• Neurosurgical Procedures

    Back Surgery

    The main types of lumbar and thoracic spine surgeries include spinal fusion, laminectomy and discectomy.

    In spinal fusions, surgeons place a bone graft between vertebrae so that new bone grows into that space. These are also known as posterior lumbar interbody fusion, or PLIF, surgeries. Generally, spinal fusions are used to reduce or eliminate instability in the back along with associated pain in the lower back and legs.

    Laminectomy surgery involves the removal of the lamina, which relieves pressure on the spinal column and eases pain. Other bony spurs can be removed during this procedure if needed.

    The discectomy is a type of surgery in which a portion of a herniated disc is removed to relieve pressure on the nerves. Part of the lamina is also usually removed to gain access to the disc.

    Neck Surgery

    For all neck surgeries, patients are placed under general anesthesia, meaning that they are asleep during the procedure.

    Most commonly, surgeons will perform an anterior incision during surgery, but occasionally, an incision will be made on the back of the neck. When multiple levels of vertebrae and discs are unhealthy, then a cervical spinal fusion is typically used, which can require the removal of entire discs and vertebrate. The spine is then stabilized to help regrow bone and stimulate safe recovery.

    A posterior fusion is often done in conjunction with an anterior fusion in order to further stabilize the neck. In this approach, compression on the spinal cord and nerves from the back is relieved. Once the compression is removed, the vertebrae is secured with rods to help increase stability of the spine. The bone removed during surgery is later used as a graft to help in the healing and fusion process.

    Carpal Tunnel Surgery

    During carpal tunnel surgery, patients are given medicine to relax and numb any pain they may be experiencing. The surgeon will then make a small incision on the wrist and cut the carpal ligament, freeing the nerve and relieving the patient’s pain. Cutting the ligament has no impact on the hand, but the incision area will need to be closed with small sutures for at least seven to 10 days.

    For patients with carpal tunnel syndrome, surgery is usually not the first choice of treatment. Whenever possible, surgeons will first see if more conservative measures such as medication or physical therapy will help relieve the pain.

    After surgery, numbness may persist until the nerve has completely healed. Since the nerve has been compressed and pinched, the damage may take several weeks to heal completely.

    Aneurysm Clipping

    Aneurysm clipping is an operative cerebral aneurysm procedure that treats blood vessel ballooning inside the brain. The procedure is performed to prevent the aneurysm from bursting and causing a hemorrhage, which could result in permanent brain damage or death.

    In this procedure, the patient is under general anesthesia. An opening is made in the skull to allow the surgeon access to the aneurysm. A surgical microscope is used to view the aneurysm and place a tiny, spring-loaded clip over the affected area, cutting off blood supply to the aneurysm.

    Hospitalization may last a week. Sometimes, multiple clips are used depending on the shape, size and blood supply of the aneurysm. After the aneurysm is located, a small metal clip is very carefully placed at its neck, cutting off blood supply and obliterating the aneurysm.

    Aneurysm Coiling

    Aneurysm coiling is a minimally invasive procedure that uses neuroendovascular surgery techniques to treat an aneurysm in the wall of a blood vessel located in the brain. This kind of procedure may be used as an alternative to the more traditional treatment of aneurysm clipping, as many patients are not good candidates for clipping due to their medical condition or the location of the aneurysm.

    Instead of the open incision used in aneurysm clipping, a platinum coil is delivered to the aneurysm through a series of tiny catheters. The catheters are inserted into a small incision in the upper thigh and guided through the bloodstream to the site of the brain aneurysm. The coil then forms a clot which prevents blood from filling up the aneurysm.

    Sometimes coiling is used in combination with stenting, in which a tiny, tube-like structure is placed near the aneurysm to keep the coiled aneurysm from collapsing the entire blood vessel and cutting off blood supply within the brain.

    Brain Surgery for Tumors

    Surgical treatments of the brain are among the most complicated and delicate procedures that exist. One type of brain surgery is a craniotomy, which is a procedure that allows access to the brain and other tissues within the skull in order to treat various conditions and disorders.

    A craniotomy involves removing a section of bone from the skull. At the end of the procedure, the bone is put back in place and eventually fuses with the bones of the skull.

    There’s also a similar procedure known as the craniectomy in which a portion of the bone is removed from the skull, but not put back in place. For example, the bone may not be replaced over an area of the skull that is covered by muscle, or a tumor may have invaded that section of bone. A prosthetic plate may replace the affected bone.