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Types of Surgeries

Spine

Spinal Cord: Cervical and Thoracic

Cervical spine surgery refers to surgery of the upper spinal column, or the neck. Thoracic surgery is surgery involving the thorax, or part of the spine that lies between the rib cage.

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Lumbar and Sacral Spine

Lumbar spine surgery refers to procedures involving the spinal cord, from the bottom of the rib cage to the pelvis. Sacral spine surgeries are procedures that involve the triangular segment of the spinal column, or the pelvis.

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Anterior Lumbar Interbody Fusion (ALIF)

Anterior Lumbar Interbody Fusion (ALIF) is a procedure for degenerative disc disease. Treatment involves fusing vertebrae together in order to stabilize the spine and reduce or eliminate pain in the leg or back.

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Anterior Cervical Discectomy

Anterior Cervical Discectomy is performed to remove a herniated or diseased disc, relieving pain from the neck and arm.

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Kyphoplasty

Kyphoplasty is a treatment for osteoporosis-related spine fractures. Surgery helps to straighten the spine and provides relief of back pain.

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Laminoplasty

Laminoplasty is performed to relieve pressure in the neck by creating more space for the spinal cord and roots.

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Laminectomy

A laminectomy is a surgical procedure for the treatment of stenosis, or narrowing of the spinal canal. The surgery removes the lamina to relieve pressure on the spinal cord and nerve roots.

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Lumbar Corpectomy

Surgery is performed to correct deformities of the spinal column and relieve pain resulting from vertebrae that block and pinch the spinal cord.

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Posterior Lumbar Interbody Fusion (PLIF)

Posterior Lumbar Interbody Fusion is performed to stabilize the spine by fusing vertebrae together using bone and graft material.

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Spinal Fusion

Spinal fusion is performed for the correction of spondylolisthesis, or displacement of the lower vertebrae.

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Transforaminal Lumbar Interbody Fusion (TLIF)

This surgery fuses vertebrae together using bone and graft material in order to stabilize the spine for patients suffering from degenerative disc disease.

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Lateral Lumbar Interbody Fusion (XLIF)

Lateral Lumbar Interbody Fusion is used in the treatment of degenerative disc disease to treat leg or back pain.

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Intracranial

Acoustic Neuromas

Acoustic Neuromas are benign tumors near the brain. These tumors may cause hearing loss or deafness, tinnitus, and loss of balance. Without treatment, acoustic neuromas may be life-threatening.

There are two types of treatment for Acoustic Neuromas, the suboccipital approach and the translabyrinthine approach. The suboccipital approach strives to preserve both the patient's hearing and facial nerves, while the translabyrinthine approach, sacrifices the patient's acoustic nerve in order to preserve the facial nerve.

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Cranial Aneurysm

A cranial aneurysm occurs when a blood vessel increases in size. Without treatment, the aneurysm may rupture and bleed into the brain, resulting in severe disability or death.

Cranial aneurysms are typically treated through a surgical procedure that involves microsurgical clipping.

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Arteriovenous Malformation (AVM)

Arteriovenous malformation refers to a mass of abnormal blood vessels in the brain or spinal cord. Individuals with arteriovenous malformation have arteries in their brain that connect directly to veins rather than going through capillaries, or tiny blood vessels. Since these veins are unable to carry all the blood flowing from the arteries, they begin to enlarge and pressure builds. This pressure can eventually lead to hemorrhaging or bleeding in the brain.

Treatment for arteriovenous malformation typically involves surgery, which is performed by completely removing this mass of abnormal blood vessels.

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Brainstem Tumors

Brainstem tumors may be benign or malignant masses located in the portion of the brain that connects the spinal cord to the cerebrum and the anterior region of the brain.

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Cerebellopontine - (CP) Angle Tumor

A cerebellopontine tumor is located near the base of the brain, near where the auditory nerve enters the skull. It may cause hearing loss or deafness, tinnitus, loss of balance, or involvement of other cranial nerves. Without treatment, a cerebellopontine tumor may be life-threatening.

Surgical treatment for a cerebellopontine tumor involves removing the tumor. However, depending on the size and exact location of the tumor, the auditory and cranial nerves may be at risk.

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Chiari Malformation - (Suboccipital Crani For)

A Chiari Malformation is a structural defect in which the cerebellum and brainstem are pushed downward. The pressure on the cerebellum may block the fluid that protects the brain and spinal cord, resulting in weakness, headache, loss of balance, and numbness, as well as vision and coordination problems.

Treatment for Chiari Malformation may involve one or more surgical procedures to stimulate the circulation of spinal fluid and relieve pressure on the brain stem, cerebellum, and spinal cord.

