Neurosurgical Techniques

Index

  • Advances in Neurosurgery
  • Brain Tumor
  • Functional Neurosurgery
  • Implantable Pain Treatment Devices
  • Neurocritical Care
  • Neuro-navigation/Frameless Stereotactic Surgery
  • Peripheral Nerve Surgery
  • Spinal Disorders

    • Advances in Neurosurgery

    Advances in neurosurgical technique employed by New England Neurological Associates physicians include:

    Laser Surgery. The laser, a precise and delicate instrument, is commonly used by the neurosurgeons. This tool adds precision and delicacy to many microsurgical approaches.

    Microsurgery. The neurosurgeons frequently employ use of special microinstruments and magnification to improve the quality of surgery of the brain, spine and nerves.

    Radioactive Implants. These implants provide precise delivery of radiation for treatment of brain tumors.

    Brain Tumor

    New England Neurological Associates offers an interdisciplinary, team approach combining the strengths and expertise of neurosurgeons, neurologists, neuroradiologists, radiation oncologists, and other specialists. Optimal patient care and outcome are enhanced by a team perspective and use of state of the art equipment.

    Benign and Skull Base Tumors. Commonly treated lesions include acoustic neuromas, meningiomas, as well as congenital lesions and trauma.

    Malignant Brain Tumor. Patients with malignant brain tumor are treated through the appropriate mix of surgery, radiation, and chemotherapy with the aim of increasing longevity and quality of life. Metastatic Brain Tumor. Specialists in neurosurgery, oncology, and radiation oncology join forces in treating metastatic brain tumor. Surgical excision, radiation therapy, and chemotherapy are employed. An advanced LINAC or gamma knife is also employed where appropriate as a surgical adjunct or in the treatment of deep and inaccessible lesions. Pituitary Tumor. Individuals with pituitary tumors are treated by a team consisting of neurosurgeons, endocrinologists, neuro-ophthalmologists, and neuroradiologists.

    Functional Neurosurgery

    Parkinson�s Disease/Pallidotomy. The goal of pallidotomy is to reduce or control Parkinsonian symptoms such as rigidity, tremor, and dyskinesias. NENA is only one of three programs privileged by BCBSMA as a Center of Excellence to provide stereotactic pallidotomies, along with the Massachusetts General Hospital and the Boston Medical Center. Dr. Bruce Cook and Dr. Lowell J. Rosman have performed the pallidotomy procedure since May of 1995. The pallidotomy program is the result of a team approach incorporating the talents of NENA neurologists and neurosurgeons, allied with the personnel and resources of Holy Family Hospital, Methuen, Mass., where the procedures take place.

    Implantable Pain Treatment Devices

    Neurocritical Care

    This service seeks to monitor and protect the brain and spinal cord in the critical care setting.

    Neuro-navigation/Frameless Stereotactic Surgery

    In conjunction with Holy Family Hospital, New England Neurological Associates has recently introduced state of the art frameless stereotactic surgery appropriate for some patients. The integration of MRI and CT scanners with a computer in the operating room provides constantly updated three dimensional information for detailed surgery of the brain or spine. This highly sophisticated system provides both planning and operative information that allows for small incisions and minimal manipulation of the normal brain and spinal cord.

    This new methodology is the natural outgrowth of standard stereotactic techniques and combines these with microsurgery to provide the benefits of both in a minimally invasive way. Most brain operations and many complex spine operations will be safer and more precise with this high powered computerized system that is available at only a few select institutions, including the Holy Family Hospital.

    Peripheral Nerve Surgery

    New England Neurological Associates has the ability to provide and coordinate the full range of services for the evaluation and surgical treatment of individuals with peripheral nerve pathology. Nerve conduction studies, EMG, and MRI are available for diagnostic assessment. Conditions referred in this program include carpal tunnel syndrome, Schwannomas and neurofibromas, brachial plexus injuries, and ulnar or peroneal nerve compression.

    Spinal Disorders

    This program is aimed at individuals with abnormalities of the spinal column, intervertebral discs, nerve roots, spinal cord, and surrounding structures. Lumbar and cervical degenerative disc disease, as well as less common vascular, neoplastic and congenital anomalies are evaluated and treated by a surgical team. Outcomes in the treatment of spinal disorder have been improved through progress in diagnostic techniques such as CT and MRI, as well as developments in microsurgery and minimally invasive techniques.

    Where appropriate, non-operative approaches to spinal disorders are employed, offering medical therapy and rehabilitation programs.

    Stereotactic Neurosurgery and Radiosurgery

    Stereotactic Neurosurgery. With use of highly sophisticated computerized localization and the use of CT and MRI scanning, tumors deep in the brain can be safely biopsied. Patients with conditions such as Parkinson's Disease and intractable pain can also be helped by this procedure.

    Stereotactic Radiosurgery. This new service permits us to aim the radiation beam from the linear accelerator with stereotactic precision for the treatment of deep arteriovenous malformations, malignant and some benign tumors, and otherwise inoperable or difficult to reach lesions.

    This technique offers a means to precisely deliver high focal diation to lesions without damaging vital areas of the brain. The procedure is non-invasive and can be performed on an outpatient basis. Stereotactic radiosurgery may be appropriate for patients with:

  • Arteriovenous malformations (AVMs)
  • Benign brain tumors
  • Skull base tumors
  • Primary malignant brain tumors
  • Metastatic brain tumors
  • Spinal tumors


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    Disclaimer: The information and references contained herein are intended solely for the information. It should not be used for treatment purposes, but rather for discussion with the patient's own physician.
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