Tuesday, November 25, 2008
Neurosurgery Service to Return to University Hospital
Dr. Culicchia, chairman of LSU neurosurgery, recently unveiled plans to reestablish full neurosurgery services at University Hospital, the LSU Interim Hospital. This could be effective as early as January 1st. In the aftermath of Hurricane Katrina, and the closure of Charity Hospital, the neurosurgery service withdrew from University Hospital because the facilities could not maintain enough elective (non-emergency) cases to meet accredidation standards for educating the residents. After extensive negotiations, the chairman was pleased to announce that he has been able to arrange the operating room space to return to full services. University Hospital is the primary source of neurosurgical care for the uninsured in southeastern Louisiana.
Thursday, November 20, 2008
Comments from Dr. Tender on Minimally Invasive Back Surgery
Minimally invasive spine surgery has changed the way people see their treatment options for sciatica and low back pain. Disc herniations can now be removed through half-an-inch incisions, 
and sciatica, in selected cases, can be cured with same-day surgery (Figure 1). For those who suffer with chronic low back pain and have exhausted most treatment options (physical therapy, medication, epidural steroid injections etc), a possible treatment may be an instrumented fusion. With state-of-the-art technology and use of the operative microscope, one or two level fusions ca
n now be achieved via two small incisions, with minimal muscle dissection and essentially no postoperative sequelae (Figure 2). Emerging techniques may reduce the morbidity associated with spine surgery even further.
and sciatica, in selected cases, can be cured with same-day surgery (Figure 1). For those who suffer with chronic low back pain and have exhausted most treatment options (physical therapy, medication, epidural steroid injections etc), a possible treatment may be an instrumented fusion. With state-of-the-art technology and use of the operative microscope, one or two level fusions ca
n now be achieved via two small incisions, with minimal muscle dissection and essentially no postoperative sequelae (Figure 2). Emerging techniques may reduce the morbidity associated with spine surgery even further.Saturday, November 8, 2008
Spinal Cord Stimulation course held at LSU Center for Advanced Practice
Spinal Cord Stimulation is a procedure in which small electrodes are implanted over the Spinal Cord to deliver low voltage electrical stimulation to the nerve fibers headed to the brain. It is used to treat forms of pain for which no other good treatments exist.
It has been crucial in restoring quality of life for people with such hard-to-treat disorders as Failed Back Syndrome and Complex Regional Pain Syndrome. While the concept has been around for years, recent advances in technology have made the devices much more successful and convenient. Still, there aren't that many doctors who are familiar with the therapy.
One of the companies that makes an FDA approved spinal cord stimulation system (ANS) has partnered with several experienced physicians including an LSU faculty member, to teach area physicians about this technique. The course participants are primarily from the surrounding region, but some come from as far as Canada!
This is an important service to the area, and we hope that LSU continues to partner with outside organizations and industry to provide continuing education for our area physicians.
It has been crucial in restoring quality of life for people with such hard-to-treat disorders as Failed Back Syndrome and Complex Regional Pain Syndrome. While the concept has been around for years, recent advances in technology have made the devices much more successful and convenient. Still, there aren't that many doctors who are familiar with the therapy.
One of the companies that makes an FDA approved spinal cord stimulation system (ANS) has partnered with several experienced physicians including an LSU faculty member, to teach area physicians about this technique. The course participants are primarily from the surrounding region, but some come from as far as Canada!
This is an important service to the area, and we hope that LSU continues to partner with outside organizations and industry to provide continuing education for our area physicians.
Thursday, November 6, 2008
Stroke: Overview
When Stroke Strikes
The phrase “Timing is everything” is never more true than when stroke strikes. From the moment symptoms begin the clock is ticking, and the more quickly a stroke victim receives the proper treatment, the more likely he or she is to recover.
First Signs
Recognizing the signs of stroke is step one. You should suspect stroke whenever any of the following symptoms appear:
• sudden numbness or weakness of face, arm or leg, especially on one side
• sudden dizziness, confusion, loss of balance
• sudden blurred vision or loss of vision
• sudden, severe headache
The presence of any of these symptoms should prompt an immediate call to 911. If possible, request transport to West Jefferson Medical Center, where the West Jefferson Neurovascular and Acute Stroke Unit is dedicated to the treatment of stroke. Physicians and staff are trained in diagnosing stroke.
The Stroke Team
The West Jefferson “Stroke Team” includes all medical personnel involved in treating stroke patients. Their work starts as soon as they are called for help. EMTs are immediately dispatched. They are trained to recognize the symptoms of stroke and can let hospital personnel know a potential stroke victim is on the way. Once a patient is brought into the Emergency Room, nurses can assess the patient and notify the appropriate physicians.
Diagnosis
Doctors must then examine the patient to confirm the diagnosis of stroke and identify which type of stroke it is, the location, and the extent of brain damage. Common tests to diagnose stroke include an examination of the blood vessels in the eye and the carotid arteries in the neck, as well as CT or MRI scans.
Treatment
It is essential for physicians to decide whether a patient has had an ischemic or hemorrhagic stroke. People who are suffering a ischemic strokes – which occur when a blood clot blocks the flow of blood to the brain – must be given a “clot-busting” drug such as tPA (tissue plasminogen activator) within the first three hours of the onset of symptoms.
