Microvascular Decompression

Microvascular decompression (MVD) is a surgical procedure for the treatment of cranial nerve compression syndromes. The commonest of these syndromes is Trigeminal Neuralgia (severe pain affecting one side of the face). Other syndromes include Hemifacial Spasm (severe involuntary twitching of one side of the face), and Glossopharyngeal Neuralgia (severe pain in one side of the throat associated with swallowing).

The surgery involves making a hole in the skull behind the ear, opening the lining of the brain (dura) and inspecting the origin of the affected cranial nerve using the microscope for magnification and illumination. In most cases a blood vessel, usually an artery, sometimes a vein, is found to be compressing the origin of the nerve. The vessel is carefully moved away from the nerve. It is held away with one or more small pieces of woven fabric (Teflon), which remains in place and cushions the nerve from the vessel.

Peripheral Nerve Surgery

The commonest indications for peripheral nerve surgery include trauma to nerves, tumours in nerves and entrapment syndromes involving nerves. Carpal tunnel syndrome (CTS) is the commonest entrapment syndrome and Carpal tunnel release (CTR) is the most common procedure performed worldwide. Symptoms of CTS include pain and numbness in the hands and sometimes up the arm, typically occurring at night or when driving the car. Other common entrapment syndromes involve the ulnar nerve at the elbow, common peroneal nerve at the knee, and posterior tibial nerve at the ankle, to name just a few.

Trauma to nerves may take the form of sharp or blunt (stretch) injuries. Generally sharp injuries are surgically repaired early, while blunt injuries are observed for a short time to see if spontaneous recovery occurs.

Sacroiliac Joint Syndrome

Dysfunction in the sacroiliac joint, also called the SI joint, can sometimes cause lower back and/or leg pain. Leg pain from sacroiliac joint dysfunction can be particularly difficult to differentiate from radiating leg pain caused by a lumbar disc herniation (sciatica) as they can feel quite similar. For decades, the sacroiliac joint was suspected as a common cause of low back and/or leg pain, although difficulty in accurate diagnostic testing left many in the medical profession skeptical. Today it is estimated that the sacroiliac joint is responsible for 15% to 30% of lower back pain cases. The sacroiliac joint connects the hip bones (iliac crests) to the sacrum, the triangular bone between the lumbar spine and the tailbone (coccyx). The primary function of the sacroiliac joints is to absorb shock between the upper body and the pelvis and legs.

Cervical Spine Surgery

There is a wide range of conditions that require cervical spine (neck) surgery, from nerve and spinal cord pinching to instability and pain. The most common surgical problem is brachialgia(arm pain from a pinched nerve). This condition in the majority of cases will improve without surgery, however, it may be required in those with weakness or severe unrelenting pain. Surgery is often done through a minimally invasive approach using microdiscectomy and microforaminotomy. Occasionally brachialgia may need to be treated by a complete discectomy and then either fusion or arthroplasty (artificial disc). Spinal cord pinching is rarely resolved with a minimally invasive approach due to the nature of the condition, however, may require surgery from the back or front of the neck.

Traumatic Injuries

A trauma patient is someone who has suffered a serious or life threatening injury as a result of an event such as a car accident, gunshot wound or fall. Traumatic injuries may affect many parts of the body, including the brain, the extremities and internal organs. The severity of injuries can range from minor to life-threatening. Trauma obviously affects the patient physically, but it can have lasting effects on the patient and those close to the patient emotionally. Therefore it is good to be able to receive prompt and thorough care after suffering any type of severe and life threatening injury.