Patients with tumors of brain and spinal cord benefit from a multidisciplinary collaboration between neurosurgeons, medical oncologists, radiation oncologists, neurologists and multiple other specialists to obtain the absolute highest level of care. At times, surgery is deferred to allow other modalities such as radiation or chemotherapy to treat the tumor. In other circumstances, surgery is the most important modality, which can be curative for certain types of tumors.
Traumatic injury of the nervous system and the spine require expert and timely management to maximize the potential for healing and recovery. Our neurosurgical team has extensive experience in surgical and non-surgical management of trauma. In fact, our neurosurgeons have led major trauma centers in perfecting the timely management of injured patients.
A multidisciplinary approach with optimization of critical care is the first and most important step. Emergent scanning, diagnosis and timely treatment is the second. Rehabilitative efforts are the last (but not the least) in maximizing the patients’ functional capability and optimizing their outcome.
MINIMALLY INVASIVE SPINE SURGERY
Minimally Invasive Surgery (also known as MIS), is a term used to describe the types of spinal surgery where, instead of traditional open approaches, every effort is made to minimize the trauma to the tissues covering the spine (skin, soft tissues, muscle). This approach allows faster recovery and less post operative pain. The goal here is to minimize the irritation surgery causes on the tissues supporting and help in moving the spine such as muscles, ligaments and tendons.
INNOVATIVE TREATMENTS FOR DISC PAIN
Pain due to a disc or “Discogenic pain” is a common source of extreme pain and disability. There are exicting advances in disc biology including science of stem cells and regeneration which is likely to ease the suffering from disabling back and neck pain due to disc degeneration.
NON-FUSION AND MOTION PRESERVATION OF
PAINFUL SPINAL SEGMENTS
There has been great controversy among various surgical and non-surgical experts, regarding the optimal treatment of spinal pain, due to incompetence of a spinal segment. There has also been an explosion of spinal implants and innovative techniques for biologic regeneration for this very reason.
Dr. Vokshoor and his expert team employs the latest proven techniques in treatment of painful disorders employing motion preserving techniques, including disc arthroplasty, interspinous devices, and dynamic stabilization techniques.
Neurosurgeons train for years to gain special expertise in microsurgical treatment of spinal stenosis especially with concomitant scoliosis. As the human spine ages, there are acquired degenerative changes that cause narrowing of the passageways for the nerves and the spinal cord. As the structure of the spine degenerates, there is a tendency toward asymmetric settling, which often causes an abnormal curvature at that location known as degenerative scoliosis. Dr. Vokshoor obtained additional fellowship training in complex surgical treatment algorithms for spinal stenosis and deforming scoliosis.
NON-SURGICAL TREATMENT OPTIONS
Initiating and maintaing a treatment algorithm for any condition is the mail goal and we commit to exploring all viable alternatives. Many patients who see us in consultation for spine or brain surgery, are actually referred to our non-surgical colleagues, ranging from massage therapists, to various medical specialists. Our surgeons’ motto has always been to exhaust all measures before resorting to surgery. In the absence of progressive weakness, neurological findings and incapacitating pain, many patients can improve from non-surgical modalities and return to their previous level of function.
SPINE PAIN MANAGEMENT:
BASIC AND COMPLEX DIAGNOSES
Pain is a complex and multifactorial manifestation of spinal dysfuction and its treatment best depends on making an accurate diagnosis. The spine institute has a network of pain management specialists who manage severe exacerbations of pain originating and radiating from the spine, and engage our patients in treatment of pain as well as pre and post operative rehabilitation. The initial evaluation of spinal pain is geared toward making the correct diagnosis, and this is indeed critical to prognosis and recovery.