Tag Archives: Orthopedic and spine institute

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 a Director of The Orthopedic and Spine Institute at Northern Westchester Hospital. 

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

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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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New York Orthopedic Specialist Discusses Ankle Sprains

Posted on: June 24, 2013

The Pain of Ankle Sprains

By – Dr. Kurt Voellmicke, Director of Foot and Ankle Section for the Orthopedic and Spine Institute, Northern Westchester Hospital.

foot-swarm As a doctor I find that it is common for many to be confused over what constitutes a sprained ankle.  What is a sprain, and what should you do if you have one? You’ll be happy to know that the answers are pretty straightforward.

 The Definition

A sprain is defined as a stretched or torn ligament — the tough, fibrous tissue that connects one bone to another and supports your joints. By far the most common type of sprain is in the ankle.  Typically people roll their ankle outward and damage the ligaments on the outside of the ankle. Basketball and volleyball players are the most susceptible to sprains, followed by soccer and lacrosse players. Jumping and then landing unevenly or on the side of another player’s foot is the typical cause of a sprain.  Ankle sprains can also occur sliding into a base or running on an uneven surface. Having high arches can put you at higher risk of a sprain: The foot is like a tripod. The higher one’s arch, the more the tripod tends to tilt to the side.  Other risk factors include weakness of the supporting leg muscles or poor balance.

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Common Sports Injuries: What you should know

Posted on: May 10, 2013

Although they rank among the most common sports-related injuries, anterior cruciate ligament (ACL), medial collateral ligament (MCL), and meniscus injuries are often misdiagnosed and/or perpetuated.

To understand the issues around diagnosis, we sat down with Victor Khabie, M.D. , FAAOS, FACS, Chief of the Department of Surgery, Co-Director of the Orthopedic and Spine Institute and Chief of Sports Medicine at Northern Westchester Hospital…

new york orthopedistTo achieve timely diagnosis and treatment, Dr. Khabie stresses the importance of physicians and athletic coaches recognizing the signs of each injury and knowing when it is appropriate to refer to a specialist.

According to Dr. Khabie, the signature characteristic of an ACL injury is an audible pop in the knee accompanied by swelling, difficulty walking and an inability to continue certain activities. While MCL and meniscus injuries also result in swelling and pain, athletes may still be able to move and participate, albeit in a diminished capacity. Patients may attempt to treat these injuries at home with propping and icing; however, many find their injuries do not improve.

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Westchester Pediatricians Discuss New Concussion Guidelines with Northern Westchester Hospital

Posted on: September 12, 2012

Protecting the Student Athlete

An Interview with Dr. Louis Corsaro and Dr. Elliot Barsh

Concussion Guidelines

You don’t really have to be a sports fan to have heard about the concern over concussions. Every few months, it seems, the national news carries another report about a former professional football player or boxer and their career filled with head trauma. But according to Northern Westchester Hospital pediatricians Elliot Barsh, MD, and Louis Corsaro, MD the damage these athletes suffered as professionals most likely began much earlier—when they were just youths playing in town and school sports programs.

We sat down with these leading Westchester pediatricians to understand the toll these school sports programs can take.

“I’ve seen very serious concussions in athletes as young as 12 and 13,” says Dr. Corsaro who, like Dr. Barsh, serves as a school physician for local Westchester County school districts. “We really need to educate youth coaches, trainers, parents, and athletes in all sports—football, soccer, lacrosse, basketball, hockey, baseball—on how to recognize the signs of a concussion and the steps to take to prevent lasting damage to the brain.”

The problem, says Dr. Barsh, is that the signs of a concussion can be maddeningly vague—especially when you consider that loss of consciousness is rarely one of the symptoms. “In 90% of concussions, the patient doesn’t lose consciousness,” he says. “And the other signs, such as headache, nausea, dizziness, fatigue, can be caused by any number of things.”

Wearing a snug helmet offers necessary protection for the skull, but it won’t prevent concussions, the doctors say. “If you think of the brain as a gelatinous-like organ,” says Dr. Corsaro, “you can picture how a sharp blow can cause a wave to pass through the brain. That wave can destroy neurons, and it will take time for the body to repair.”

The doctors both praise recently released New York State Concussion Guidelines that address concussions. The guidelines recommend that any athlete who takes a hit to the head and feels woozy immediately head for the sidelines. “Once you’ve suffered one concussion,” says Dr. Barsh, “you’re much more vulnerable to subsequent concussions, and to further cognitive consequences.”

“The guidelines help us manage the recovery process.” The athlete should rest quietly—no cell phones, video games, television, or schoolwork for 3-5 days following the injury. “Any cognitive strain or stimulation can delay the recovery,” shared Dr. Barsh. When the athlete is symptom-free for one week, he or she can begin a gradual return to play.

Dr. Corsaro also likes the idea of preseason cognitive testing of healthy athletes so that coaches and parents have a baseline measure. “If there’s an injury, we can do testing and compare it to the baseline to get a clear idea of the potential damage.” Several districts have already implemented such testing, he says.

Both doctors have met resistance to the new guidelines. “Parents, coaches, and kids really don’t like taking time off,” says Dr. Corsaro, “but that’s the only way to heal.” And the consequences of not respecting the downtime are severe: Memory loss, increased irritability, poor impulse control, increased risk of substance abuse, and depression are just a few of the potential outcomes. “Some parents can’t understand why I’m preventing their kids from playing,” says Dr. Corsaro. “I want that athlete out of play because I’m thinking about their future.”