Our physicians and surgeons are skilled in performing highly complex, proven treatments for a wide range of neurosurgical conditions. Each specialist combines advanced training with years of experience in their subspecialty area to give you exceptional results. While we perform more complex neurosurgical procedures than any other area practice, we start with the most conservative treatment option appropriate for your condition and help you fully understand all of your treatment options.

treatments

Anterior Cervical Discectomy and Fusion

Review some of the most commonly asked questions about Anterior Cervical Discectomy and Fusion (ACDF): What is Anterior Cervical Discectomy and Fusion? What Are The Benefits of Anterior Cervical Discectomy and Fusion? What Are The...

Botulinum Toxin Injections

What is botulinum toxin injection? Botulinum toxin injection is an effective treatment for a variety of movement disorders including myoclonus, hemifacial spasm, spasticity, tremor, blepharospasm, cervical dystonia, spasmodic torticollis and dystonia of the leg and...

Brain Arteriovenous Malformation Treatment Options

Review some of the most commonly asked questions about brain arteriovenous malformation: What is a brain arteriovenous malformation? What are the symptoms of a brain AVM? How are brain AVMs diagnosed? What is the best...

Brain Mapping and Awake Brain Surgery

Cortical Motor Mapping Electrophysiological brain mapping is performed as a necessary adjunct in surgery to clarify the relationship of brain tumors to functional regions of the brain. Mapping is most commonly performed during surgery to...

Brainstem Surgery

What is the brainstem? The brainstem is a vital part of the nervous system that not only transmits motor and sensory fiber tracts but also houses centers or ‘nuclei’ which initiate and maintain a variety...

Cerebral Angiogram

Review some of the most commonly asked questions about cerebral angiograms: What is a cerebral angiogram? When are cerebral angiograms needed? How to prepare for a cerebral angiogram? What to expect during the procedure? Follow...

Cerebral/Spinal Angiography

What is a cerebral angiogram? Angiography is the most reliable and sensitive diagnostic test for the detection and clarification of the anatomy of brain aneurysms, AVM and other cranial or spinal vascular lesions. This procedure...

Cerebrovascular Bypass Procedures

In certain cases when the brain aneurysm cannot be safely clipped using standard techniques, and the aneurysm cannot be treated with coils, the patient may require a reconstruction of the arterial tree allowing for blood...

Chiari Malformation, Chiari Decompression Surgery

Commonly asked questions: What is a Chiari Malformation? What is a Chiari Decompression Surgery? Recovering from Chiari Decompression Surgery Chiari Malformation and Chiari Decompression Surgery What is a Chiari Malformation? Chiari malformation is a condition...

Clinical Trials for Brain Tumors

The division of neuro-oncology is actively involved in research to advance the treatment of gliomas and other brain tumors. Clinical trials are offered to carefully selected patients and serve as an adjunct to standard of...

Computerized Tomography Angiography (CTA)

Computerized Tomography (CT) Despite the fact that MR has largely superseded CT in defining the anatomy, CT remains a necessary tool for the neurosurgeon in a variety of circumstances. CT is used routinely in emergency...

Cortisone injection

We provide cortisone injections in various joints such as the shoulder, elbow wrist, hip and knee. Cortisone is a powerful anti-inflammatory that can achieve significant temporary relief of conditions such as bursitis, tendinitis and arthritis....

Cranial Stereotactic Radiosurgery

Accuracy and conformity of targeting in cranial neurosurgery is achieved through the use of stereotaxis. With this technique, imaging studies are used to create a three dimensional map of the skull and brain or other...

Craniofacial Resection

Craniofacial Resection procedures require the coordinated efforts of a team of surgeons generally comprised of a skull-base neurosurgeon, an otolaryngologist and a plastic and reconstructive surgeon. Together these specialists work to resect tumors that typically...

Craniotomy

What is Craniotomy? Review some of the most commonly asked questions about Craniotomy: What is a craniotomy? Which conditions can benefit from a craniotomy? How to prepare for a craniotomy? What happens during craniotomy? What...

