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- George F. Gade, MD
Our Services
Chiari Decompression: A Chiari malformation occurs when part of the lower brain crowds into the foramen magnum, or large opening in the bottom of the skull, where the spinal cord exits the skull. Pressure caused by this displacement can cause a number of symptoms. Chiari decompression surgery is a method for removing bone around the foramen magnum and sometimes the lamina from vertebrae in the neck to reduce pressure and alleviate symptoms.
Cranioplasty: We provide surgical repair for defects or deformities of the skull. Craniotomy: To gain access to the brain to remove lesions (damaged areas), we temporarily remove a portion of the skull (cranium) to gain access to the brain, and then replace it after the operation. There are many types of brain lesions, including abscesses (infections), AVM's, infarctions (tissue death caused by stroke), etc. They can cause headaches, neck pain or stiffness, changes in vision, mood, behavior or mental ability, seizures, fever, memory loss or a host of other symptoms.
Craniectomy: Decompressive craniectomy is surgery procedure in which part of the skull is removed to allow a swollen brain room to expand without being damaged by high pressure. It can help reduce the intracranial pressure caused by traumatic brain injury and stroke.
Steriotactic Radiosurgery for Cranial and Spinal Lesions: Our surgeons use a stereotactic radiosurgery to target brain or spinal lesions or tumors by delivering a focused high dose of radiation precisely to the target. This surgery is non-invasive and is often used when the target cannot be safely reached by other surgical methods.
Skull Base Surgery: Tumors and other problems located near "the floor" inside the skull pose special challenges for surgeons. The skull base is where the brain rests and the spinal cord and other nerves, as well as major blood vessels of the brain, head and neck, enter the skull through holes or foramina. Thanks to advances in diagnostic and surgical techniques, new treatments are available for these areas.
Shunt Creation, Removal, Replacement, and Reprogramming: Our surgeons create various shunts for draining excess fluid from and relieving pressure on the brain, as well as removing them, replacing them and reprogramming programmable shunts.
Spinal surgery is a complex field. Even minor injuries sometimes warrant the evaluation of a neurosurgeon. Results from spinal surgery can vary based on a number of factors. Even when a procedure appears successful, spinal function and shape can deteriorate and require remedial attention. We carefully evaluate our patients on an individual basis using state-of-the-art technologies to evaluate, diagnose and manage understand all forms of spinal trauma and then determine the best way to address it.
Spine Surgery: We perform minimally invasive surgery (MIS)/Complex Instrumentation of the entire spine from the occiput (back part of the skull above the base of the neck) to the lower end of the spine where iliac hardware (a support structure attached to the hip and pelvis) is used for treating complex spinal disorders.
Minimally Invasive Decompression Surgery: A common surgical procedure for the older population, decompression surgery provides pain relief for patients suffering from spinal stenosis, a narrowing of the spinal canal in the back or neck that puts pressure on the spinal nerve. We also perform X-STOP MIS Decompression Surgery where through a small opening we place a spacer to alleviate painful neurogenic claudication (pain in legs with walking)
Adult Deformity Correction Surgery: Commonly known as scoliosis surgery, this procedure involves placing metal rod implants along the spine to correct its sideways curvature and restore the natural curvature of the spine.
Osteoporosis/Vertebral Compression Fracture Management (including kyphoplasty and vertebroplasty): If the load on a back or neck bone (vertebra) becomes too great, the result can be a collapse or compression fracture that results in sudden and chronic pain. Osteoporosis is the most common cause of compression fractures, but trauma or a tumor can also be a factor. Multiple fractures in the upper back can result in kyphosis, commonly known as hunchback. Pressure from kyphosis can result in numbness, tingling or weakness. Approximately 800,000 Americans suffer from vertebral compression fractures each year. If compression fractures fail to heal or if pain persists, minimally invasive surgery may be helpful. During kyphoplasty, the surgeon inserts and inflates balloon in the affected vertebra to elevate it, restore it to a more normal position and create a cavity inside. The balloon is then removed and the doctor uses special instruments under low pressure to fill the cavity with a bone cement material that hardens quickly and stabilizes the bone. Vertebroplasty is a similar minimally invasive procedure in a needle is used to inject cement into the fractures vertebra to create an internal cast in the vertebra to stabilize it.
Anterior and Posterior Cervical Problems (including cervical myelopathy): Cervical disc problems such as herniation (rupture) are common as patients age, as is spinal stenosis (mentioned above). If non-operative management doesn't help alleviate pain, minimally invasive surgery can be helpful.
Fusion Surgery: A common stress fracture called spondylolysis, usually in the lower spine can weaken a vertebra and it may not stay in place. If it slips forward (a condition called spondylolisthesis), it may pinch nerve roots and cause pain to radiate through legs into the feet. Fusion surgery is used to relieve pain by removing the part of the vertebra that covers the spinal cord (lamina), removing any bone that may be pinching the nerve and adding bone grafts along the sides of the vertebra and its neighbor to fuse them together. Rods are also secured to the fractured vertebra and its neighbor with screws to hold the bones and disc in place while the grafts heal into solid bone to stop further slippage. This type of surgery is not usually the initial treatment for back pain but is only considered after other conservative treatments have been tried for three to six months.
Services for Common Brain Tumors and Metastasis: We evaluate, diagnose and recommend treatment for all types of benign and malignant brain tumors, both those that originate in the brain (primary) and those that do not (secondary or metastatic). See the section of our Web site devoted to providing more information about brain tumors.
Spinal Cord Tumor Evaluation and Management: Benign or malignant growths in or around the spine can cause progressively worsening back pain that intensifies in a reclining position and is not related to activity. Progressively weak muscles, decreased sensation in certain parts of the body, loss of bowel control and bladder function, erectile dysfunction or paralysis may also result. Tumors are often removed surgically, but radiation therapy can be used in addition to surgery or even instead of surgery for those that are inoperable.
Peripheral nerve surgery (including carpal tunnel release and ulnar decompression): Peripheral nerves (outside the brain and spinal cord) are subject to injury, disease, tumors or entrapment (compression). Carpal tunnel syndrome means the median nerve from the forearm to the hand is compressed or squeezed where it passes through the carpal tunnel at the wrist. Compression occurs when tendons, also passing through the tunnel, become thickened or when there is other swelling. Carpal tunnel release, one of the most common surgeries in the nation, is usually performed only if pain persists after six months of non-surgical treatments. The surgery can be performed by making an incision in the wrist or by minimally invasive endoscopic surgery using a camera. Ulnar decompression is a surgical procedure to relieve pressure on the ulnar nerve when it becomes entrapped or compressed at the elbow (cubital tunnel syndrome).
Neuroplasty of the ulnar nerve: This procedure is used to repair or restore damaged ulnar nerve tissue, including freeing intact nerve tissue from scar tissue (lysis of adhesions or breaking up of scar tissue). The ulnar nerve traverses the inside of the upper arm, passing through a tunnel (cubital tunnel) behind the inside of the elbow around a bump on the upper arm bone (epicondyle), sometimes called the "funny bone," because bumping it can cause pain to shoot down the arm. Finally, it passes through another tunnel in the wrist, carrying sensations from the little finger and the nearest half of the ring finger.
Neuroplasty of the median nerve: This procedure is also used to repair or restore damaged median nerve tissue and/or free it from scar tissue or adhesions.