About Us

About: Tyler Neurosurgical Associates

Our team of physicians work together with patients, medical facilities and insurers to offer the most advanced procedures for treatment of spine, brain and peripheral nerve disorders, diseases and injuries.

Our highly-qualified, experienced team makes Tyler Neurosurgical Associates exceptional. Our neurosurgeons and staff are committed to caring for patients in a timely, professional matter. Our treatment approach includes working closely with referral sources and offering ongoing consultation once patients have returned to their home communities.

Our neurosurgeons reach out to Tyler and the local East Texas community with periodic free seminars on neurosurgical subjects. Also, we share neuroscientific knowledge with medical practitioners throughout the East Texas area through topic and case presentations at Grand Rounds.

MEET OUR SURGEONS

Dr. Paul W. Detwiler

Paul W. Detwiler, M.D.

Surgeon

Place of Birth: Pennsylvania

Board Certification: American Board of Neurological Surgery

Education

Premedical Education:

  • Drexel University, Philadelphia, Pennsylvania, B.S. Chemical Engineering, June 1986
  • Columbia University, New York, New York, M.S. Chemical (Biomedical) Engineering, January 1989

Medical Education: Albert Einstein College of Medicine, Bronx, New York, Degree of Medicine, June 1993

Internships & Residencies

Internship: Maricopa Medical Center, Phoenix, Arizona, July 1993 – June 1994

Residency: Neurological Surgery, Barrow Neurological Institute, Phoenix, Arizona
July 1994 – June 1999

Fellowships & Memberships

Fellowships:

  • Spine Surgery, Barrow Neurological Institute, Phoenix, Arizona, July 1998 – December 1998
  • Cerebrovascular and Skull Base Surgery, Barrow Neurological Institute, Phoenix, Arizona, July 1997 – June 1998, February 1999 – June 1999

Membership in Medical Societies:

  • North American Skull Base Society
  • American Association of Neurological Surgeons
  • Congress of Neurological Surgeons
  • Texas Medical Association
  • Smith County Medical Association
  • Texas Association of Neurological Surgeons

Hospital Membership Affiliations:

  • East Texas Medical Center Hospital, Tyler, Texas
  • Texas Spine & Joint Hospital, Tyler, Texas
  • Trinity Mother Frances Hospital, Tyler, Texas
Dr. Thomas W. Grahm

Thomas W. Grahm, M.D.

Surgeon

Place of Birth: Wichita Falls, Texas

Board Certification: American Board of Neurological Surgery

Education

Premedical Education: University of Texas, Arlington, May 1979
Graduate, B.S. – Biology

Medical Education: University of Texas Medical Branch, Galveston, Texas, May 1983 Graduate

Internships & Residencies

Internship: Phoenix Integrated Surgical Residency, V.A. Medical Center, Phoenix, Arizona, 1983 – 1984

Residency: Neurological Surgery, Barrow Neurological Institute,
Phoenix, Arizona 1984 – 1989

Fellowships & Memberships

Fellowship: Vascular/Skull Base Surgery, Barrow Neurological Institute,
1989 – 1990

Board Certification: American Board of Neurological Surgery

Membership in Medical Societies:

  • American Association of Neurological Surgeons
  • American Society of Neurophysiological Monitoring
  • Congress of Neurological Surgeons
  • Executive Board of Texas Association of Neurological Surgeons
  • North American Skull Base Society
  • North American Spine Society
  • Smith County Medical Society
  • Texas Medical Association

Hospital Membership Affiliations:

  • East Texas Medical Center Hospital, Tyler, Texas
  • Texas Spine & Joint Hospital, Tyler, Texas
  • Trinity Mother Frances Hospital, Tyler, Texas
Dr. Mark B. Renfro

Mark B. Renfro, M.D.