Craniotomy and Clipping of Brain Aneurysms

What is microsurgical clipping? Anatomical factors at times compel the surgeon to recommend microsurgical clipping of an aneurysm rather than endovascular coil embolization. Craniotomy and clipping requires the placement of an incision behind the hairline...

Craniotomy, Craniectomy, Cranioplasty

Craniotomy vs Craniectomy vs Cranioplasty The three procedures of craniotomy, craniectomy, and cranioplasty are all related in that a surgeon performs a procedure to access the cranial cavity. The differences between a craniotomy vs craniectomy...

Deep Brain Stimulation (DBS)

What is Deep Brain Stimulation Deep brain stimulation (DBS) for Parkinson’s disease, essential tremor and dystonia relies on the application of small but meaningful electrical pulses to well defined targets (nuclei) in the brain rather...

Degenerative Disc Disease

Review some of the most commonly asked questions about Degenerative Disc Disease Treatment: What is Degenerative Disc Disease? What are the Degenerative Disc Disease symptoms? Is surgery necessary for Degenerative Disc Disease? What are the...

Discectomy

Review some of the most commonly asked questions about Discectomies: What is a discectomy? When is a discectomy recommended? What are the risks for a discectomy? How do you prepare for a discectomy? What happens...

Dorsal Column Stimulation

This procedure is based on the hypothesis that the awareness and debilitating quality of back and leg pain may be lessened by modulating the electrical conductivity of the spinal cord. Modulation of electrical activity is...

EMG Nerve Testing

We have the capability to perform in office EMG nerve testing. This involves testing the electrical response of muscles and nerves and can help diagnose conditions such as sciatica, pinched nerves, and carpal tunnel syndrome.

Endoscopic Biopsy and Resection of Intra-Ventricular Tumors

Endoscopic techniques are useful in treating a variety of intra-ventricular conditions including hydrocephalus and for tumor biopsy. Ventricles are the fluid filled spaces in the center of the brain; cerebrospinal fluid (CSF) is synthesized in...

Endovascular Embolization/Coiling of Brain Aneurysm

Brain aneurysm coiling minimally invasive procedure is performed under general anesthesia and is similar to cardiac catheterization. As reviewed in the cerebral angiography section above, a small plastic tube (catheter) is placed into an artery...

Endovascular Tumor Embolization

A major factor in the duration of and complications related to the resection of brain and spinal tumors is tumor vascularity-the density and richness of blood supply. In selected cases, the surgeon may request that...

Fluorescent Guided Tumor Resection

This adjunct to the surgical resection of brain tumors aids in distinguishing the infiltrative edge of tumors from normal brain tissue thereby increasing the possibility of a more complete resection (figure 1). Pre-operative administration of...

Gamma Knife Radiosurgery for AVM

Petrosal sinus sampling Endovascular treatment of ischemic stroke: Intra-arterial thrombolysis MERCI clot retrieval Stenting of vascular stenosis and dissection Direct surgical repair of aneurysms Intra-cerebral arterial angioplasty: Pharmacologic Mechanical–balloon Ventriculostomy (EVD) Cerebrospinal fluid shunts Ventriculo-peritoneal...

Gamma Knife Radiosurgery for Trigeminal Neuralgia

What is Gamma Knife Radiosurgery? This technique was developed in the 1960’s and allows for the focusing of high and therapeutic doses of radiation with great accuracy thereby limiting damage to surrounding structures. The effect...

Image Guided Frameless Stereotactic Biopsy

Some circumstances require that a biopsy of a tumor is recommended rather than performing significant removal or debulking. Stereotactic biopsy is recommended in this case and is performed using a computer system as noted in...

Incisionless Ultrasound Procedure

Incisionless Procedure: Option for Essential Tremor Essential tremor is a neurologic condition that causes uncontrollable shaking, especially the arms or hands. This movement disorder can prevent a patient from living an independent and active lifestyle,...

Intra-Operative Electromyography

This modality is used to assess the integrity of nerves by measuring the excitability and activity of their target muscles during surgery. The resection of tumors intimately attached to nerves is facilitated by monitoring activity...