Patients whose strokes are hemorrhagic, in which bleeding occurs in the brain, must not receive clot-busters. Their treatment may include emergency surgery to drain blood and clip a ruptured artery or aneurysm. The Neurosurgeons of the LSU Department of Neurosurgery, who work with the West Jefferson Stroke Unit, are skilled at evaluating patients to make sure the correct treatment is carried out. And because they are constantly taking part in research studies, they know the latest and most effective treatments to help their patients.
Some people will need surgery, such as a carotid endarterectomy to remove plaque from the large carotid arteries, emergency brain surgery to remove a blood clot in the brain, or to stop the bleeding from a ruptured aneurysm.
Recovery
A big part of the recovery process is occupational and physical rehabilitation. Specialists at the Stroke Unit work with patients as they recover, helping them cope with problems they may have speaking or walking. They also work with a patient’s family. Education also comes into the picture. Patients and their families are taught how to prevent future strokes through diet, exercise and other lifestyle modifications.
Each year about 750,000 people in the U.S. have a stroke. From the moment the first symptom appears to the time a stroke patient walks out of the hospital, a myriad of specialists are busy treating the physical, emotional and social repercussions of the stroke. When they all work together, the chances of a successful outcome are greatly increased. The hope is that stroke patients can recapture the life they had before stroke entered the picture, temporarily robbing them of the health and mobility we all value.
The phrase “Timing is everything” is never more true than when stroke strikes. From the moment symptoms begin the clock is ticking, and the more quickly a stroke victim receives the proper treatment, the more likely he or she is to recover.
First Signs
Recognizing the signs of stroke is step one. You should suspect stroke whenever any of the following symptoms appear:
• sudden numbness or weakness of face, arm or leg, especially on one side
• sudden dizziness, confusion, loss of balance
• sudden blurred vision or loss of vision
• sudden, severe headache
The presence of any of these symptoms should prompt an immediate call to 911. If possible, request transport to West Jefferson Medical Center, where the West Jefferson Neurovascular and Acute Stroke Unit is dedicated to the treatment of stroke. Physicians and staff are trained in diagnosing stroke.
The Stroke Team
The West Jefferson “Stroke Team” includes all medical personnel involved in treating stroke patients. Their work starts as soon as they are called for help. EMTs are immediately dispatched. They are trained to recognize the symptoms of stroke and can let hospital personnel know a potential stroke victim is on the way. Once a patient is brought into the Emergency Room, nurses can assess the patient and notify the appropriate physicians.
Diagnosis
Doctors must then examine the patient to confirm the diagnosis of stroke and identify which type of stroke it is, the location, and the extent of brain damage. Common tests to diagnose stroke include an examination of the blood vessels in the eye and the carotid arteries in the neck, as well as CT or MRI scans.
Treatment
It is essential for physicians to decide whether a patient has had an ischemic or hemorrhagic stroke. People who are suffering a ischemic strokes – which occur when a blood clot blocks the flow of blood to the brain – must be given a “clot-busting” drug such as tPA (tissue plasminogen activator) within the first three hours of the onset of symptoms.
Patients whose strokes are hemorrhagic, in which bleeding occurs in the brain, must not receive clot-busters. Their treatment may include emergency surgery to drain blood and clip a ruptured artery or aneurysm. The Neurosurgeons of the LSU Department of Neurosurgery, who work with the West Jefferson Stroke Unit, are skilled at evaluating patients to make sure the correct treatment is carried out. And because they are constantly taking part in research studies, they know the latest and most effective treatments to help their patients.
Some people will need surgery, such as a carotid endarterectomy to remove plaque from the large carotid arteries, emergency brain surgery to remove a blood clot in the brain, or to stop the bleeding from a ruptured aneurysm.
Recovery
A big part of the recovery process is occupational and physical rehabilitation. Specialists at the Stroke Unit work with patients as they recover, helping them cope with problems they may have speaking or walking. They also work with a patient’s family. Education also comes into the picture. Patients and their families are taught how to prevent future strokes through diet, exercise and other lifestyle modifications.
Each year about 750,000 people in the U.S. have a stroke. From the moment the first symptom appears to the time a stroke patient walks out of the hospital, a myriad of specialists are busy treating the physical, emotional and social repercussions of the stroke. When they all work together, the chances of a successful outcome are greatly increased. The hope is that stroke patients can recapture the life they had before stroke entered the picture, temporarily robbing them of the health and mobility we all value.
Wednesday, November 5, 2008
Dr. Tender teaches area surgeons techniques of minimally invasive spine surgery
In October, Dr. Gabriel Tender partnered with spine instrumentation company Stryker, to provide a training course in the use of new instrumentation techniques that allow spinal fusion operations to be done through much smaller incisions. Dr. Tender originally designed and began offering the course several years ago for the residents in the LSU training program, but it has grown each year, and this year several physicians from throughout the region and nearby states attended as well.
If you have heard about minimally invasive spine surgery, and have questions that you would like to ask Dr. Tender, please, send them in!
If you have heard about minimally invasive spine surgery, and have questions that you would like to ask Dr. Tender, please, send them in!
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