Neurosurgeons at Chicago Institute of Neurosurgery and Neuroresearch using new mesh-like device to make spine surgery safer

Chicago — May 22, 2007 — Neurosurgeons at the Chicago Institute of Neurosurgery and Neuroresearch are the first in the Chicago area to use a new device that is designed to make neurosurgery safer and prevent additional operations.

Today, thousands of patients suffer from pain in their lower back, frequently radiating into the buttocks and legs due to herniated discs, or rupture in the tissue that surrounds the disc. This causes the soft inner part of the disc to push out and compress the nerve root, causing intense and debilitating pain.

To treat this, neurosurgeons perform a discectomy, which requires they make a small incision in the outer layer of the disc, called the annulus fibrosus. Then, the surgeon removes the portion of the disc that is applying pressure to the nerves.

However, according to neurosurgeon Dean Karahalios, MD, of CINN, the disc could re-herniate through this opening or defect in the annulus fibrosus, resulting in relapsing pain and additional surgery. Statistics show that approximately 10% or more of patients have reherniation following a lumbar disectomy and many of these patients require a re-operation.

To help address this problem Dr. Karahalios and his colleagues are using a new approach called Anular Disc Repair. After removing the offending portion of the disc, Dr. Karahalios implants a barrier to facilitate the healing process of the anulus fibrosus. The barrier is an umbrella-like mesh implant made of polyethylene that is inserted through the defect and opened up to act like a seal against the disc material that might otherwise push through after the surgery.

“This procedure provides a unique new method for re-enforcing the anulus fibrosis following a discectomy procedure,” said Dr. Karahalios. “Previously, we did not have a reliable method of closing the anulus of the disc and when it is not repaired, the material inside may re-extrude, compress the nerve root, and result in recurrent pain and re-operation”

According to Dr. Karahalios, the procedure adds minimal time to the overall procedure and is easily completed. Patients are usually walking the same day and commonly begin physical therapy and exercise within 10 days to two weeks.

As in most cases of spine-related pain, surgery is considered only after conservative methods such as medication or physical therapy, are ineffective.

For more information call 1-800-446-1234.

Neurosurgeons can see the brain and how it functions like never before: described as GPS for the brain

May 10, 2007 - (Chicago) – For victims of stroke, every second counts. New technology at Rush University Medical Center helps surgeons treat the delicate blood vessels in the brain faster and with less risk. The new neuroendovascular suite is equipped with the latest in advanced, three-dimensional imaging and interoperative software allowing surgeons to see the blood vessels and surrounding brain tissue in ways they could not before.

Neuroendovascular surgeons use a catheter and an image-guidance system to thread tiny instruments through the femoral artery in the leg up to the brain vessels. The new imaging system at Rush produces 3-dimensional CT scans rendered in real time. As the surgeon snakes the catheter through the twists and turns of the blood vessels, a computerized 3-D image of the blood vessel and surrounding soft tissue can be rotated to view from any angle. The image is translucent allowing the surgeon to see exactly where the catheter is in the tiny blood vessels.

“It can be compared to having a GPs system to guide you to your destination as opposed to navigating by the stars,” said Dr. Demetrius Lopes, a neurosurgeon and neuroendovascular specialist at Rush.

While the procedure it taking place, the surgeon can visualize fine details such as the shape of the aneurysm or the exact placement of a stent. And with the ability to take CT images in the new facility, the impact on other structures in the brain can be immediately evaluated. Potential complications like intracranial bleeding and hydrocephalus can be detected faster than every before. Previously patients often had to be wheeled out of the angiography suite and to the nearest CT scanner an elevator ride away.

In addition to visualizing the brain, it is crucial for surgeons to know how well the brain is functioning during the procedure. In the new suite, Rush anesthesiologists offer a unique neurophysiologic monitoring system. During surgery, the specialists can monitor the patient’s vision, sensation and movement even while the patient is under general anesthesia.

“Now we can predict the success of the surgery prior to the patient waking up,” said Lopes. “Our main goal is patient safety. With the combination of these systems, we can understand the brain anatomy and the brain function to avoid complications.” In addition to treatment of acute stroke, the new system enhances existing neuroendovascular treatments of cerebrovascular diseases such as aneurysms, stenosis (narrowed arteries), and arteriovenous malformations (AVMs). According to Lopes, the potential of the system it untapped.

“We now have the ability to do what we couldn’t in the past. This opens a new window for neuroendovascular surgery,” said Lopes. “Complex procedures that once required open surgery can now be offered using a minimally invasive approach.”