Neurosurgery

Brain surgery is a type of neurosurgery used to treat a variety of conditions in the brain and surrounding structures. Depending on the condition and severity, brain surgery can involve either craniotomy or minimally invasive techniques. Brain surgery is typically used to address life-threatening conditions.

Sentara utilizes brain surgery to treat patients with a variety of concerns, including:

• Arteriovenous malformations (AVMs): These complex tangles of abnormal arteries lead to a weakening of the arteries over time. A hemorrhage, also known as a stroke, can happen when the arteries weaken and allow blood to leak into the brain. This can possibly cause brain damage.
• Blood clots on the brain (hemorrhagic stroke): Two types of hemorrhagic stroke can occur - intracerebral hemorrhage and subarachnoid hemorrhage. A weakened blood vessel collapses and allows blood to flow into the brain and compress tissue.
• Brain aneurysm: A brain aneurysm is a weak area on your blood vessel's wall. The weakened area bulges over time and can rupture, causing bleeding. If an unruptured aneurysm grows, it may push against blood vessels or other structures in your brain.
• Head trauma: Though it may not always require surgery, head trauma can be misleading, sometimes appearing to be mild because of the lack of signs of impact and subtle symptoms. Any injury to the head must be fully evaluated and treated based on testing results to minimize potential lifelong concerns.
• Hydrocephalus: This condition involves pressure on your brain, due to cerebrospinal fluid that has abnormally accumulated.
• Metastatic brain tumor: A brain tumor is a mass of abnormal cells growing inside your brain. Brain tumors can be benign (not cancerous) or malignant (cancerous). A brain tumor that begins in your brain is called a primary brain tumor. If the tumor results from cancer that has spread from another part of the body, it is called a metastatic or secondary brain tumor.
• Pituitary tumors: The pituitary gland produces several hormones and can be affected by tumors both benign (non-cancerous) and malignant (cancerous.)
• Recurring brain tumors: Some patients experience additional brain tumors after successfully being treated. Your physician and surgeon will evaluate new tumors and recommend additional treatments based on the size and location of new growths.
• Trigeminal neuralgia: This condition involves a nerve on your face that develops a sensitivity to normal touch or movement and produces pain that grows into your brain.

Sentara combines experienced surgeons, technology and support teams that patients and their families seek when needing guidance about brain surgery. Our program covers all major general and trauma neurosurgical operations.

Functional neurosurgery is a varied field that involves ways to surgically improve your nervous system. It can include the use of devices implanted in your body to positively alter the way it functions.

Functional neurosurgery can assist those whose day-to-day lives are impacted by conditions related to the nervous system. Some of the treatments include:

MRI-Guided Focused Ultrasound for essential tremor (FUS): Using advanced technology, our neurosurgeons use high-intensity focused ultrasound energy, guided by magnetic resonance imaging (MRI), to heat a small targeted area of tissue in the brain, which can reduce tremor. Only where the ultrasound waves converge is the target heated to cause a small ablation, which produces the therapeutic effect and improvement in hand tremor with immediate results. FUS is an incision-less treatment requiring no hospital stay. This treatment is available at Sentara Norfolk General Hospital.

Deep brain stimulation (DBS): This surgery treats severe cases of Parkinson's disease or epilepsy. Your surgeon places electrodes in areas of your brain that controls motor function. We also implant an impulse generator (IPG) under your collarbone. The device is similar to a pacemaker. It provides an electrical impulse to stimulate your brain's electrodes so you can better control your movements.

Vagus nerve stimulation: Using an implanted device to stimulate one of your vagus nerves, which run on both sides of your body from your brain to your abdomen, can help treat conditions such as epilepsy, depression, headaches and other pain.

Our comprehensive team provides results to improve the lives of our patients, with individualized evaluation to optimize treatment outcomes. Our neurosurgeons use advanced technology to treat deep in the brain, often with no surgical incisions.

The term "peripheral surgery" refers to nerve surgery of the hands, arms, legs and feet. Peripheral surgery often involves releasing nerves that have become "trapped" by an overlying structure, such as a tendon. Peripheral surgery also can refer to treatment of nerve tumors.

While we perform all types of peripheral nerve surgery at Sentara, we specialize in treating:

• Brachioplexus tumors
• Carpal tunnel syndrome
• Nerve tumors
• Thoracic outlet syndrome
• Traumatic nerve injuries
• Ulnar nerve entrapment

Repetitive motion injuries, such as carpal tunnel syndrome, can cause severe pain for many people. When medications and physical therapy fail to provide relief, it may be time to consider surgery.

At Sentara, we perform all types of peripheral nerve surgery. Our minimally invasive approach means quicker healing for you.

Spine surgery is used to help treat conditions of the spine. Spine surgery can be done either to relieve pain, slow progression of symptoms, return function or restore independence.