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Cortical Tumors – (Frontal/Parietal Lobe)

Cortical tumors are tumors located in the cerebral cortex.

Surgical treatment for cortical tumors involves completely removing the cancerous mass.

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Occipital Lobe

The occipital lobe contains the portion of the brain that has to do with vision. Any surgery performed in this area of the brain may place the optic areas at risk.

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Temporal Lobe

The temporal lobe refers to the lower portion of the brain that has to do with hearing and language.

Procedures performed in the temporal lobe often place at risk portions of the cortex responsible for language recognition and production. These structures are monitored by stimulating the cortex to determine whether language is disrupted by temporarily blocking their function with stimulus (electrocortiocography).

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Microvascular Decompression of Facial Nerve VII for Hemi-Facial Spasm

Hemi-facial spasm refers to a “tick” in the facial muscles which results from mechanical irritation of the facial nerve as it passes between the skull and the brainstem. It is often treated by surgically repositioning arteries that may be impinging on the nerve.

Facial nerve paralysis can be treated through electrophysiology.

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Microvascular Decompression of Trigeminal Nerve V - (For Tic-Douloureux)

Tic douloureux is a condition in which the trigeminal nerve, the nerve that provides sensation to the face, delivers a sharp pain to one side of the face. Patients suffering from tic douloureax experience intense facial pain of the jaw, cheek, or lip. Such pain occurs periodically, lasting from only a few seconds to a few minutes. This condition may arise from mechanical pressure on the trigeminal nerve as it passes between the skull and the brainstem.

In some cases, this condition can be treated by surgically repositioning arteries touching the trigeminal nerve.

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Optic Nerve Tumor

A tumor of the optic nerve, also known as the cranial nerve II, may be removed through surgery. However, since disruptions along the optic nerve path can result in vision loss, neural monitoring is necessary to reduce the chance of nerve damage. Flash visual evoked potential testing is performed throughout surgery.

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Pallidotomy/Thalamotomy

Pallidotmy and thalamotomy are surgical procedures often used to treat patients suffering from Parkinson's Disease. Pallidotomy destroys an area of the brain known as the globus pallidus, which controls movements. Through its destruction, the patient often regains balance in this area of the brain and is better able to control muscles that were once moving involuntarily.

Thalamotomy, on the other hand, is a surgical procedure used to reduce tremors by destroying part of the thalamus.

Deep brain stimulation is now used as a method of treatment to block abnormal nerve signals in the brain, thereby reducing or eliminating neurological movement disorders. The procedure involves implanting an electrode deep in the brain. Electrical current from this stimulator blocks the function of certain areas and relieves the symptoms of tremors. Neural monitoring is used to accurately locate the exact part of the brain into which the electrode will be inserted.

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Parotidectomy

Parotidectomy is performed to surgically remove the parotid gland, the largest salivary gland. The facial nerve passes through this gland and may be injured during surgery. Facial nerve monitoring helps protect this very important cranial nerve.

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Transphenoidal Hypophysectomy - (Pituitary Tumor Removal)

Transphenoidal hypophysectomy is the removal of a pituitary tumor through the nasal cavity. The pituitary gland rests just below the optic nerve. Continuous visual monitoring can aid in protecting the optic nerve and preserving visual function.

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Tympanomastoidectomy

A tympanomastoidectomy is a surgical procedure of the middle ear to remove an abnormal growth located behind the eardrum. During this procedure, and other surgeries of the middle ear, the facial nerve is at risk for damage since it passes very close to the middle ear cavity. Facial nerve function is monitored by means of facial EMG.

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Peripheral Nerves

Acetabular Fracture Reduction

Acetabular fractures typically result from trauma to the pelvis and femur. Fracture reduction is performed to realign the bones in a normal position.

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Peripheral Nerve Repair

Peripheral nerves that have suffered trauma due to a severe or repetitive injury may need repair. Such repair can be achieved through surgery by restoring the connection between the nerve ends, with or without a nerve graft.

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Vascular

Carotid Endarterectomy

Carotid endarterectomy is a surgical procedure to remove the inner lining of a carotid artery due to damage or thickening; thereby removing plaque and restoring blood flow.

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Cardiopulmonary Bypass with Induced Hypothermia

A cardiopulmonary bypass is performed in order to repair a cardiac defect. To do this, the lungs and heart must be stopped, and blood and oxygen are delivered to the body through mechanical pumps. Hyperthermia is induced to cool the body, thereby protecting the brain. When the body is cool, the brain's need for oxygen and nutrients is reduced.

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Aortic Aneurysmectomy

An aortic aneurysmectomy is a surgical procedure wherein an aneurysm, or blood-filled blood vessel in the aorta is surgically removed.

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