Patient Education

At Birmingham Neurosurgery & Spine Group, P.C., we strive to provide the highest level of patient care. Our surgeons realize that many times patients can find relief from their symptoms through a variety of conservative treatments. You can rest assured that, if our surgeons feel that it might be possible to get you well without surgery, they will try to do so. When conservative treatments fail, or are not an option due to the nature of the problem, they may then recommend surgery to correct the problem.

This information is intended to give a broad overview of these conditions and is not intended for patients to attempt self-diagnosis. Always consult your physician regarding your specific condition for proper diagnosis. Should you have questions about any of the information presented here, please consult your physician during your next office visit.

Neurosurgical Anatomy: The Spine

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The Spine is the central support of our bodies. Made up of bones called vertebrae, and separated by cushions called discs, our spines also house the bundle of nerves responsible for our movements, called the spinal cord. Nerves exit the spine through openings called foramina and branch out to the rest of the body.

A healthy spine allows us to move freely, supporting our entire body throughout everyday movements such as bending, stooping, standing and sitting. Because the spine plays such an integral role in so many everyday movements, it is no surprise that these same movements can cause it to wear over time, or degenerate. Wear and tear on the spine can often be seen in bulging discs, ruptured or herniated discs, arthritis, bone spurs, instability, or compression fractures. These same conditions can also be caused by injuries such as a fall or a motor vehicle accident.

Medical Illustration Copyright © 2007 Nucleus Medical Art, All rights reserved.
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Neck and Arm Pain

Neck and Arm Pain can be caused by a variety of conditions such as Cervical Disc Disease, or Cervical Stenosis. Sometimes these problems can be due to injury, but most of the time they are due to simple wear and tear on the spine as we age.

In Cervical Disc Disease, one or more of the discs that serve as cushions between the bony vertebrae in the cervical spine, or neck, may become worn out, or degenerated. This is often described as a bulging, herniated, or "slipped" disc. This herniated part of the disc may press on the nerves as they exit the spine through the foramina. In Cervical Stenosis, calcium deposits, often called bone spurs, may develop on the vertebrae causing a narrowing of the canals through which the nerves exit the spine. Both conditions may cause pain, numbness, tingling and even weakness in the neck, shoulder, arm and hand. This is called Cervical Radiculopathy.

Several tests are commonly used to diagnose conditions of the cervical spine. These include X-ray, MRI, CT, Myelogram, Discogram and EMG/Nerve Conduction Studies. Based on your physical exam, your physician will determine the proper testing to diagnose your symptoms. In some cases, more than one test is required to determine your diagnosis. Once your condition has been diagnosed, your physician will recommend appropriate treatment.

Many conservative measures may be prescribed to treat the symptoms, such as physical therapy, epidural blocks, and/or anti-inflammatory medications and muscle relaxers. When conservative treatments are no longer effective, your physician may recommend surgery to remove the herniated part of the disc or bone spur and take pressure off the nerve.

Low Back and Leg Pain

Low Back and Leg Pain, or Sciatica, can be caused from a variety of conditions. Some of these include Degenerative Disc Disease, Herniated Disc, Lumbar Stenosis, and Lumbar Compression Fracture. Sometimes these problems can be due to injury, but most of the time they are due to simple wear and tear on the spine as we age.

The discs that separate our vertebrae act as cushions and shock absorbers between the bones. Over time, these discs can wear out and flatten, causing Degenerative Disc Disease. Sometimes a sudden movement or injury may cause a Herniated Disc, also called a Bulging Disc or "Slipped" Disc. Lumbar Stenosis occurs when calcium deposits, also called bone spurs, form on the vertebrae. All of these conditions can put pressure on the nerves as they leave the spine through the openings called foramina. Many people who experience one of these conditions complain of Lumbar Radiculopathy, also known as Sciatica, or leg pain. This is when the Sciatic nerve, which runs from the spinal cord down the back of the leg, is pinched. Other symptoms of Lumbar Spine Conditions include numbness, tingling, and/or weakness in the leg or foot.

Several tests are commonly used to diagnose conditions of the lumbar spine. These include X-ray, MRI, CT, Myelogram, Discogram, and EMG/Nerve Conduction Studies. Based on your physical exam, your physician will determine the proper testing to diagnose your symptoms. In some cases, more than one test is required to determine your diagnosis. Once your condition has been diagnosed, your physician will recommend appropriate treatment.

