Tag Archives: New York spine surgeon

Cervical Spine Disc Replacement: A Major Gain in Mobility

Posted on: April 26, 2016

A newer spine surgery technique called cervical spine disc replacement leaves you far more mobile than traditional spinal fusion.  By Dr. Marshal D. Peris, Co-director of Spine Surgery at the Orthopedic and Spine Institute of Northern Westchester Hospital

Dr. Marshal Peris Northern Westchester spine surgeonIf you have discomfort – such as neck or arm pain – due to problems with cervical spinal discs (those in your neck), you’ve probably heard of the spinal fusion procedure, a common surgical solution, which locks cervical vertebrae together permanently after removing damaged discs. While this spine surgery offers excellent results, you need to know about a newer technique, called cervical spine disc replacement that leaves you far more mobile. Here, I explain this advanced and exciting treatment option, and help you determine if you might be a candidate.

The cervical spine is housed in the neck, with seven vertebrae separated by discs. Because cervical disc malfunction can impact the spinal cord, you can have problems throughout your body. You may experience neck or arm pain; weakness in the arms; numbness and tingling in the arm or hand; or balance problems. Symptoms can be intermittent, chronic, or triggered by specific activities.

Ultimately, all symptoms result from compression or narrowing (stenosis) of the space for the spinal cord or the nerves exiting the spinal cord. Stenosis occurs in various ways. As you age, your spinal discs lose height (that’s why we all get shorter), causing them to bulge. Picture gently squeezing down on a cream donut: It gets shorter but also wider. A bulging disc can press on a nerve exiting the spinal cord. At a later stage, the bulge can harden (calcify) into a bone spur, which can also compress a nerve. In the case of a herniated disk, now you’re squeezing the cream donut so hard that cream leaks out. This disc material can put direct pressure on a nerve.

Now, a sophisticated procedure called cervical spine disc replacement a goes a step better for suitable candidates than traditional fusion surgery, which reduces movement. By replacing the damaged disc with an implant closely resembling a human disc, the procedure maintains the mobility of the cervical spine; in some cases, even improving motion. In other words, your neck retains some – or even better — range of motion.

The best candidates are active people under 60 years, who want to maintain greater mobility. In fact, post-surgery movement is so good, that I don’t recommend the procedure for patients with existing arthritis in the neck joints. If you increase movement in a place with arthritis, you actually increase pain. While documented outcomes for cervical spine disc replacement are positive for 15 years, no longer-term data exists.

Following surgery, you will likely go home the same day, take precautions for six weeks, then resume full activities.  Northern Westchester Hospital is one of the few hospitals in the region to perform cervical spine disc replacement; surgeons use the most advanced version of the procedure, which permits the implanting of two discs at once.

Dr. Marshal Peris is a member of the Mount Kisco Medical Group, Co-Director of Spine Surgery at The Orthopedic and Spine Institute at Northern Westchester Hospital and President of the Medical Staff at Northern Westchester Hospital.  He received his undergraduate degree from Cornell University and received his medical degree from the University of Pittsburgh School of Medicine.  Dr. Peris completed his internship, orthopedic surgery residency, and a fellowship in spine surgery at the University of Pittsburgh Medical Center.

Marshal D. Peris, MD FAAOS is Co-director of Spine Surgery at the Orthopedic and Spine Institute of Northern Westchester Hospital and Director of Spine Surgery, Mount Sinai Health System at CareMount Medical. Dr. Peris is a Board Certified orthopedic surgeon and a Fellow of the American Academy of Orthopedic Surgeons. He received his medical degree from the University of Pittsburgh School of Medicine. Dr. Peris completed his internship, orthopedic surgery residency, and a fellowship in spine surgery at the University of Pittsburgh Medical Center. Learn more at www.nwhorthoandspine.org/DrPeris.

 

 

 

 

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Neurosurgeon Sheds Light on Former President Jimmy Carter’s Cancer Diagnosis

Posted on: August 27, 2015

Neurosurgeon Sheds Light on Former President Jimmy Carter’s Cancer Diagnosis

By Dr. Ezriel Kornel

Former President Jimmy Carter recently received his first radiation treatment targeting four Kornel, (Ezriel Kornel, MD)spots of melanoma on his brain.

Many people have only heard of melanoma on the skin. However, melanoma has a high rate of metastasizing to the central nervous system, including the brain and spinal cord. In the case of a single metastasis, surgical removal is typically an option. In the case of Jimmy Carter, he has multiple melanoma spots on his brain, and is being treated with radiation.

At Northern Westchester Hospital, we treat many of our brain cancer patients with radiation using a Gamma Knife. Not to be confused with an actual knife or incision, it is a large helmet-shaped device which the patient slides into after having a head-frame placed under brief sedation.  It delivers high doses of radiation in one sitting that lasts  from a half hour to a couple of hours.

The primary goal of this procedure is to stop the cancer from growing, and it has a very high success rate – more than 90% – with minimal if any side effects. It is very successful in that it is so precise that it does not damage surrounding areas in the brain.

While I’m not treating Jimmy Carter, I would say that at the age of 90, if he has no new cancerous lesions elsewhere, he can continue to maintain his current schedule and activities. And if there are new lesions discovered in the future in his brain, he can repeat his radiation treatments.

The melanoma, itself, presents risks. Some patients experience seizures or neurologic symptoms such as balance issues. And melanoma has tendencies to bleed, which can have devastating neurologic consequences.

The good news is that melanoma is to a large extent preventable. Avoiding excessive exposure to sunlight is important, and wearing sunscreen is always imperative with prolonged sun exposure. If you see any questionable spots on your skin, or spots that change, make an appointment with your primary care physician or dermatologist as soon as possible. Like many cancers, if melanoma is caught early, it is treatable.

Editor’s Note: Ezriel Kornel, MD, FACS, is a Neurosurgeon and Director of Neurosciences at The Orthopedic and Spine Institute at Northern Westchester Hospital. 

Read additional blog posts about the gamma knife, melanoma and sun safety.

New York Spine Surgeon describes the O-Arm CAT Scanner

Posted on: December 19, 2013

Meet the O-Arm:  New technology in the OR

By John Abrahams, MD, FAANS, Chief of Neurosurgery, Co-Director of Spine Surgery, Orthopedic and Spine Institute

Dr. John Abrahams Northern Westchester HospitalThe Orthopedic & Spine Institute of Northern Westchester Hospital recently brought new technology into the operating room – the O-Arm from Medtronic.

The O-Arm is an intra-operative CAT Scanner with Image Guidance used to make placement of spinal instrumentation more accurate and safer. 

Typically, the O-Arm would be mainly used for patients undergoing spine surgery that need instrumentation placed such as rods and screws.  During these procedures, patients are put to sleep with general anesthesia and prepped for surgery.  An incision is made over the surgical site and then the O-Arm is brought in to obtain a CAT Scan with three-dimensional imaging.

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