Together with your physician and surgeon, you can pinpoint the surgery best suited for you. Our surgeons are expertly qualified to provide the following options, among others:

• Cervical decompression and spine fusion: Your surgeon makes an incision in the lower front of your neck and then removes certain intervertebral discs, using retractors to protect your neck's soft tissue. Most often, your surgeon removes only abnormal discs.
• Cervical discectomy and fusion: Your surgeon retrieves a disc in your neck and fuses the vertebrae together. This procedure relieves pressure and pain by stabilizing the damaged area of your spine.
• Cervical disc replacement (arthroplasty) using artificial discs: To preserve as much motion as possible in your cervical spine, your surgeon replaces an affected disc with an artificial one.
• Cervical laminectomy: In this operation, your surgeon removes the laminae, the "roof" of the spinal canal, along with soft tissue that might be causing pressure on your spinal cord.
• Complex reconstructive spine surgery: This type of surgery helps patients who have had back, neck or spine surgery, scoliosis or another condition that involves more than three spinal segments. Your surgeon will have a subspecialty in complex surgery.
• CyberKnife® robotic radiosurgery: For complex or hard-to-reach spinal cancer, we offer CyberKnife® robotic radiosurgery. This innovative system allows us to deliver high doses of radiation to a tumor with pinpoint accuracy.
• Kyphoplasty: This minimally invasive procedure corrects a compression fracture. Your surgeon inserts a needle through a small incision, then inflates a balloon in your damaged bone. He or she then injects bone cement into the new space, where it hardens and reinforces the vertebrae.
• Lumbar decompression and fusion: To ease pain and improve stability, your surgeon may recommend fusing vertebrae together. This procedure stabilizes the spine and relieves pain.
• Lumbar laminectomy: For people who have spinal stenosis, this decompression surgery makes the spinal canal larger and eases pain. Your surgeon removes a portion of the vertebra called the lamina to reduce pressure on the spinal canal.
• Lumbar microdiscectomy: To relieve sciatica pain, your surgeon removes part of a disc that places pressure on the nerves.
• MAZOR robotic-assisted spine surgery: Our experts use the MAZOR Robotics Renaissance System for its precision, safety and effectiveness. Prior to surgery, we create a blueprint of our surgical plan using groundbreaking 3D planning software. The Renaissance system guides your surgeon's tools and ensures precision throughout the surgery.
• Resection of spinal tumors: With this surgery, our team can remove tumors in the lumbar spinal canal and then determine if they are benign (non-cancerous) or malignant (cancerous).
• Spine trauma surgery: Teaming with an extensive group of experts, our surgeons repair and minimize broken bones, disks and vertebrae and stabilize the spine so that you can regain as much movement as possible.

For many people, spine pain can be debilitating, making it difficult to function in their day-to-day lives. Spine pain has many causes. You may have pressure on the nerve roots or spinal canal. Spine may pain is caused by:

• Arthritis
• Bone spurs
• Calcium deposits
• Degenerative disc disease
• Fractures
• Herniated, bulging or slipped discs
• Infection
• Injuries
• Scoliosis
• Spinal stenosis
• Spondylolisthesis
• Tumors

When other treatments have been tried or a major injury occurs, spinal surgery may be needed to help find relief from these conditions.

Our neurosurgery experts at the Sentara Spine Center focus on the patient and provide the proper care to ease discomfort and restore movement.

Our experts treat the full range of spine issues resulting from arthritis, congenital disorders and injuries. We use state-of-the-art imaging, precision surgical tools and innovative techniques to thoroughly diagnose and provide safe treatments - from therapies to minimally invasive procedures, motion preservation surgeries and guided recovery - that don't require long-term reliance on pain medications. Our goal is to keep you safe and provide the most successful spine surgery possible. We put our experience to work for you so you can get back to doing what you love.

We want you to know what to expect before undergoing a procedure. Our support services include preoperative (pre-op) education, a guidebook and a spine patient navigator. We understand education empowers you to play an active role in your recovery and return to your favorite activities as soon as possible. You can rely on us for:

• Pre-op education: Pre-op education is crucial for you and your coach (a family member or friend who will support you both before and after surgery) to gather information about pre-and postoperative care and procedures, what to expect and how to prepare your home for recovery. You'll be equipped with the information you need to feel comfortable and confident as you take steps to improve your life.
• Sentara Spine Center Patient and Family Guidebook: In your guidebook, you will find valuable information on preparing for your surgery, medication guidance, tools and techniques to manage and describe pain, exercises, and tips for daily living and tools that can assist you before and after surgery.
• Dedicated spine patient navigator: Expert nurses with advanced experience in spine care that can answer questions about both your condition and the recommended solutions as they guide you through your surgical journey.

Please visit our spine education page to access our educational tools to prepare you for your upcoming spine surgery. This page also includes details about the location where you are having surgery.