Many conservative measures may be prescribed to treat the symptoms, such as physical therapy, epidural blocks, and/or anti-inflammatory medications and muscle relaxers. When conservative treatments are no longer effective, your physician may recommend surgery to remove the herniated part of the disc or bone spur and take pressure off the nerve.

Neurosurgical Anatomy: Peripheral Nerves

Peripheral nerves are the nerves in our arms and legs. Sometimes, wear and tear or injury can affect these nerves also, causing pain, numbness, tingling, and sometimes weakness. In addition to treating conditions of the spine and brain, our neurosurgeons also treat two of these conditions, called Carpal Tunnel Syndrome and Ulnar Neuropathy.

Carpal Tunnel Syndrome

In the wrist, a major nerve called the median nerve crosses through a narrow tunnel of bone and tough ligamentous tissue. Carpal Tunnel Syndrome is caused when the carpal tunnel in the wrist becomes constricted, placing pressure on the median nerve. It is a condition generally characterized by numbness, cramping, and or pain in the hand and wrist. The condition is diagnosed by an outpatient test called and EMG/NCV

Carpal Tunnel Syndrome can be caused by overuse of the hand and wrist or by injury to the wrist. Fluid retention, or edema, can collect in the tissue of the wrist and compress the median nerve. This most commonly occurs during pregnancy. In most cases, the pressure is relieved when the pregnancy is over and symptoms disappear. Many patients find that wearing wrist extension splints, especially at night, and/or taking anti-inflammatory medication provides relief from the symptoms of Carpal Tunnel Syndrome. When these conservative measures are no longer of benefit, it may be necessary to consider surgery called Carpal Tunnel Release.

Ulnar Neuropathy

Ulnar Neuropathy is a condition generally characterized by numbness, and pain in the elbow and hand, and is diagnosed with an outpatient test called an EMG/NCV. It is caused by entrapment of the ulnar nerve which runs from the elbow into the ring and little finger. In many cases, rest and the use of anti-inflammatory medications can relieve symptoms of Ulnar Neuropathy. When these conservative measures are no longer of benefit, it may be necessary to consider surgery called an Ulnar Nerve Decompression.

Neurosurgical Anatomy: The Brain

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The brain is the body's control center. It allows you to move, via nerves running through the spinal cord. It also allows you to think, remember, feel, and experience emotions. Different areas of the brain are very specific to different functions. The brain is surrounded by several layers of bone, tissue, and fluid for protection. Arteries and veins run throughout the brain to provide oxygen and nourishment for the tissues.

There are a variety of different conditions that can affect the function of the brain. Some can be controlled with medication, while others require surgery to remove the problem. Some of the most common conditions are brain injury, tumor, and aneurysm.

Brain Injury

Brain injury can be a result of a direct blow to the head, or a whiplash-type injury where the brain is traumatized inside the skull. Both of these can cause tearing, bleeding, or swelling of the brain. Because there is not much room inside the skull, bleeding (often called Inter-Cranial Hemorrhage) or swelling can put too much pressure on the brain, which can impair its function temporarily or permanently. When one of these conditions occurs, it is often necessary to perform surgery, cutting a hole in the skull to allow the brain more room or to remove blood, called a hematoma.

Brain Tumors

There are a variety of types of brain tumors. Not all brain tumors are malignant, or associated with cancer. Some are very slow growing and do not effect the brain's function. Symptoms of a brain tumor vary widely and can manifest slowly over time or seem to occur suddenly. To properly diagnose a brain tumor, a patient should have a physical exam and testing, such as an MRI or CT. Sometimes, it is necessary to perform a brain biopsy to determine more about the tumor before recommending a treatment plan.

Today, there are a wide variety of options to treat brain tumors, depending on the type of tumor and other factors. These treatments may includesurgery to remove the tumor, chemotherapy to shrink the tumor, and traditional radiation or Gamma Knife or Cyberknife to shrink or obliterate the tumor. In some cases, based on the type, size, and location of the tumor along with other health factors, it may be safer to monitor the tumor instead of proceeding with surgery. Your physician will recommend the proper treatment, once the tumor has been diagnosed.

Aneurysm

An aneurysm is a defect in an arterial wall. Over time, the flow of blood through the artery weakens this area, causing a balloon-like area, which leaks blood that can damage the brain. Depending on the size and location of the aneurysm, your physician may recommend surgery to clip or seal the aneurysm and prevent any further leaks.