Neurosurgical Procedures
 About CU Neurosurgery Clinical Services
Our outpatient facilities are located in The Anschutz Outpatient Pavilion (AOP) and at the Hospital-Based Sub-Specialty facility at the 9th Ave. Hospital. Inpatient facilities are University of Colorado Hospital (9th Ave.), Veteran’s Administration Medical Center, The Children’s Hospital of Denver and Denver Health Medical Center. Common Procedures performed at these facilities are:
Typical Neurosurgical Procedures
Acoustic Neuroma Tumor Removal ( Craniotomy/Radiosurgery)
Acoustic tumors arise from the eighth cranial nerve which is the nerve that transmits
auditory information from the ears to the brain. Acoustic neuromas typically present with a hearing loss, dizziness or an abnormality such as tinnitus (continuous high pitched noise). Patients can have two options for treatment, either open craniotomy or radiosurgery.
Aneurysm Surgery (Craniotomy/Radiosurgery/Endovascular)
An aneurysm is an abnormal outward bulging of blood vessels that occur at sites along arteries where the vessel walls are weak. Depending on the location and size of the aneurysm, it can be treated by either open craniotomy and placement of a clip on the aneurysm or by coil embolization. Endovascular treatment of brain aneurysms involves insertion of a catheter (small plastic tube) into the femoral artery in the patient's leg and navigating it through the vascular system, into the head and into the aneurysm. Tiny platinum coils are threaded through the catheter and deployed into the aneurysm, blocking blood flow into the aneurysm and preventing rupture.
AVM Craniotomy/Radiosurgery/Endovascular)
Arteriovenous malformations (AVMs) are collections of abnormal blood vessels that can steal blood supply from normal brain tissue causing seizures or that can hemorrhage causing blood clots in or around the brain. Typically patients will have three surgical options for treatment of AVM’s: conventional surgery (craniotomy), endovascular embolization and radiosurgery. The choice of treatment depends on many factors, including the size, location, and extent of the AVM.
Brain Tumor Surgery (Craniotomy/Radiosurgery)
Brain tumors treated include primary and metastatic tumors of the central nervous system, pituitary gland, third ventricle, brain stem, pineal region, eloquent brain regions, skull base, cavernous sinus, and pediatric brain tumors. Craniotomy and radiosurgery are two of the options for treatment of these tumors.
Pituitary Tumors (Transsphenoidal procedure)
Pituitary adenomas are benign tumors which arise from the pituitary gland. Pituitary tumors are rarely malignant. These tumors are usually treated by surgical removal, using a transsphenoidal approach. This approach involves making an incision in the upper gum line or nasal cavity and accessing the tumor through the base of the skull. This approach is usually the procedure of choice because it is less invasive, has fewer side effects, and patients generally recover more quickly. Patients can often leave the hospital as early as two to four days after surgery.
Epilepsy (Craniotomy)
Select patients with intractable epilepsy can benefit from temporal lobectomy. This is usually a two step procedure with a craniotomy and grid placement performed to localize the seizure focus followed by a craniotomy to remove the focal point of the seizure.
Craniotomy
Any operation on the cranium or incision into the cranium. (Dorland, 28th ed).
Craniotomy is the name of the opening for most intracranial neurosurgical procedures. A craniotomy can also be a small opening advanced by the new minimally invasive approaches. Craniotomy is actually not the most commonly performed neurosurgical procedure (actually, almost 80% of the cases done annually by neurosurgeons are surgeries of the spine.)
VNS
Vagus nerve stimulation (VNS) is a treatment for patients with intractable seizures that are no longer responding to medication. A vagus nerve stimulator is a device shaped like a hockey puck but quite a bit smaller. It is placed in the chest in a manner similar to a pacemaker for the heart. The surgeon wraps its lead wires around the vagus nerve through an incision in the neck. The vagus nerve carries information to and from the brainstem (the lower part of the brain), and it innervates a large portion of the body (neck, chest, and part of the abdomen). Once implanted, the neurologist will program the VNS to deliver stimulation to the vagus nerve at various strengths and frequencies.
Deep Brain Stimulation
Deep brain stimulation (DBS) is a surgical procedure used to treat a variety of disabling neurological symptoms—most commonly the debilitating symptoms of Parkinson’s disease (PD), such as tremor, rigidity, stiffness, slowed movement, and problems with walking. The procedure is also used to treat essential tremor, a common neurological movement disorder. At present, the procedure is used only for patients whose symptoms cannot be adequately controlled with medications.
DBS uses a surgically implanted neurostimulator-- a device similar to a heart pacemaker and approximately the size of a deck of cards—to deliver electrical stimulation to targeted areas near the center of the brain that control movement. It is believed to work by blocking the abnormal neral signals that cause tremor and Parkinsonian symptoms.
Spinal and Neck Surgery
Discectomy
Cervical discectomy removes a cervical disc herniation through an anterior approach to relieve spinal cord or nerve root pressure and alleviate corresponding pain, weakness, numbness and tingling. The anterior approach to the cervical spine (from the front of the neck) can provide exposure from C2 down to the cervico-thoracic junction. Discectomies can be performed on other parts of the spinal column and are often performed in conjunction with a laminectomy from a posterior approach.
Laminectomy
A laminectomy removes a small portion of the bone over the nerve root and/or disc material from under the nerve root to relieve neural impingement and give it more space. This procedure treats spinal stenosis (cervical, lumbar and rarely thoracic), relieving the pressure on the nerves.
Stereotactic Radiosurgery
Stereotactic radiosurgery is a radiation therapy procedure that uses special equipment to position the patient and precisely deliver a large radiation dose to a tumor. This procedure does not use surgery. It is used to treat brain tumors and other brain disorders. It is also being studied in the treatment of other types of cancer, such as lung cancer.
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