This
is a list of the procedures provided at Goldsboro
Neurological Surgery. It is not a comprehensive list
in view of the fact that variants of the procedures
mentioned in this list are performed without necessarily
labeling these in one or another category. This is
a guideline that will give the reader an idea of the
nature of our practice. You may also find more information
on these diseases under our Medical
Links page.
CAROTID ENDARTERECTOMY:
This procedure consists of the opening of a blocked
artery in the neck for the purpose of improving blood
supply to the brain. The operation is done under general
anesthesia with transcranial cerebral oximetry monitoring
which is a relatively innovative technique of measuring
oxygen supply in the brain during surgery. Usually,
patients stay in the hospital overnight and leave
the next morning after breakfast.
PERIPHERAL
NERVE SURGERY:
Carpal Tunnel Release
Carpal tunnel syndrome occurs when a nerve in the
wrist becomes pinched. The treatment is a minimally
invasive operation through a small incision in the
palm of the hand which can relieve the symptoms of
a carpal tunnel syndrome quite promptly. The operation
is done as an outpatient under regional anesthesia
and takes approximately 10 minutes.
Post-Op Instructions Following
Carpal Tunnel Release
Ulnar Nerve Release
Ulnar neuropathy occurs when the ulnar nerve is compressed,
usually at the elbow but sometimes at the wrist as
well. This nerve can be released and/or relocated
if necessary according to the patient's condition.
90% of patients do quite well with a simple decompressive
procedure. The operation is done as an outpatient
under regional anesthesia and takes approximately
10 to 20 minutes.
Reconstructive/Reparative surgery for Peripheral Nerves
Any nerves that are severed by trauma can be repaired
with a nerve graft or a small collagen absorbable
tube that brings two ends of the nerve together. Although
nerve function after nerve repair is not normal, in
many cases, depending on the individual nerve and
the nature of the injury, relatively good function
can be obtained. We specialize in this particular
type of surgery and the nature, risks and postoperative
course depend on the individual nerve and particular
injury.
Release of Various Nerves in The Upper and/or Lower
Extremities
Other than carpal tunnel syndrome or ulnar neuropathy
at the elbow, other nerves can be compressed in different
areas of the body. For instance, the peroneal nerve
around the knee can be compressed, causing a peroneal
neuropathy that can mimic a pinched nerve in the back.
The posterior tibial nerve can be pinched at the ankle,
causing a tarsal tunnel syndrome. We specialize in
the release of nerves in the upper or lower extremities
as needed, in various locations, depending on the
patient's particular condition.
CRANIOTOMIES:
Aneurysms
An aneurysm is an abnormality of a blood vessel which
results in a balloon-shaped weak spot which can rupture.
This can cause a devastating condition called subarachnoid
hemorrhage which may result in death. One of the main
purposes of treatment consists of separating the aneurysm
from the rest of the circulation in order to prevent
rebleeding. This usually requires opening the skull
and placing a small clip on the neck of the aneurysm
in order to separate it from its primary artery.
Chiari Malformation
We have been performing more and more surgery for
Chiari I malformation in patients who were not previously
diagnosed with this entity. We have been surprised
by the excellent results following surgery. The operation
usually takes approximately an hour. It consists of
enlarging the foramen magnum which is the opening
of the base of the skull connecting the brain stem
to the spinal cord. In addition, a part of the back
of the cervical spine may need to be removed as well.
Most patients stay in the hospital overnight and leave
the next morning after breakfast. The nature and extent
of surgery varies from one patient to another, according
to the severity of the Chiari malformation.
Hematomas
Various kinds of hemorrhages in or around the brain
may necessitate surgery. Those are usually secondary
to trauma or high blood pressure. Those operations
are to be discussed with each patient individually
according to the nature of hemorrhage they have experienced.
Tumors
One of the main treatments for brain tumors, whether
or not they involve the brain or put pressure on the
brain, involves removal of the tumor mass. This requires
opening the skull and debulking or completely removing
the tumor, if possible, without injuring healthy brain.
The nature of the operation depends on the location
of the tumor as well as the nature of the tumor.
SPINE SURGERY:
Decompressive Cervical or Lumbar Laminectomy
These operations are classical neurosurgical procedures
which consist of removal of part of the back part
of the spine in order to make more room for the spinal
cord and/or nerve roots. Depending on the patient,
they are either done as an outpatient or overnight
observation. These operations are done under general
anesthesia.
Post-Operative Instructions
Following Decompressive Lumbar Surgery
Anterior Cervical Discectomy and Fusion
Most often, diseases of the cervical spine are treated
with an operation that is done from the front of the
spine. It is performed under general anesthesia and
requires a small incision in the front of the neck
through which the spine is accessed. Following removal
of the offending agent (herniated disc or spur), the
two vertebra are fused to each other by a mechanical
device and/or bone. We have been using anterior cervical
plates or interbody cages for his purpose. The type
of device used depends on the nature of the disease
and the patient's quality of bone.
Post-Operative Instructions
Following Anterior Cervical Discectomy And Fusion
With A Plating System
Post-Operative
Instructions Following Anterior Cervical Discectomy
And Fusion With A Interbody Cage
RECONSTRUCTIVE LUMBAR
SPINE SURGERY:
Unstable lumbar spine pathology can be fixed by placement
of hardware that connects the various segments of
the spine that are involved. This may require operations
from the front or from the back of the spine and various
types of hardware the nature of which depends on the
pathology of individual patients.
SHUNTS:
Hydrocephalus
Hydrocephalus is an accumulation of spinal fluid inside
the ventricles which are fluid chambers in the brain.
This is due to various causes and quite often requires
placement of a tube that connects the inside of the
ventricle to the peritoneal cavity or the chest cavity
for drainage of this fluid.
Syringomyelia
This is a condition in which there is an accumulation
of spinal fluid inside the spinal cord. Often times
it is secondary to a Chiari Malformation which, when
corrected, can result in improvement and sometimes
complete disappearance of the syrinx cavity. However,
sometimes the cavity persists and may require placement
of a drain.
PLACEMENT
OF VAGUS NERVE STIMULATOR:
We have recently begun to offer a new procedure for
the treatment of seizures. Placement of a vagus nerve
stimulator is a relatively new operation for patients
who are unresponsive or poorly tolerant of their anti-seizure
medication. These patients come to us upon referral
from a neurologist following a work up to determine
eligibility. The surgery, which takes an hour, is
very well tolerated and performed as an outpatient
procedure. For further information, please refer to
Cyberonics,
the company that manufactures the stimulator. We have
a news article
about the nerve stimulator as well.
Return
to top of page
