Q: Why do Neurosurgeons treat "back" problems?

A: Ask most people what neurosurgeons do and they'll tell you they operate on the brain. People are often surprised when we tell them that neurosurgeons are back specialists, too! Today more than 80% of the nation's 3800 active neurosurgeons specialize in treating back problems.

Neurosurgeons perform many of the surgeries used to provide relief from the degenerative spinal condition known as lumbar spinal stenosis (LSS). LSS is characterized by intermittent pain in the lower back which radiates to the buttocks, thighs, and legs of older patients. LSS is often associated with numbness, tingling, and weakness when walking. In its most advanced stages, LSS can occasionally cause severe neurological problems, including significant leg weakness and difficulty with bowel and bladder function.

For advanced cases, surgery is often the only treatment of choice. The most common procedure, known as decompressive laminectomy, is performed about 60,000 times annually on patients over 60, with improvement in 75-80 percent of patients. Many patients can resume normal activities including walking, golf and gardening. Improvements can be remarkable!

Q: Why does a herniated disc in my back cause pain in my leg?

A: With wear and tear, a fragment from the inside of a disc can migrate out of the disc space and lodge itself under a nerve root. This is called a disc herniation. Since the disc herniation pinches a nerve, it can cause greate pain, numbness, and/or weakness down the path of that particular nerve (usually into the arm or leg).

If nonsurgical treatments fail, then we usually recommend a microdiskectomy. This involves removing the disc fragment through a small incision, with the aid of an operating microscope. Patients are usually only hospitalized overnight, and recover quickly.

Q: Should I have surgery for carpal tunnel syndrome?

A: When the median nerve is compressed in the tunnel of ligaments, bones, and tendons at the wrist, known as the "carpal tunnel", numbness, tingling, and pain in the thumb and adjacent two fingers occurs. If the compression is severe enough or has been present long enough, nerve damage will occur. With nerve damage, the prominent muscles at the base of the thumb begin to atrophy, or waste away. In addition, the sensation at the fingertips begins to slowly decrease, and simple tactile functioning, such as buttoning your clothes, can be impaired. If left untreated, the median nerve injury can become permanent and irreversible.

Surgical treatment of carpal tunnel syndrome is prescribed after conservative (nonsurgical) treatment is no longer effective in controlling the symptoms mentioned above. Our surgical procedure involves complete division of the carpal ligament using a small one-half inch incision in the crease of the wrist. The procedure takes about ten minutes and the incision is closed with two to three stitches. Return to work usually occurs within three weeks, and regular activities resume almost immediately.

For more information, simply call our office for a brochure. Also, our Carpal Tunnel Coordinator is available during office hours for your questions.

Q: How is tremor treated?

A: Tremor is a specific type of movement disorder that may be caused by Parkinson's Disease, essential tremor, or multiple sclerosis. Most patients with tremor are able to live with their illness. Many use medication successfully. Sometimes, however, tremor becomes too severe and patients cannot perform their normal daily activities, such as holding a cup without spilling the contents.

A specially trained neurosugeon can perform DBS (Deep Brain Stimulation) on patients who have failed medical treatment, or when their medications have become less effective. DBS involves placement of a small electrode into the brain area where movement is controlled. This electrode is attached to a stimulator much like a cardiac pacemaker. The entire DBS device sits permanently under the skin, and can be very effective in controlling severe tremor and other movement problems related to Parkinson's Disease. For more information on this procedure, contact our office.

Q: What are cerebral aneurysms and how are they treated?

A: Cerebral aneurysms are weakened points in a blood vessel that feeds the brain. These areas balloon outward like a blister, and can rupture, causing severe bleeding and stroke. Unfortunately, most patients with aneurysms do not know they have one until it bleeds. Aneurysms may also be discovered unexpectedly on an MRI or arteriogram that is being performed for a different reason.

Whether an aneurysm has bled or not, we can treat them through surgery to prevent future bleeding. We also work with neuroradiologists, who have a nonsurgical approach to treating aneurysms. They are able to treat aneurysms from within the blood vessel itself by using a small catheter. There are certain risks and benefits to either of these procedures, and we would be happy to discuss the options with you if you are seeking treatment.

Q: What is carotid stenosis and how is it treated?

A: Carotid stenosis is a narrowing of one of the major blood vessels that feeds the brain. The narrowing can cause strokes to occur. For certain patients, studies have clearly shown that surgical treatment of this condition is superior to medical treatment alone (taking a blood thinner). Surgery involves removing the plaque that resides within the wall of the artery, thereby creating room for the blood to flow more freely.

Q: What are the different types of brain tumors and how are they treated?

A: There are many different types of brain tumors. They can be benign or malignant, and can either arise from brain tissue itself, or can spread from other parts of the body. Depending on the patient's condition and the tumor's type, size, and location, there are different treatment options available.

The main types of treatment include surgical removal or biopsy, radiation therapy, and chemotherapy. Sometimes a patient needs a combination of one or more treatments.