Neurosurgery Treatments at Monmouth Pain

Neurosurgery is a term short for neurological surgery which is a specialty in medicine that focuses on the diagnosis and treatment of nervous system disorders.  The nervous system is composed of the brain, spine and nerves.  An important distinction made by the Cleveland Clinic is that Despite the “surgeon” part of the word, neurosurgeons provide both surgical and nonsurgical treatments. (Source) 

Our Neurosurgeon at Monmouth Pain is Dr. Tamir Tawfik.  Dr. Tamir Tawfik is a fellowship trained neurosurgeon who specializes in spine surgery both minimally invasive as well as complex.  During his fellowship at the Swedish Neurosciences Institute in Seattle, Washington, Dr. Tawfik was featured in World Neurosurgery for his anatomical study in the neck (cervical spine).  His passion in research continues as he explores the newest techniques in spinal surgery.

When Is Spinal Neurosurgery Necessary?

In most cases, neurosurgery is recommended only after more conservative treatments have failed to provide desired results. In some cases, an evaluation of the patient’s condition may result in doctors recommending neurosurgery as the first course of action because an issue needs to be treated right away to prevent further complications or issues.

Some conditions or symptoms that might be treated by neurosurgery include:

• Disc Herniation (Cervical, Thoracic, Lumbar)
• Spinal Radiculopathy
• Failed Back Syndrome
• Cervical and Lumbar Stenosis
• Revision of Failed Spinal Instrumentation

Types of Neurosurgery Procedures

Neurosurgeries can be conducted using a range of technologies and techniques that move well beyond the traditional scalpel. Here are just a few types of procedures that fall under this umbrella:

• Anterior cervical discectomy with fusion surgery (ACDF) – During this procedure, a disc is removed from the spinal column in the neck area. This is typically done to treat neck and arm pain and involves removing a disc that is causing the symptoms and fusing the surrounding discs together. This procedure is considered a combination of both a spinal decompression surgery and a spinal fusion surgery.  This is used primarily to treat conditions in the neck such as herniated discs and radiculopathy (pressed or pinched nerves).

• Cervical and Lumbar Fusions – Spinal instability can be a cause of pain in the neck or back and pain down the arm or leg. During a fusion, a surgeon will provide stability via stabilizing hardware to decrease pain in the neck or back.

• Corpectomy – During this procedure, the neurosurgeon removes part or all of the vertebrae (bone) to relieve pressure on the spinal cord and/or spinal nerves (spinal stenosis).  When the spinal cord becomes compressed symptoms may include things like loss of balance, difficulty walking, and problems with fine motor skills (known as cervical myelopathy.)   This surgery is performed in the neck (cervical) spine and occasionally in the mid-back (thoracic) spine.  This is rarely performed in the low back (lumbar) spine.  The surgeon may use a bone graft from the pelvis to replace a portion of the diseased and damaged vertebrae.

• Laminectomy – This procedure involves removing part of all of a vertebrae. Usually, the removal is to reduce pressure that’s causing nerve pain or spinal cord issues.

• Lumbar Decompression Surgery – Also known as Lumbar Microdecompression Surgery, Lumbar Decompression Surgery is a minimally invasive method of removing bone spurs from around the spinal cord and nerves in the low back.  This procedure opens the space in the spinal canal thereby removing pressure from the neural elements like the nerves and spinal cord. Oftentimes, immediately results are achieved with symptoms such as nerve pain, numbness, tingling. Muscle weakness improvement typically takes a bit more time. In a less invasive way, the goal of this procedure is to effectively treat sciatica, radiculopathy, and spinal stenosis.

• Microdiscectomy – This procedure is known as a minimally invasive discectomy. Here the neurosurgeon removes part of the damaged disc using small incisions instead of opening a larger area. There are different methods to accomplish this.  One method is through the insertion of a small tube where instruments pass through to remove portions of herniated disc.  Another method is through the use of a laser to accomplish the same result. During this procedure, the neurosurgeon does not remove any of the bone or muscle that may occur during more invasive procedures. This minimally invasive procedure has been shown to be more effective for the relief of the radiating pain (radiculopathy or sciatica). Patients typically experience almost immediate relief from this procedure and go home with a significant decrease in symptoms.  If the patient’s symptoms were more involved to include numbness, tingling, or muscle weakness, it typically takes much more time for the nerves to heal and symptoms tend to subside over time.

• Minimally invasive spine surgeries – These types of surgeries are typically performed via small incisions and may use technologies such lumbar fusion/fixation. They may be used to provide remedies to stabilize the spine, remove or treat bone spurs or deal with other issues that don’t require more invasive approaches.