With regards to surgical treatments, this means causing the least amount of tissue disruption possible while still performing maximally effective surgery. However, the least invasive treatment of many potentially surgical problems involves no surgery at all. At ANSS we use a multidisciplinary approach to push patients through a full spectrum of non-operative treatments before committing to the risk and tissue disturbances associated with surgical intervention. For brain tumor patients this may mean a minimally invasive biopsy, followed by Radiosurgery. Many patients with trigeminal neuralgia can now be effectively treated without ever making an incision. Neck and back pain patients can usually get substantial relief from physical therapy, anti-inflammatory medications and lifestyle modifications.
For patients who do require surgery, this same thought process is brought into the operating room. Neuro-navigation (GPS for the brain) allows smaller incisions, and reduces risk for brain tumors. Muscle sparing spine surgery maintains the normal stabilizing function of the muscles around the spine and also allows an equally effective operation to be done through a much smaller incision.
A minimally invasive approach to neurosurgery leads to better results for patients by avoiding surgery until it is necessary, smaller incisions, faster recovery, fewer complications, and reducing long term pain.
Minimally Invasive Surgery
This condition occurs when the cushion pad center of a spinal disc in the neck or the low back pushes through a crack in the tougher outer ligament.
Some herniated discs cause moderate local pain. Others can irritate nearby nerves and result in pain, numbness, or weakness in an arm or leg. In some cases the disc herniation can cause serious neurological injury, and if there is pressure on the spinal cord it can cause a spinal cord injury.
Not every disc herniation needs intervention. When needed, conservative treatment includes anti-inflammatory medication, physical therapy, and possibly injections. In cases where this fails surgery is usually very helpful.
Trauma to the spine comes in many forms. Some injuries are minor and may cause minimal pain. Others are life altering events that can cause paralysis. The treatment is also quite varied. Some fractures require no treatment, others are treated with bracing, pain control and rest, and others require surgery.
Spinal stenosis or narrowing is a common condition that occurs when the small spinal canal, which contains the nerve roots and spinal cord, become compressed or. This causes pressure on the spinal cord and nerve roots. The pressure leads to pain, cramping, weakness, and numbness. In severe cases balance trouble, loss of dexterity, and incontinence can be problems. Depending on where the narrowing takes place, you may feel these symptoms in the lower back and legs, neck, shoulder or arms.
Usually, the narrowing is caused by wear and tear arthritis, of the joints in the spinal column. It may also be caused by a thickening of the ligaments or bulging of the discs that separate the vertebrae.
Symptoms of lumbar spinal stenosis often start slowly and get worse over time. Pain in the legs may become so severe that patients cannot walk even short distances. Physical therapy, blocks, and anti-inflammatory can help, but this problem usually worsens to the point of surgical intervention.
Cervical stenosis also causes progressive symptoms which are usually modest at first but can rapidly progress to severe dysfunction in the arms and legs. If neck and arm pain are the only problems, nonsurgical treatment may be an option. However, if there is spinal cord dysfunction, surgery will be necessary.
Brain tumors very widely, from tiny benign meningiomas to highly aggressive glioblastomas. The optimal treatment of brain tumors requires a multidisciplinary approach with oncology, radiation oncology, neurology, anethesia and neurosurgery all working together. At Alabama Neurological Surgery and Spine we strive to provide outstanding neuro oncologic care for our brain tumor patients using the most advanced imaging, surgical, and radiosurgical techniques.
Trigeminal neuralgia is a Very painful condition that affects the nerve, which carries sensation for your face. The electrical like pain usually seems to come from nowhere, but with trigeminal neuralgia, drinking, brushing your teeth or putting on makeup may trigger a jolt of excruciating pain.
Patients with trigeminal neuralgia usually experience attacks that only last a second or two, but the pain can sometimes progress and cause longer, more-frequent bouts of burning pain. Trigeminal neuralgia affects women more often than men, and it's more likely to occur in people who are older than 50. This seems to be coming from short circuiting in the nerve associated with a blood vessel pressing on and damaging the trigeminal nerve as it comes out of the brainstem.
Treatment for trigeminal neuralgia is usually medical at first using Tegretol or other seizure medicines. However, if these treatments fail surgical options such as a microvascular decompression or stereotactic radiosurgery are usually very effective.
Hydrocephalus is the backing up of spinal fluid in the brain. This causes elevated pressures and can damage neurologic structure leading to loss of function. At times this elevated pressure can be life-threatening and at other times it is simply debilitating.
Hydrocephalus can come from a variety of sources. Bleeding in the brain is a common source of hydrocephalus as is trauma, Brain tumors or infections are also causes of hydrocephalus. Alternatively some patients have idiopathic forms of hydrocephalus that do not have a clear source.
The treatment of hydrocephalus involves diverting the spinal fluid. This prevents the damage caused by the buildup of pressure. Hydrocephalus is usually treated by placing a shunt to take the spinal fluid elsewhere in the body, such as into the peritoneal cavity or around the lung. In some very specific cases of spinal fluid flow obstruction a hole can be created in the base of the brain called a third ventriculostomy. This allows spinal fluid flow past an obstruction and around the brain where it can be absorbed normally.
Carpal Tunnel Syndrome
Compression of the median nerve at the wrist causes carpal tunnel syndrome. This results in a painful numbness involving the palm and first four fingers. This is worse at night or with activity. initial treatment involves medication and bracing. This can respond well to surgery if conservative treatment fails.
The ulnar nerve passes around the elbow and is commonly called the "funny bone". compression at the elbow can create pain, numbness and weakness in the hand. If there is significant weakness or the symptoms are bothersome decompression and possibly moving the nerve can significantly help
Spinal Cord Stimulation
Sometimes low back and leg pain are coming from a problem that cannot be directly fixed. In these cases spinal cord stimulation can help with the pain. This involves placing a set of electrodes into the spinal canal and connection to a pacemaker like device.
Before we become involved in placing a spinal cord stimulator, a pain management physician does a trial to see how well it will work. in the trial, temporary electrodes are placed through a needle.
If we determine that stimulation is the best option for you, we will refer you to a pain management physician to undergo the workup and trial.
Benign and malignant tumors spinal column can create pain and cause neurologic dysfunction. These typically require a multimodality approach involving an oncologist, a radiation oncologist, and a neurosurgical specialist. Each of these cases is unique and at Alabama Neurological Surgery and Spine your care will be tailored to your specific circumstances. With modern decompressive and reconstructive techniques, even dramatic difficulty from invasion of the spinal column from cancer can be successfully addressed.
Normally the cerebellum and parts of the brain stem sit above an opening in the skull for the spinal cord called the foramen magnum. When part of the cerebellum extends below the foramen magnum and into the upper spinal canal, it is called a Chiari malformation This causes pressure on the cerebellum and brain stem that may affect functions controlled by these areas. It also blocks the flow of spinal fluid. The blockage in the flow of spinal fluid can cause damage from abnormal fluid pressure in the brainstem and spinal cord.
Some Chiari malformations cause problems and require surgery, while others do not. Generally if there is significant headache in the base of the skull with straining, it will get better with surgery. If there is swelling in the brainstem or spinal cord or a dilated fluid space called a syrinx surgery is important to preserve neurologic function. Many other Chiari malformations do not require any treatment.