Intraoperative Ultrasound

Limitations of MR and CT guided navigation are based on the fact that imaging is obtained prior to surgery and does not reflect subtle real time changes in the position of the brain occurring during...

Intrathecal Morphine/Baclofen Pump

This procedure involves the implantation of a small catheter into the spinal canal of the lower thoracic and upper lumbar spine. This allows for the regulated administration of medication directly into the thecal sac-the fluid...

Laminectomy

Review some of the most commonly asked questions about Laminectomy: What is a laminectomy? Why is a laminectomy performed? How is a laminectomy performed? How long is laminectomy surgery? What are the potential risks or...

Lumbar Discectomy Surgery

Review some of the most commonly asked questions about Lumbar Discectomy Surgery: What is Lumbar Discectomy Surgery? Recovery After Lumbar Discectomy Surgery What Are The Risks of Lumbar Discectomy Surgery? What is lumbar discectomy surgery?...

Lumbar Fusion Surgery

Review some of the most commonly asked questions about Lumbar Fusion Surgery: What is Lumbar Fusion Surgery? How is Lumbar Fusion Surgery Performed? What is the Recovery After Lumbar Fusion Surgery? When Should I Consider...

Magnetic Resonance Imaging (MRI)

This non-radiation based diagnostic study was developed in the 1970’s and was widely distributed in the 1990’s and offers a precise view of brain and spinal anatomy. MR is an indispensable study to all neurosurgical...

Meningioma

Meningioma is one of the most common types of brain tumors, and there are several treatment options depending on your specific case. Age, overall health, symptoms, size of the tumor, and location of the tumor...

Microvascular Decompression

What is Microvascular Decompression? Microvascular decompression is a surgical procedure that was developed based on a hypothesis that pain or other aberrant nerve function was the result of repetitive trauma incurred by the pulsations of...

Minimally Invasive Spinal Surgery

Review some of the most commonly asked questions about Minimally Invasive Spinal Surgery: What Does Minimally Invasive Spinal Surgery Mean? What Are The Benefits of Minimally Invasive Spinal Surgery? Which Conditions Can Be Treated With...

MR Guided Laser-Induced Interstitial Thermotherapy (LITT)

This novel technique has recently been shown to be effective in the management of selected brain tumors and as a method for the management of intractable epilepsy. The procedure involves the placement of a 1.65...

MRI Guided (asleep) DBS

Select patients with Parkinson’s are at times unable to participate in traditional DBS. The necessity of stopping Parkinson’s medication preoperatively is often greatly debilitating and the anxiety associated with participation in surgery is prohibitive of...

Myelotomy

This procedure involves an incision in the spinal cord and is often necessary when removing spinal cord tumors. Alternatively, myelotomy may be a procedure unto itself when considering treatment of lower extremity or pelvic pain...

Neck Surgery / Cervical Spine Surgery

When considering neck surgery there are a number of questions you may have: Do I Need Neck Surgery? What is the Difference Between a Discectomy and a Spinal Fusion Surgery? What Should I Look for...

Neuro-Navigation

This technology has been present for over 15 years and links patient anatomy in the operating room to an imaging study obtained expressly for surgical planning immediately prior to operation. This device occasionally requires the...

Neurophysiological Monitoring (MEP, SSEP and BAER)

In contradistinction to intra-operative mapping, neurophysiological monitoring does not serve to identify the location of critical regions but rather provides real-time information about the integrity of the connections of motor, sensory and auditory systems. As...

Percutaneous Trigeminal Rhizotomy

What is a Percutaneous Trigeminal Rhizotomy? These operations involve the radiographically guided placement of a needle through the skin of the cheek to the foramen ovale – the canal transmitting the trigeminal nerve and the...

Radiosurgical Management of Skull-Base Tumors

Skull-base tumors are by definition located underneath the brain in difficult-to-reach areas and are intimately associated with vital and delicate neurovascular structures. Surgical resection is often necessary to alleviate mass effect and brain swelling associated...

Schwannoma

What is a schwannoma? A schwannoma is a rare type of tumor that forms in the body’s nervous system and grows from Schwann cells. Schwannoma tumors are often benign and slow growing, which means that...

