Peripheral Nerves

The peripheral nervous system involves all the nerves outside the central nervous system (brain and spinal cord). The most common peripheral nerve surgeries performed are the carpal tunnel release and ulnar nerve transposition. These surgeries involve the decompression of nerves in the hand or arm to treat pain and/or loss of function in the affected arm. In addition, traumatic injury to nerves throughout the body is often treated by a neurosurgeon. Surgery is not always needed immediately; delayed repair is done after electrical studies confirm the degree of injury and healing.

Baclofen Pumps

People suffering from spasticity or stiffening of the muscles, from spinal cord injury, multiple sclerosis, stroke or head injury, can sometimes be helped with the placement of a Baclofen pump. Baclofen, an oral drug used to treat spasticity, can be infused in to the spine to help stop spasms and stiffness from spasticity. A test dose is tried first. If the test shows good results, then a pump may be placed. The pump is completely internalized. Refills and programming of the pump is done in the office. The pump requires refilling approximately every 1 to 3 months. The battery of the pump can last up to 5 years. Programming is done with a magnet in the office. Please refer to the Medtronic website on ITB (intrathecal baclofen therapy).

Shunting

When the fluid that bathes the brain and spinal cord builds up pressure, it may result in the condition known as symptomatic hydrocephalus. As the fluid builds up, the pressure in the head rises. This can require shunting. The symptoms of hydrocephalus can include headache, visual changes, and vomiting among other problems. One form of hydrocephalus, Normal Pressure Hydrocephalus or NPH, is associated with dementia, incontinence and difficulty walking. In most circumstances, hydrocephalus requires shunting to treat the symptoms.

A shunt is a plastic tube that diverts the fluid to another part of the body, so that the pressure in the head does not get too high. These tubes come in a variety of designs. Some have programmable valves that are changed with a magnet. The surgeon determines what type of shunt is needed in any given circumstance. Routine check ups with the neurosurgeon may be necessary to insure the shunt is working properly, or for programming the valve.

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