July 24, 2015
4 min read

A conversation with Rex A.W. Marco, MD

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In this issue, Spine Surgery Today poses five questions to Rex A.W. Marco, MD. He is vice chairman, chief of reconstructive spine surgery and musculoskeletal oncology, Department of Orthopaedic Surgery, at Houston Methodist Hospital.

Dr. Marco completed his pre-med studies at the University of California at Irvine, where he graduated magna cum laude and he completed a research fellowship at the Howard Hughes Medical Institute – National Institutes of Health and later received his medical degree from the UCLA School of Medicine. He had internship at Virginia Mason Medical Center in Seattle and completed his orthopedic surgery residency training at University of California – Davis Medical Center.

With a deep interest in spine surgery and oncology, Dr. Marco double-specialized and completed two fellowships; one in musculoskeletal oncology at Memorial Sloan Kettering Cancer Center in New York City and the other a spine surgery fellowship at Rush-Presbyterian-St. Luke’s Medical Center in Chicago.

Dr. Marco started his career as a spine surgeon and musculoskeletal oncologist at MD Anderson Cancer Center in Houston in 2000. He is a professor in the Department of Orthopaedic Surgery at The University of Texas Medical School at Houston, where he is also the chief of spine surgery and musculoskeletal oncology. In addition, he has faculty appointments with Baylor College of Medicine – Department of Orthopaedic Surgery, Rice University – Department of Bioengineering and the Weill Cornell Medical College/Methodist Hospital Orthopaedic Surgery Residency. Dr. Marco is also co-director of the Spine Service at Shriner’s Hospital for Children in Houston.

Rex Marco

Rex A. Marco

Certified by the American Board of Orthopaedic Surgery, Dr. Marco’s professional affiliations include memberships in the American Academy of Orthopaedic Surgeons, Scoliosis Research Society, North American Spine Society, Cervical Spine Research Society and the Musculoskeletal Tumor Society.

With more than 25 years of combined training and experience, Dr. Marco believes it is a privilege and his duty to train future orthopedic and spine surgeons. He is the director of The Texas Medical Center Spine Fellowship and trained 15 spine fellows who have become outstanding spine surgeons. Dr. Marco has also trained and mentored dozens of orthopedic surgery residents with The University of Texas Medical School at Houston, Baylor College of Medicine, Scott & White and The Methodist Hospital orthopedic surgery residency programs.

Spine Surgery Today: What was the defining moment that led you to your field?

Rex A.W. Marco, MD: I was in my fifth year of training as an orthopedic surgeon and I was already planning to complete a fellowship in musculoskeletal oncology at Memorial Sloan Kettering Cancer Center the following year. I was working with Munish Gupta, MD, as the chief resident on the spine service and then I realized that I really enjoyed the precision required to be a master surgeon in the spine. I realized then that there was nobody in the world who had formal training and clinical expertise in both musculoskeletal oncology and reconstructive spine surgery. I remember setting my goal to become one of the first surgeons to combine this type of training into a practice.

Spine Surgery Today: Who has had the greatest influence on your career?

Marco: There are so many people in my life who have taught me to be the best that I can be. However, the following mentors taught me lessons that I use everyday to help improve my patients’ lives: John Ryan, MD, taught me the importance of “Age, sex, diagnosis and treatment;”Michael Chapman, MD, taught me to “Do the right thing;”Joe Matthews, MD, taught me to “Be part of the solution, rather than part of the problem;” John Healey, MD, taught me to be “a ‘splitter’ rather than a ‘lumper’”; Ronald DeWald, MD, taught me to “Trust no one;” and Howard An, MD, taught me to “Be the best you can be.”


Spine Surgery Today: What area of research in spine surgery most interests you right now?

Marco: I am most interested in the prevention of head injuries and catastrophic cervical spine injuries associated with improper tackling techniques. Why? My son was playing tackle football about 7 years ago and the coaches were teaching him how to tackle “properly” using the “head across the bow” technique. Jerry Buchert, my physician assistant, was an athletic trainer at the University of Florida. I asked him if this technique was the proper way to teach players to tackle. He informed me this technique would place the player at risk of head and neck injuries and lead to more missed tackles. We subsequently studied thousands of tackles and confirmed Jerry’s hypothesis.

Spine Surgery Today: What advice would you offer a medical school student today?

Marco: I am a huge fan of John Wooden. Some of his core principles include the following: Try your best. Have fun. Stay enthusiastic. Maintain self-control. There is much more to his “pyramid of success,” but those are critical components that are easy to remember, yet tend to wax and wane more than others.

Spine Surgery Today: What are your hobbies outside of practicing medicine?

Marco: My main hobbies are snowboarding and physical fitness. I am an avid snowboarder. I am a certified instructor for the American Association of Snowboard Instructors, and I am also a team physician for the U.S. Snowboarding team. I had a passion for coaching baseball, but now that my sons are older, I have redirected my focus to educating others about Shatterproof. Shatterproof is a national, non-profit organization that saves lives by educating those affected by the consequences of alcohol and drugs. Their mission is to save lives by ending the blame and shame associated with alcohol and drug use.

Disclosure: Marco reports he is on the speaker’s bureau and does paid for presentations for DePuy Synthes and Nuvasive and is a paid consultant to Aesculap/Bbraun.