Microdiscectomy

Hi all, Ramin Rak here with another blog post about the complex neurosurgical procedures I complete at Neurological Surgery, P.C.

I specialize in the completion of surgeries meant to treat ailments affecting the brain and spine. In previous blog posts I have discussed my work with the NSPC Brain Tumor Center and spinal procedures such as Spinal Fusion and the X-Stop Procedure. One spinal procedure that I have not written about is a microdiscectomy.

When a patient complains of leg pain I can use magnetic resource imaging (MRI) or a computer tomography (CT) scan to determine if the patient has a herniated disc.

Using these results, I then decide whether or not a microdiscectomy will relieve the patient’s symptoms.

This spinal procedure is primarily used to treat leg pain, specifically leg pain arising from a herniated lumbar disc. Compression or impingement on the nerve root, defined as bone colliding with or striking the nerve root, will cause considerable leg pain. A microdiscectomy is used to relieve leg pain, and in many cases the patient will feel relief immediately after completion of surgery.

When completing a microdiscectomy, I examine the disc and nerves under a high powered microscope so that I only need to make a small incision.

By using this microneurosurgical technique instead of performing a discectomy, patients experience a much smaller recovery time because there is less tissue damage.

After the incision is made, I move the back muscles off of the bony arch (lamina) of the spine. I am then able to enter the spine by removing a membrane over the nerve roots and visualize the nerve using operating glasses. Once herniated disc material is removed, the procedure is complete.

For more information about the types of spinal procedures I have completed, take a look at my other blog posts or view some of the surgical videos I have uploaded to Vimeo by clicking here.

Thanks for reading,

Ramin Rak

 

PS For more information on the completion of a microdiscectomy, visit this link.

Kyphoplasty Surgery

Hello again, my name is Ramin Rak and I am writing this post to share information about another complex spinal procedure that I perform at Neurological Surgery, P.C.: Kyphoplasty Surgery.

I am one of six Neurological Surgery, P.C. neurosurgeons who performs kyphoplasty surgery. The others are:

  • Dr. Stephen D. Burstein
  • Dr. William J. Sonstein
  • Dr. Benjamin R. Cohen
  • Dr. Artem Y. Vaynman
  • Donald S. Krieff, D.O., F.A.C.O.S.

I perform kyphoplasty surgery in order to reverse spinal compression caused by a spinal bone fracture.

Individuals who experience compression lose vertebral body height and experience intractable pain. Fortunately kyphoplasty surgery removes pain relief roughly 48 hours after completion of the procedure, and patients can leave the hospital on the same day the procedure is completed.

Once the patient has been sedated, I make a small incision in the patient’s back so that I can insert a narrow tube-like needle into the fractured vertebral body.

I then use an imaging technique called fluoroscopy, which uses x-rays to provide a real-time moving image of the patient’s spinal structure, to guide the needle into the fractured area. Once a path has been made to the spot of the fracture, I insert a balloon into the tube, guide it to the vertebrae, and then slowly inflate it. The inflated balloon elevates the spinal structure, which restores vertebral body height. Next I remove the balloon and fill the cavity created by the balloon with a cement-like material that hardens quickly and stabilizes the spinal structure.

The entire procedure takes roughly one hour per affected vertebra and following conclusion of the procedure, the patient is observed in the recovery room until my doctors determine that he or she can leave.

This is how I complete kyphoplasty surgery at Neurological Surgery, P.C.

Learn more about how I complete this procedure by reaching out to me on Doctor’s Hangout.

Thanks for reading,

Ramin Rak

 

Ramin-Rak-Kyphoplasty

During kyphoplasty surgery, a balloon is inserted into the spine and inflated via a small tube.

Spinal Fusion

Good afternoon, and thank you for visiting my blog.

My name is Dr. Ramin Rak and I am a neurosurgeon with Neurological Surgery, P.C. Though I primarily specialize in techniques that treat brain injuries and tumors (like the Cyber Knife and GammaKnife procedures that I spoke of in earlier blog posts), I also complete complex procedures intended to alleviate spinal conditions. Last week I detailed my use of the X-Stop Procedure for individuals suffering from back pain and this week I will talk about my technique for treating a condition called spondylolisthesis.

Spondylolisthesis occurs when a damaged or fractured joint allows a vertebra to slip forward and pinch a nerve joint in the spine.

This pain will travel all the way down to the patient’s legs via the sciatic nerve. Surgeons perform a spinal fusion to treat this condition and alleviate patient pain. At Neurological Surgery, P.C. I am a member of the Spinal Fusion Team along with:

  • William J. Sonstein, M.D. F.A.C.S.
  • Benjamin R. Cohen, M.D. F.A.C.S.
  • Artem Y. Vaynman, M.D. F.A.A.N.S.
  • Donald S. Krieff, D.O. F.A.C.O.S.

My team and I perform the spinal fusion procedure to treat intractable back pain by fusing two or three lumbar spine segments.

We start by removing the lamina, which is the portion of the spine that covers the problematic vertebra. Next, the Spinal Fusion team removes any piece of bone that is pinching the vertebra, relieving any pressure and pain. A bone graft is then performed, which fuses together the two spine segments around the vertebra. Finally, screws and rods are used to hold the spine in place while the grafts heal. Once the grafts heal, they will fuse into place and keep the discs from slipping and causing future complications.

Learn more about the spinal fusion team and the PLIF (posterior lumbar interbody fusion) or spinal fusion procedure by clicking here to view a video demonstration on NSPC’s website. Stay up to date on my other neurosurgical techniques when you follow me on Twitter.

Thanks for reading,

Dr. Ramin Rak

 

Ramin Rak Spinal Fusion

Screws and rods are used to hold the bone grafts in place so that the spinal fusion results are permanent.