The specialty-trained, board-certified neurosurgeons at MedStar Montgomery specialize in the treatment of conditions of the nervous system, divided into subspecialties of the brain, spine and peripheral nerves. Our tailored approach to neurosurgical treatments are the technology available allows the team to address the specific needs of each patient. Our patients benefit from access to multidisciplinary teams that include specialists in neurology, neurosurgery, orthopaedics, neuroradiology and rehabilitation medicine.
MedStar Montgomery offers a wide range of neurosurgical services performed by board-certified neurosurgeon specialists. We offer some of the most advanced treatments and technologies currently available. We offer new hope to patients who have been told their brain or spinal tumors are inoperable, and we are on the cutting edge of research in movement disorders, epilepsy, and stroke treatment.
The unique working partnership among the departments of neurology, neurosurgery, orthopedics, neuroradiology, and rehabilitation medicine makes our interdisciplinary approach succeed. The doctors in these specialties are committed to a multidisciplinary approach to patient care, helping to ensure the right diagnosis and the most effective treatment plan.
When you choose CyberKnife treatment at MedStar Montgomery, you can rest assured that you're getting one of the most advanced treatments for cancer available—and the nation’s most experienced CyberKnife experts. Though it sounds like a surgical procedure, CyberKnife is actually a painless and non-invasive form of radiation that offers accurate, effective treatment for tumors anywhere in the body—even in places previously considered unreachable. CyberKnife uses a combination of computers, image-guided cameras, and robotic technology to concentrate radiation directly at tumor cells, while limiting radiation exposure to surrounding healthy tissue. The specialists at MedStar Montgomery Medical Center use CyberKnife to kill cancerous cells in the brain and spinal cord, as well as to destroy skull base tumors.
Deep brain stimulation (DBS) is based on the same technology used in cardiac pacemakers—it delivers carefully controlled electrical stimulation to precisely targeted areas of the brain that affects movement. The electrical charge interrupts or overrides the brain's faulty signals and, in conjunction with medication, reduces the rigidity, tremors, slow movement, and other symptoms of advanced movement disorders.
In general, you become a candidate for DBS if:
- Suffer moderate to severe symptoms
- Begin to experience difficulty or side-effects with medication, but are still responsive
- Have no indication of dementia
- Are in overall good health
DBS is both reversible and adjustable, making it a vast improvement over other surgeries. As a patient's disease progresses over time, the device can be reprogrammed accordingly to minimize new or increasing symptoms. The device can also be removed entirely to make way for newer treatments, improved techniques, or a medical cure.
DBS installation, activation, and programming are a three-part procedure, usually completed over the course of a month to six weeks. It carries no more risk than any other surgical procedure. For many patients, the mere placement of the electrodes is enough to produce immediate improvement. Others may not notice an appreciable difference in symptoms for several months.
Gamma Knife is the most accurate tool for treating brain tumors and other neurological disease without open brain surgery. This minimally invasive alternative to conventional grain surgery allows for a safe and effective treatment, typically with fewer side effects. As a result, this is an outpatient treatment.
Gamma Knife is a machine that uses imaging technology to focus hundreds of tiny radiation beams at a precise targeted location of the brain. Specialized equipment keeps your head steady during the procedure so radiation targets only your cancer, not healthy tissue. The procedure delivers a very strong dose of radiation so you generally need just one pain-free session. Since Gamma Knife spares most healthy tissue, you experience fewer side effects from treatment than from other forms of radiation.
Gamma Knife surgery may serve as the patient's primary treatment, or it can be used in conjunction with other modalities, such as conventional surgery, chemotherapy or radiation therapy. Its unique capabilities are effective on a range of conditions, including benign and malignant brain tumors and functional disorders. [Link to Neurologic Oncology page] Research and clinical trials are ongoing to assess the effectiveness of Gamma Knife in treating intractable pain, obsessive compulsive disorders, headaches and epilepsy.
- Safe: Since there is no incision, the risk of surgical complications, such as infection, hemorrhage, and reactions to anesthesia are minimal. The vast majority of adult patients require only local anesthesia and a mild sedative during the procedure.
