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Neurosurgery Treatments & Procedures

The contents of this website are information and educational purposes only.  SIU School of Medicine does not provide medical advice on this website.  If you need medical advice please contact your physician directly.

Listed below are common procedures performed at the SIU School of Medicine Division of Neurosurgery.  The list is not inclusive. 

Each heading will give a description of the procedure.  In certain cases there will be an additional link to an animated patient education file denoted by a link.

Note that the animated education files are generalized and there may be some aspects of the procedure that may be done differently by your surgeon.


 

Cranial Procedures

Craniotomy – is the neurosurgical procedure used to enter the skull in order to gain access to the brain.   Specific terms are used to describe the location of the incision, frontal, pterional, and temporal craniotomies.  This is the procedure that would be used for: brain tumors, aneurysms, brain abscess, brain hemorrhage and brain trauma.  Typically general anesthetic is used however; there are certain times when a local anesthetic is used along with mild sedation.  Local anesthetic would be used for certain brain tumors or in cases where the patient cannot tolerate general anesthetic.  Two of the common types of craniotomies are described in the animated patient education files, see animated file under Neurology – Bifrontal Craniotomy and Craniotomy for tumor

Surgeons performing this procedure at SIU: Dr. Cozzens, Dr. Espinosa

Craniectomy – is the neurosurgicalapproach to the posterior fossa or back of the skull to gain access to the cerebellum and several of the cranial nerves. This procedure, like craniotomy, is used for the treatment of: brain tumors, aneurysms, brain abscess, cerebellar hemorrhage, brain trauma.  Acoustic neuromas, Trigeminal Neuralgia and Hemi facial Spasm are specific diseases that are treated using this surgical approach.   Our animated files under Neurology – Microvascular Decompression and Subocciptal Craniectomy illustrate two of these procedures.

Surgeon(s) performing this procedure at SIU: Dr. Cozzens, Dr. Espinosa

Transphenoidal Surgery – is an endoscopic procedure used to remove tumors in the pituitary gland.  This utilizes small endoscopes placed through the nose and the sphenoid sinus to give access to the pituitary fossa and gland. Typically this procedure is used for pituitary tumors but can also be used in some case of spontaneous cerebral spinal fluid (CSF) leaks.  – See animated file under Neurology – Transphenoidal Surgery 

Stereotactic Brain Biopsy – is a procedure used to obtain a biopsy of a tumor or other abnormality in the brain.  Sophisticated computer guidance systems are used so that only a small hole is placed in the skull usually less than 5mm.  The procedure is typically performed using local anesthesia.  Most patients go home the day after the procedure.  Depending on the size and location of the tumor various devices are used to guide the biopsy needle into place.  Biopsies are used to help determine what further treatments or procedures would be best to treat the disease.  – See animated file under Neurology – Stereotactic Biopsy  

Surgeon(s) performing this procedure at SIU: Dr. Cozzens, Dr. Espinosa

Deep Brain Stimulator (DBS) Burr Hole -  The placement of a deep brain stimulator is for the treatment of various movement disorders such as: essential tremor and Parkinson’s Disease.  Using stereotactic guidance small wire are placed at specific targets in the brain and then attached to a small stimulator much like a pacemaker. Local anesthesia is used so the effectiveness of the electrode placement can be monitored by observing the patients tremor. Often the stimulator is placed at a later date once the electrodes have been shown to be effective without side effects.  The stimulator itself is placed under the skin just beneath the collar bone.  There is ongoing research that suggests these stimulator may be helpful in depression and obsessive compulsive disorders.
See animated file under Neurology – Deep Brain Stimulation 

Ommaya Reservoir Placement - is a procedure used to allow administration of drugs to the ventricles (cerebral spinal fluid cavities) in the brain.  This is used to treat infections and certain types of brain cancers.  It occasionally used to allow periodic drainage of a cyst related to a tumor.  The procedure can be done under local or general anesthetic.  The hospital stay is typically one day.  - See animated file under Neurology – Ommaya Reservoir Placement 

Surgeon(s) performing this procedure at SIU: Dr. Cozzens, Dr. Espinosa

Spinal Procedures

Lumbar Microdiscectomy - see animated file under Spine – Lumbar Disc Microsurgery and Micro Endoscopic Discectomy