Sciatica Treatment Options

Review some of the most commonly asked questions about sciatica treatment options: What is a sciatica? What are the symptoms of sciatica? What causes sciatica? What are the risk factors for sciatica? How is sciatica...

Selective Dorsal Rhizotomy

This procedure is offered to select patients with spasticity resulting primarily from cerebral palsy who may not be ideal candidates for other types of surgical intervention. The surgery is performed through a lumbar laminectomy which...

Skull-Base Surgery

Although the majority of tumors of the skull-base are not cancerous but rather slowly growing, they have the capacity to cause harm due to their proximity to critical structures underneath the brain. These tumors commonly...

Spinal Decompression

For individuals experiencing back, neck, arm or leg pain due to spinal stenosis, relief may come in the form of spinal decompression. There are several surgical options that can offer symptomatic relief by reducing pressure...

Spinal Fusion

What is spinal fusion surgery? Spinal fusion surgery is a procedure that stabilizes or secures two or more bones of the spine together. The stabilized bones will then heal or “fuse” together over time. The...

Spinal Radiosurgery

Radiosurgical principles may also be used for the treatment of selected spinal tumors as an adjunct to spinal surgery. This technology allows for the administration of a therapeutic dose of radiation to the tumor with...

Spinal Stenosis Treatment Options

Spinal stenosis is a fairly common condition marked by the narrowing of the spinal canal. When the spinal canal narrows, people experience back pain and other nerve issues. There are a range of spinal stenosis...

Spinal Tumor Treatment Options

Review some of the most commonly asked questions about spinal tumor treatment options: What is a spinal tumor? What are the symptoms of a spinal tumor? What are the risk factors with a spinal tumor?...

Stereotactic Cingulotomy

The cingulum is a region of the brain associated with the “limbic” system; this circuitry regulates the perception of emotion and its relationship with pain. Stereotactic cingulotomies have been performed for treatment of refractory depression...

Stereotactic Pallidotomy

Pallidotomy is an ablative procedure that involves the creation of a small lesion in the globus pallidus or pallidum, a sub-region in the chain of nuclei called the basal ganglia necessary for the control of...

Stereotactic Thalamotomy

What is a Stereotactic Thalamotomy? A stereotactic thalamotomy procedure may be used to treat patients with essential tremor or Parkinsonism with tremor as the primary debilitating symptom. During a stereotactic thalamotomy procedure, precise lesions may...

Transcranial doppler (TCD)

This non-invasive bedside test measures the velocity of blood flow from cerebral vessels at risk for the development of vasospasm. An increase in blood flow velocity when compared to baseline measurements offers a reliable indication...

Transsphenoidal Pituitary Surgery

Endoscopic endonasal skull-base surgery is performed routinely allowing for maximal resection of selected tumors of the pituitary gland and surrounding structures. The transsphenoidal surgery takes advantage of the space afforded by the nose and paranasal...

Trigger point injection

We perform trigger point injections which are soft tissue injections usually of a local anesthetic and a small amount of cortisone. Trigger points are areas of painful soft tissue and muscle, usually at the base...

Viscosupplementation “Gel“ Injections

For knee arthritis not requiring surgery we provide viscosupplementation injection of hyaluronic acid, a natural substance. These injections commonly referred to as “gel” injections can temporarily decrease pain, have an anti-inflammatory effect and potentially protect...

WADA Testing

The hippocampus is a region of the temporal lobe that forms the anatomical center of memory. Although language centers consistently localize to the left side of the brain (in the right handed), localization memory is...

Xray

Our office has a state of the art digital x-ray suite allowing us to perform in office x-rays with images immediately available to the physician and patient to review.

Gamma knife treatment trigeminal nerve
Gamma knife treatment plan demonstrating targeting of trigeminal nerve.

 

MRI imaging
Axial (A) and coronal (B) T1 weighted MR fMRI localizing hand function with relation more laterally placed hypo-intense neoplastic process (white arrows) with more medially situated descending motor fibers of cortico-spinal tract as indicated by MR tractography