These can also be called cortisone injections or facet joint steroid injections or spinal epidural and potentially can help to alleviate the neck pain, arm pain, lower back pain and leg pain. These injections help to take away the inflammation of the nerves and facets joints.
Epidural, facet joint or steroid injections are given under local anaesthesia or sedation and performed with x-ray guidance and can be very effective to the pain. In fact a steroid injections do not make the herniated disc go back, it only helps the pain and its the effects can last for a few weeks to a year.
A microdiscectomy procedure is a minimally invasive procedure during which a 1” to 1½” incision is made in the midline and the nerve root is decompressed. In some cases part of the disc is removed which has been pinching the nerve root. This minimally invasive procedure is usually performed for disc prolapses, nerve root compressions or similar conditions. More than 90% of patients undergoing this procedure go home the same or next day.
During this procedure the spinal canal and the nerve roots are both decompressed which helps to improve leg and arm symptoms. During this procedure part of the laminae and soft tissue is removed to decompress the nerve roots, spinal canal and spinal cord.
Hydrocephalus is a condition in which pressure in the brain increases due to excess cerebrospinal fluid which then collects in the brain’s cavity called ventricles. Hydrocephalus potentially can happen in children, in adults and in old age when it is called normal pressure hydrocephalus. In old age normal pressure hydrocephalus usually causes problems with balance, urinary incontinence and poor memory.
Most of the time hydrocephalus is treated with a ventriculoperitoneal shunt which is a medical device or valve and catheter which relieves the pressure on the brain which is caused by the accumulation of cerebrospinal fluid. In some cases where appropriate the hydrocephalus is treated with an endoscope and camera to make the extra opening in the floor of the brain ventricles. This is to reroute the cerebrospinal fluid to reduce the intracranial pressure and this procedure is called endoscopic ventriculostomy.
The craniotomy is a procedure during which part of the bone is removed to access the brain. The size of the craniotomy has reduced in size because we use imaging guidance and computerised tool like GPS. The members of the Neurosurgery group are capable of removing a wide variety of tumours with minimally invasive surgery by using the latest tools like image guidance, computer and endoscope.
The craniotomies are made with the help of computerised navigation techniques known as robotic or stereotaxic and this technique improves the accuracy of the surgery and reduces the size of the craniotomy and associated complications. It avoids the important structure of the brain while removing the tumours. Stereotactic and robotic brain surgery is like a satellite navigation or GPS and it guides the surgeon to proceed to surgery through small openings with precision.
Traditionally cervical spine disc surgery includes removal of the disc and replacing it with a cage. This fuses the spine which potentially can cause some loss of motion, flexibility and cause acceleration of disc degeneration at the level above and below.
Recently however the disc is removed and replaced with an artificial disc to maintain movement, flexibility and this also helps to reduce the chance of causing damage to the adjacent levels. Therefore artificial disc replacements are a contemporary new treatment for cervical spine or neck disc disease. This procedure is performed through minimally invasive access under microscope and recovery is quick. The patients usually go home the very next day and recovery is quite rapid.
