Comprised of our Neurology and Neurosurgery programs, the St. Vincent's HealthCare Neurosciences service line treats patients with a variety of ailments, including epilepsy, stroke, degenerative disc disease, multiple sclerosis and brain tumors. We are committed to cutting-edge patient care and the treatment of patients with spinal and neurological illnesses.
This procedure is similar to the posterior lumbar interbody fusion except that the disc space is fused by approaching the spine through the abdomen instead of the through the lower back.A three- to five-inch incision is made on the left side of the abdomen. Some ALIF procedures can even be done using only one very small incision or with a scope that allows the surgery to be done through several one-inch incisions.
To begin, the surgeon uses MRI and CAT scans to determine what size implant(s) the patient needs. Once this is completed, the surgeon must prepare the disc space. The surgeon then carefully removes the lamina to be able to see and access the nerve roots. The surgeon then removes the affected disc and surrounding tissue and prepares bone surfaces of adjacent vertebrae for fusion.
Doctors - Ali Chahlavi, M.D., Eric M. Gabriel, M.D., Kent C. New, M.D., Ph.D., Ashutosh A. Pradhan, M.D.
Location - St. Vincent's Medical Center, St. Luke's Hospital
This surgical approach is similar to a discectomy; however, the patient is placed in a position with the head in a slight extension and a larger vertical incision is made in the neck to allow more extensive exposure. A discectomy is performed at either end of the vertebral body to be removed. The area must then be reconstructed with a special fusion technique.
This procedure is performed on the upper part of the spine in order to relieve pressure on nerve roots or the spinal cord. Through a small incision on the neck, the intervertebral disc and bone spurs are removed. A bone graft is placed in the disc space and will begin to fuse the vertebrae. Although fusion is done with a bone graft, occasionally metal plates are added for stability and to aid the healing process.
An artificial cervical disc is a device inserted between two cervical vertebrae after an intervertebral disc has been removed. The device is put in place to preserve motion at the disc space as an alternative to a bone graft or plates and screws. This procedure is typically done on patients with cervical disc herniations that have not responded to non-surgical treatment. The advantages to this procedure are that the patient can maintain normal neck motion and has a faster recovery time.
This procedure involves the removal of a small piece of brain tissue to find a diagnosis of abnormalities of the brain including Alzheimer's disease, tumors, infections and inflammation. After this invasive procedure, the patient is monitored in a recovery room for several hours and usually required to spend a few days in the hospital.
This surgery is performed to treat carpal tunnel syndrome. The surgeon cuts through the affected ligament to make more space for the nerve and tendons. Easing the pressure on the median nerve. Although this outpatient procedure will help decrease pain, nerve tingling and numbness to restore muscle strength, it does not guarantee you will be completely free of symptoms after recovery.
This procedure is intended to relieve pressure on the spinal cord while maintaining the stabilizing effects of the posterior elements of the vertebrae. The surgeon "hinges" one side of the posterior elements of the spine and cuts the other side to form a "door." The door is opened and held in place with wedges. The goal of the procedure is to stop the progression of damage to the spinal cord and allow for recovery.
This surgery widens the opening in your back where the nerve roots leave your spinal column. This takes pressure off of a nerve in your spinal column allowing it to move more easily. An incision is made in the middle of the back of the spine. Disc fragments and other bone may be removed to make room. Spinal fusion may also be necessary. This procedure often provides full or partial relief of symptoms.
This surgical procedure is performed in many cases, including to repair a fracture, remove a tumor or lesion, remove a blood clot, treat an area of infection, stop bleeding, implant electrodes to monitor seizures or treat an aneurysm.After surgery, the patient is monitored closely in an intensive care unit. The sutures will be removed in about a week and you will be given intravenous fluids for the first few days. The medical team will also monitor intracranial pressure.
A surgical treatment involving the implantation of a medical device called a brain pacemaker. This pacemaker sends electrical impulses to specific areas of the brain. The procedure has been known to provide remarkable therapeutic benefits for chronic pain, Parkinson's disease, tremors and dystonia. It directly changes brain activity in a controlled manner and its effects are reversible.
Doctors - Kent C. New, M.D., Ph.D.
Location - St. Luke's Hospital
This fairly new treatment option is done for some types of lower back pain and may become the standard treatment. It is similar to other types of joint replacement in that the surgeon removes a damaged joint and replaces it with a metal and plastic implant. This implant is designed to move just like a normal disc. The advantages are that the new disc allows motion at the damaged level and does not transfer stresses to adjacent levels.
Surgery for those with epilepsy is an alternative for those with seizures that cannot be controlled by medications. The benefits outweigh the risks, however, there is no guarantee that it will be successful at controlling seizures. This surgery is especially beneficial to those who have seizures associated with structural brain abnormalities, such as benign brain tumors, malformations of blood vessels and strokes.
Doctors - Ali Chahlavi, M.D., Kent C. New, M.D., Ph.D.
A minimally invasive procedure where an implant is placed between the spinous processes of the symptomatic disc levels. This procedure was developed for those with Lumbar Spinal Stenosis and who are only able to relieve their symptoms by bending forward or flexing the spine. The implant is designed to limit pathologic extension of the spinal segments and maintain them in a neutral or slightly flexed position allowing patients to resume their normal posture.
The use of specific methods to monitor the functional integrity of the nerves during complex surgery, especially during manipulation of the spinal cord. This method greatly reduces the risk of surgery-related nerve damage.
