in a letter praising the Neurosurgery Clinic at Walter Reed.

Her exceptional outcome is a direct result of the vision and leadership of her surgeon, U.S. Navy Capt. (Dr.) Michael Cirivello, chief of Walter Reed Neurological Surgery, who is leveraging that same standard of care to shape the future of military medicine.

Cirivello, who is also an assistant professor at Uniformed Services University (USU), recently became the program director for the only Tri-Service Neurosurgery Residency Training program in the military. “We want to continue to expand our capabilities here and our referral base,” he said, explaining that a robust and complex caseload is essential for top-tier training and military medical readiness. Acknowledging a dip in referrals since the COVID-19 pandemic, he has developed a comprehensive strategy to market the department’s extensive services and deepen its most critical partnerships.

The department’s offerings are vast. Cirivello leads a team capable of performing the full spectrum of neurosurgical care, from minimally invasive spine procedures to complex skull base and endovascular treatments for aneurysms and arterial venous malformations (AVMs). This clinical work is highly collaborative, featuring a bi-monthly tumor board where neurosurgeons, radiologists, and oncologists discuss complex brain tumor cases, and a quarterly board with endocrinology to manage pituitary disorders.

The key to building more referrals is the department’s relationship with the Department of Veterans Affairs (VA). “We have our best working relationships with the VA of D.C.,” he noted, explaining that the department already sees 300 to 400 VA patients annually and performs about 100 surgeries from the D.C. facility alone. Now, he aims to increase that collaboration, especially with the D.C. and Martinsburg, West Virginia VA Medical Centers.

To do this, Cirivello outlines a proactive plan. He hopes to re-establish a key liaison position at Martinsburg, a position once held by a nurse practitioner who was instrumental in the pain management program. “In the meantime,” he said, “we have a PA [physician assistant] here that has received their credentials at Martinsburg, and they are volunteering their time to go to Martinsburg to see a clinic to bridge the gap.” Looking forward, he added, “One of my other interests there is a new large VA clinic in Fredericksburg [Virginia]. It would be nice to get in front of their medical staff and see if we can’t garner referrals from there as well.”

This outreach is built upon a global platform. The department serves not just the local military community but also provides tele-consults worldwide through the Global Telecommunications Portal (GTP), allowing any military provider to access their expertise.

From Sarah Thompson’s reclaimed future to a resident’s complex training, it is all interconnected. Under Cirivello’s leadership, Walter Reed Neurosurgery is not just healing patients today; it is strategically building the programs and partnerships that will define excellence in military and veteran care for years to come.

For more information on the Neurosurgery Clinic at Walter Reed, visit https://walterreed.tricare.mil/Health-Services/Hospital-Care-Surgery/Neurosurgery.