Lumbar Laminectomy - see animated file under Spine

Anterior Cervical Discectomy/Fusion – This procedure is used for degenerative diseases such as herniated disks and for trauma resulting in a fractured neck.   An incision is placed on the front of the neck in a transverse (crossways) orientation on the right or left side.  The anterior aspect of the spine is visualized using a surgical microscope.  The disc is removed and replaced with a bone graft that can be from the patient’s hip (autograft) or from a cadaver donor (allograft).   The surgeon may place a small titanium plate to secure the bone graft.  The surgery typically takes about 1 ½ hours with an over night hospital stay.  Post operatively the patient is seen 2 weeks, 6 weeks and 12 weeks in clinic where X-rays are evaluated and the patient’s progress checked.  For sedentary jobs the return to work is allowed between 2-6 weeks after surgery.  For heavy labor jobs the patient is off of work for 3-4 months. 

See animated file under Spine – Anterior Cervical Discectomy

 

Anterior Cervical Corpectomy -   This procedure involves removal of a single or multiple vertebral bodies in the neck and is utilized to treat advanced degenerative disease of the cervical spine, trauma with fracture of the cervical spine and cancer where bone has been destroyed by a tumor.  The incision is on the front of the neck and may be transverse (crossways) of vertical depending on the extent of the surgery needed.  Once the affected vertebrae are removed a graft is fashioned from either a donor site on the patient, such as a rib, or from a cadaver donor.  The bone graft is then secured with a titanium plate.  The surgery can be lengthy 2-6 hours, depending on the complexity of the fusion graft and plate called the construct. The hospital stay varies.  Often a cervical brace is worn after surgery until the fusion has healed sufficiently to be stable. Follow up visits in clinic are at 2, 6, and 12 weeks post op and then as needed until healing is completed.

See animated file under Spine – Anterior Cervical Corpectomy

Artificial Cervical Disk Replacement – There are now several types of artificial discs used to treat cervical disc disease.  All of them are indicated only in patients with single level disc disease that have not had any other surgery on their cervical spine and do not have any instability.  The procedure is performed in the same manner as an anterior cervical Discectomy except there is no bone graft.  The artificial disc is made of titanium.  The advantages of this procedure is that there is no fusion, allowing for maintenance of normal motion of the neck, and the patient can return to heavy activity and work in 2 weeks.

See animated file under Spine – Artificial Cervical Disk Replacement

Cervical Posterior Foraminotomy- This procedure is used to treat a pinched nerve in the cervical spine due to bony narrowing of the foramina (the opening in the bone through which the nerve passes) or due to a herniated disk.  The incision is on the back of the neck and the procedure may be done using a small tube and microscope (Minimally Invasive Surgery) or through a lager incision depending on the extent of the compression and surgeons preference.  No fusion is produced with this technique.

See animated file under Spine – Cervical Posterior Foraminotomy

Cervical Laminoplasty – This is a newer procedure and is done as an alternative to a cervical laminectomy.  The goal is to decompress the spinal cord and nerve roots in a patient with spinal stenosis.   The incision is on the back of the neck.  The laminae are hinged open to make the spinal canal larger.  By leaving the lamina in place there is a reduced risk of delayed instability and subsequent deformity (miss alignment) of the spine that can occur with a laminectomy.

See animated file under Spine – Laminaplasty

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Lumbar Microdiscectomy – The procedure is used to treat a herniated disc in the lumbar spine.  The surgeon may use a small tube or a micro-retractor and a microscope or endoscope during the procedure.  This is usually done as an outpatient.

See animated file under Spine – Lumbar Disc Microsurgery and Micro Endoscopic Discectomy

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Lumbar Laminectomy – This procedure removes the lamina from one or more levels in the lumber spine to treat spinal stenosis.  The traditional approach is through an incision in the middle of the low back with removal of the lamina.  Utilizing minimally invasive technique the procedure can be done through small incisions and with less muscle injury making it available to more elderly patients.

See animated file under Spine -Laminectomy

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Transforaminal Lumbar Interbody Fusion - See animated file under  Spine – TLIF

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Posterior Lumbar Interbody Fusion - See animated file under  Spine – PLIF

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Interspinous Process Decompression – X-STOP -  See animated file under  Spine – Interspinous Process Decompression

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Kyphoplasty-  See animated file under  Spine – Kyphoplasty

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