- Precise: Gamma Knife sets the bar for accuracy, with a level of precision that enhances physician confidence and ensures patient safety. Gamma Knife delivers radiation to the targeted area with pinpoint accuracy, enabling the surgeon to destroy diseased tissue while preserving the healthy surrounding brain tissue.
- Fast: The Gamma Knife procedure takes less than one hour and generally requires only one session. The procedure is usually performed on an outpatient basis. Patients are able to go home the same day.
- Less Expensive: Since the procedure and recovery times for Gamma Knife surgery are significantly less than traditional neurosurgery, the cost of the Gamma Knife procedure is often 25 to 30 percent less than open brain surgery. Medicare and most insurance plans cover the cost of the procedure.
- Less painful: As a non-invasive technique, patients experience little discomfort during the surgery and have virtually no post-operative recovery pain.
- Successful: This surgical procedure has been developed and refined during the past 40 years. Its clinical success has been demonstrated worldwide. More than 2,500 peer-reviewed articles have been published about the Gamma Knife, and nearly 350,000 patients have benefited from Gamma Knife surgery.
The surgeons at MedStar Montgomery have extensive training and experience in performing microscopic and minimally invasive spinal surgeries. During minimally invasive techniques, MedStar Montgomery surgeons make a small incision and use advanced computer technology and specialized instruments to repair back and spine conditions. In microscopic surgery, we combine minimally invasive techniques with highly sensitive, cutting-edge surgical microscopes to access even the most delicate areas with precision. More information on this type of treatment is available here.
- Faster recovery time than traditional spinal surgery
- Reduced infection
- Reduced blood loss
- Less scarring
- Faster return to your regular lifestyle
Nerve decompression surgery is a minimally invasive surgical procedure to relieve pressure caused by a neuroma, a pinched or entrapped nerve. Your surgeon relieves the pressure on the nerve by cutting tight tunnels around it. This way, even though the nerve is still swollen, there is no pressure on it from surrounding structures in your body, enabling the nerve to start functioning normally again.
Patients suffering symptoms (numbness, pain, and/or functional loss) from such conditions, who have not found relief through other, more conservative methods, may consider nerve decompression surgery. The specialists at MedStar Health can address the following with this treatment:
- Upper extremities: Surgery for carpal tunnel, cubital tunnel, or decompression of radial nerve
- Lower extremities: Surgery for femoral nerve, peroneal (foot drop) nerve, tarsal tunnel release
- Trunk: Thigh pain, burning or numbness (called meralgia paresthetica), release of lateral femoral cutaneous nerve
- Chronic migraine headaches: Decompression of nerves in the back, side and/or front of the head.
- Diabetic neuropathy
Surgery can relieve symptoms and halt further damage; however, it does not change the underlying problems. A person whose job requires repetitive wrist movements is still susceptible to nerve dysfunction. People with diabetes will continue to have swollen nerves that are more prone to compression and damage.
Most patients have repeat neurosensory testing six to twelve weeks after surgery. This determines if the nerves are repairing themselves and if function is improving. Most patients, especially those with diabetes, should undergo neurosensory testing each year to detect possible new nerve damage and measure the progress of existing nerve damage.
In order to preserve function when nerves are damaged, surgeons use microsurgical suturing techniques. However, surgeons are often not able to reconnect the nerve fibers because of the amount of damage at the injury site. Instead, our surgeons use a combination of the following to repair the nerves:
- Nerve conduits (tubes to bridge small nerve defects)
- Nerve allografts (processed human nerve to bridge small-large nerve gaps)
- Nerve allografts (used from the patient him/herself from other, less critical nerves)
Some examples of the types of injuries that are candidates for this treatment include:
- Hand/finger injuries with sharp objects (usually knife) resulting in scar, pain, and/or numbness
- Traumatic or surgical injuries or any major upper or lower extremity nerve injury resulting in acute or delayed loss of the nerve function
- Nerve deficit following nerve tumor removal
- Patient with peroneal nerve neuropathy
Repairs such as these should ideally be done immediately (same day). If that is not possible, every attempt should be made to perform nerve repair within three to four weeks. After that period, it's possible there will be irreversible loss of nerve function. Once the nerve is reconstructed, it recovers at a rate of approximately one half millimeter to one millimeter per day.