This catheter creates a pathway for medication flowing from a pump to the drug delivery site in patients with spinal cord injuries.
This minimally invasive spinal procedure is done to treat small fractures in the spinal column due to osteoporosis. It can also help prevent weak vertebra from becoming fractured by strengthening the bones in your spinal column.The procedure involves the use of balloons and the injection of a fast-hardening glue into the regions that are fractured or weak. Two small incisions are made in the back where the balloons are placed and inflated to widen the areas affected. This method has shown to be safe and effective, and because the glue hardens within 15 minutes, there is little or no healing process. Pain from the procedure is usually gone within two weeks.
This surgery removes the lamina, two small bones that protrude from a vertebra, or bone spurs in the back taking pressure off the spinal nerves or spinal column. This procedure opens up the spinal canal so the spinal nerves have more room. Once the procedure is complete, a medical professional has the patient walk around as soon as the anesthesia wears off. Most patients are allowed to go home one to three days after surgery.
This is a relatively new, minimally invasive approach performed on the anterior spine. This procedure avoids an incision that traverses the abdomen and also avoids cutting or disrupting the muscles of the back. In this fusion technique, the disc space is accessed from a very small incision on the patient's side a couple of inches in length, occasionally with another small, one-inch incision just behind the first.Special retractors are utilized, in addition to a fluoroscopy machine, which provide real-time x-ray images of the spine. In addition, special monitoring equipment is used to determine the proximity of the working instruments to the nerves of the spine. The disc material is removed from the spine and replaced with a bone graft, along with structural support from a cage made of bone, titanium, carbon-fiber or a polymer.This technique typically allows a shorter hospital stay and may be less painful than traditional approaches to the spine, however it also has limitations. Only those vertebra of the spine that have clear access from the side of the body can be approached using this technique. Also, only one or two levels can usually be accessed via this method.
This procedure is performed to fuse two vertebral bodies together due to a fracture of the lumbar vertebral body, or for significant compression of the dura mater from the vertebral body. The goal is to position a graft in order to eventually join and fuse with the vertebrae above and below it.
There are two types of this procedure, Microcompression and Microdiscectomy. Microdecompression is the removal of bone from the spine and Microdiscectomy is the removal of the disc. Both procedures are a way to perform lower-back surgery through a small incision and take pressure off nerves to reduce symptoms.
This procedure is a less invasive way to fuse the spine and is generally used for the treatment of back pain caused by degenerative disc disease. The damaged disc is partially removed to eliminate the inflammatory proteins within the disc. Temporary spacers are inserted into the empty disc space to realign the bones and lift pressure from the pinched nerve roots. They are then replaced by threaded metal cages packed with bone graft, which are then screwed into place.
A surgical procedure used to relieve pressure off the spinal canal for the exiting nerve root and spinal cord. It increases the amount of space available for the neural tissue, releasing the nerve. This procedure is done in order to treat bone spurs, pinched nerves, spinal stenosis, herniated discs, bulging discs and arthritis of the spine.
This system is used for spinal stabilization and has become fairly common in spine surgery. The screws traverse all three columns of the vertebrae allowing rigid stabilization of the ventral and dorsal aspects of the spine. The fixations do not require intact dorsal elements, so they can be used after a laminectomy or traumatic disruption of laminae.
Before this procedure an X-ray is done in order to assure the surgeon is entering the correct part of the spine. A small incision is made on the back of the neck to remove the effected parts of the disc. For better visualization, an operating microscope is used. The major advantage of this approach for a cervical disc herniation is that a fusion does not need to be performed resulting in shorter healing time. One major disadvantage is that since the disc is not completely removed, re-herniation is possible.
Performing a cervical discectomy from the back of the neck is often considered for large soft disc herniations that are to the side of the spinal cord. The key advantage to this approach is that there is no need for a spinal fusion after removing the disc. This preserves the normal motion of the cervical spine and could shorten healing time. However, since this approach does not completely remove the disc, there is a chance of it re-herniating in the future.
The PLIF procedure involves three basic steps. First is pre-operative planning and templating where the surgeon uses MRI and CAT scans to determine what size implant(s) the patient needs.Once this is completed, the surgeon must prepare the disc space and remove the affected disc and surrounding tissue. The surgeon then prepares the bone surface of the adjacent vertebra for fusion. Once the disc space is prepared, a bone graft, allograft, or BMP with a cage (a biomechanical spacer implant) is inserted into the disc space to promote fusion between the vertebrae. The implant may be made of bone, metal, carbon fiber or other material. Additional instrumentation, such as rods or screws, will also be used at this time to further stabilize the spine.
This implant is used to exert pulsed electrical signals to the spinal cord to control chronic pain. This is currently the most used treatment of failed back surgery syndrome, complex regional pain syndrome and refractory pain due to ischemia.
This surgical procedure fuses, or permanently places together, vertebrae that cause back pain. It is usually done along with other spinal surgical procedures. Patients normally have to stay in the hospital for three to four days after surgery in order to be monitored and to be kept in the right position to maintain alignment.
This type of spinal fusion is a surgical technique to stabilize the spinal vertebra and the disc between the vertebra. This procedure is designed to create solid bone between the adjoining vertebra to eliminate movement between the bones. The overall goal is to reduce pain and nerve irritation.
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