Surgeon

Place of Birth: Pensacola, Florida

Board Certification: American Board of Neurological Surgeons

Education

Premedical Education: University of North Carolina, Chapel Hill, North Carolina, B.S. in Zoology, Graduate of Distinction and Highest Honors, August 1982 – May 1986

Medical Education: University of Florida, Gainesville Florida, Degree of Medicine with Honors, August 1986 – June 1990

Internships & Residencies

Internship: General Surgery, Department of Surgery, University of Florida, Gainseville, July 1990 – June 1991

Residency: Neurological Surgery, Department of Neurosurgery, University of Florida, Gainesville, July 1991 – June 1997

Fellowships & Memberships

Honors/Awards:

  • Phi Beta Kappa
  • AOA
  • University of Florida Neurosurgical Award
  • College of Medicine Alumni Scholarship for Academic Excellence

Memberships:

  • American Board of Neurological Surgeons
  • Congress of Neurological Surgeons
  • Smith County Medical Society
  • Texas Medical Association

Hospital Membership Affiliates:

  • East Texas Medical Center Hospital
  • Texas Spine & Joint Hospital
  • Trinity Mother Frances Hospital, Tyler, Texas
Publications & Presentations

Publications:

Renfro M, Delashaw JB, Peters K, et al: Anterior Third Ventricular Meningioma in an Adolescent: A Case Report. Neurosurgery 31: 746-750, 1992.

Renfro M, Day AL, Rhoton AL Jr. The Extracranial and Intracranial Vessels: Circulation, Normal Anatomy, and Variation. In: Cerebrovascular Disease. Raven Press, 1996.

Renfro M, Day AL, Paraclinoid Carotid Aneurysms: Surgical Techniques. In: Cerebrovascular Disease. Raven Press, 1996.

Renfro M, Rhoton AL Jr. The Microsurgical Anatomy of the Infratemporal Fossa (publication pending final artwork).

Presentations:

Renfro M, Fessler R. Retroperitoneal Approach to the Lumbar Vertebrae.
Joint Section on Disorders of the Spine.
Miami Florida, February 1992.

Renfro M, Rhoton AL Jr. The Microsurgical Anatomy of the Pterygopalatine Fossa. The North American Skull Base Society.
Naples Florida, February 1995.

Renfro M, Rhoton AL Jr. The Microsurgical Anatomy of the Infratemporal Fossa/Pterygopalatine Fossa. The Japanese Skull Base Society. Fukuoka Japan, May 1995.

Renfro M, McDonald J, Day AL. The Subtemporal Anterior Transpetrosal Approach to the Upper Basilar Artery and Pontomesencephalic Junction: a Clinical and Anatomical Study. The North American Skull Base Society. San Diego CA, 1996.

Dr. Stephen V. Nalbach

Stephen V. Nalbach, M.D.

Surgeon

Place of Birth: Plainview, New York

Board Certification: Board Eligible

Education

Premedical Education:

  • Undergraduate: Binghamton University, State University of New York, B.S. Psychobiology, May 2000 Graduate
  • Post Baccalaureate: Stonybrook University, State University of New York, Physics and Basic Science, August 2000-May 2003

Medical Education: Temple University School of Medicine; Philadelphia, PA, May 2007 Graduate

Internships & Residencies

Internship: Brigham and Women’s Hospital/ Children’s Hospital Boston and Harvard Medical School, Boston, MA, Neurological Surgery, June 2007- July 2008

Residency: Brigham and Women’s Hospital/ Children’s Hospital Boston and Harvard Medical School, Boston MA, Neurosurgery, July 2008- June 2014

Fellowships & Memberships

Memberships:

  • Congress of Neurological Surgeons
  • American Association of Neurological Surgeons
  • American College of Surgeons
  • Smith County Medical Society

Hospital Membership Affiliations:

  • East Texas Medical Center
  • Texas Spine & Joint Hospital
  • Trinity Mother Frances Hospital
Publications & Presentations

Publications:

  • Nalbach SV, Ropper AE, Dunn IF, Gormley WB. Craniectomy-associated Progressive ExtraAxial Collections with Treated Hydrocephalus (CAPECTH): Redefining a common complication of decompressive craniectomy. Journal of Clinical Neuroscience. 2012 Sep;19(9):1222-7.
  • Magge SN, Smyth MD, Governale LS, Goumnerova L, Madsen J, Munro B, Nalbach SV, Proctor MR, Scott RM, Smith ER. Idiopathic syrinx in the pediatric population: a combined center experience. J Neurosurg Pediatr. 2011 Jan; 7(1): 30-6.
  • Ropper AE, Nalbach SV, Lin N, Dunn IF, Gormley WB. Resolution of extra-axial collections after decompressive craniectomy for ischemic stroke. Journal of Clinical Neuroscience. 2012 Feb; 19(2): 231-4. Epub 2011 Dec 23.
  • Lin N, Zenonos G, Kim AH, Nalbach SV, Du R, Frerichs KU, Friedlander RM, Gormley WB. Angiogram-negative subarachnoid hemorrhage: relationship between bleeding pattern and clinical outcome. Neurocrit Care. 2012 Jun; 16(3): 389-98.
  • Ropper AE, Nalbach SV, Groff MW. Vascular Complications from Anterior Lumbar Spine Surgery. World Neurosurgery. 2012 Dec 13.
  • Santiago-Sim T, DePalma SR, McDonough B, Hennessy M, Patek K, M.S. Sankarapani V, Anaya M, Nalbach SV, Colosimo S, MacRae CA, Dymecki S, Seidman CE, Seidman JG, Kim DH. Loss-of-function mutations in THSD1, encoding thrombospondin type-1 domain-containing protein 1, cause autosomal-dominant intracranial aneurysms. Nature Genetics. 2013. Submission.

Presentations:

  • 2009 AANS Poster Title: A Study of Idiopathic Syringomyelia in the Pediatric Population: Natural Progression and Implications for Management. Suresh N. Magge, MD, Childrens Hospital Boston, Boston, MA; SamerFadl, BS, New Haven, CT; Lance S. Governale, MD, Boston, MA; Stephen V. Nalbach, MD, Boston, MA; Edward R. Smith, MD, Boston, MA.
  • 2010 CNS Digital Poster Acceptance TITLE: Spontaneous Subarachnoid Hemorrhage with Negative Initial Angiogram: Bleeding Pattern, Diagnostic Yield, and Clinical Outcome Ning Lin, MD, Stephen V. Nalbach, MD, Albert H. Kim, MD, PhD.
  • 2011American Stroke Association – Bugher Foundation Centers for Stroke Prevention Research Center Science/Fellow Meeting Poster TITLE: Genetic diagnosis using whole exome capture and linkage analysis implicates gene THSD1 in intracranial aneurysms. Stephen V. Nalbach, M.D.; Teresa Santiago-Sim, Ph.D.; Steven R. DePalma, Ph.D.; Barbara McDonough, R.N.; Christine E. Seidman, M.D.; J.G. Seidman, Ph.D.; Dong H. Kim, M.D.
  • Ropper AE, Wong JM, Ho A, Nalbach SV, Chi JH. Intraoperative durotomy and wound-related complications in spinal tumor surgery. Annual meeting of the New England Neurosurgical Society. Brewster, MA. Jun. 2012.
Dr. Nicholas S. Andrade

Nicholas S. Andrade, M.D.

Surgeon

Place of Birth: Dallas, Texas

Board Certification: Board Eligible

Education

Premedical Education: University of Texas at Austin, Austin, Texas, B.A. in Spanish, May 2003

Medical Education: UT Southwestern Medical School/ UT School of Public Health, Dallas, Texas, Degree of Medicine, May 2008

Internships & Residencies

Internship: Neurological Surgery, University of Texas HSC San Antonio, San Antonio, Texas, June 2008- June 2009

Residency: Neurological Surgery, University of Texas HSC San Antonio, San Antonio, Texas, June 2009- June 2015

Fellowships & Memberships

Membership in Medical Societies:

  • American Association of Neurological Surgeons
  • Congress of Neurological Surgeons
  • Texas Medical Association
  • Texas Association of Neurological Surgeons

Hospital Membership Affiliations:

  • East Texas Medical Center Hospital, Tyler, Texas
  • Texas Spine & Joint Hospital, Tyler, Texas
  • Trinity Mother Frances Hospital, Tyler, Texas