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Brain Terminology

Burr Hole

A small hole(s) is/are created in the skull to remove blood or take samples of a brain tumor.

Carotid Stenosis

The narrowing of the carotid artery by a plaque of fatty deposits (arthrosclerosis), which reduces the blood flow to the brain. 

Cerebral Aneurysm

A thin or weak artery in the brain, which can bulge out and fill with blood. Aneurysms can spontaneously rupture, causing life-threatening consequences.

Cerebral Arteriovenous Malformation (AVM)

An abnormal connection between the arteries and veins which can be seen in the brain and spine. AVMs can rupture and cause life-threatening consequences.

Cerebrospinal Fluid

The fluid that is by the brain to support and nourish the brain and spinal cord.

Hydrocephalus

An abnormal accumulation of cerebrospinal fluid (CSF) that builds up within the fluid containing cavities (ventricles) of the brain, which can increase the intracranial pressure.

Microsurgery

A general term for surgery which requires the use of a which is typically microscope.

Surgical Procedures for the Brain

Awake Craniotomy

A craniotomy that is performed while the patient is awake to participate for an exam, in order to monitor and preserve function. We are one of the few centers in the United States to conduct this type of surgery.

Aneurysm Clipping

A surgical procedure where a metal clip is placed at the base of the aneurysm to prevent blood flow into the aneurysm.  The aneurysm clips are MRI compatible.

Carotid Endarterectomy

A surgical procedure to open and remove the fatty deposits in the carotid artery to reduce the risk of stroke.

Chiari Decompression

A surgical procedure that removes part of the bottom of the back of the skull to create more room for the brainstem and promote normal cerebrospinal fluid (CSF ) flow at the brain and spine junction.

Computer Assisted Brain Surgery

Computer Assisted Brain Surgery represents a surgical concept and set of methods that uses computer technology for surgical planning and for helping to guide the surgical approach. In computer-assisted brain surgery, the treatment team uses imaging technologies, such as magnetic resonance imaging (MRI), intraoperative MRI, computerized tomography (CT), to create a 3-D model of a person’s brain. The computer system precisely guides the brain surgeon (neurosurgeon) to plan the safest way to the area(s) of your brain that requires treatment.

Craniectomy

A surgical procedure where part of the skull is removed and not replaced for weeks to months to allow room for the brain as it swells. Swelling of the brain can occur in victims of traumatic brain injury and stroke.

Cranioplasty

A surgical procedure to repair a bone defect that was removed from a previous operation or injury. The bone can be from the stored original skull piece or a synthetic bone substitute.

Craniotomy

A surgical procedure that removes part of the skull to expose and gain access to the brain.

Deep Brain Stimulation (DBS)

The stimulation of the deep brain structures is used to treat Parkinson’s disease, dystonia and Essential Tremors. DBS is recommended for patients with these conditions who are not being fully controlled by standard medications. Inova Medical Group neurosurgeons use state-of-the-art stereotactic imaging systems to visualize, analyze and plan for the best surgical approach using real-time interactive 3-D image guidance.

We are one of the few centers in the United States to conduct this type of surgery.

Electrode Placement

The intracranial electrodes are placed through a burr hole to determine the seizure focus (where the seizure occurred) in a patient with medically refractory complex partial seizures; such cases are consideration for NeuroPace, Responsive Neurostimulation. 

Microvascular Decompressions

A surgical procedure used to relieve symptoms, such as facial pain or facial twitching, that can occur when the nerve is compressed by an artery or vein.

NeuroPace, Responsive Neurostimulation

NeuroPace is a Federal Drug Administration (FDA) approved system as an adjunctive treatment (another treatment used together with the primary treatment) for adults with medically refractory partial seizures occurring from one or two seizure targets. These targets are identified by the neurosurgeon following electrode placement. NeuroPace is placed under the skull by our neurosurgeon.

Subdural Hematoma Evacuation

A surgical procedure in which a craniotomy is performed, or a burr hole is created, to gain access inside the skull to remove blood (hematoma).  

Ventriculoperitoneal Shunt Placement

A small tube surgically placed into the ventricles to help drain cerebrospinal fluid and redirect it to drain into abdomen (peritoneum). When draining to the abdomen is not an option, a ventriculoatrial (heart) or ventriculopleural (lung) shunt is placed. This is typically the case when there is hydrocephalus. 

Vagal Nerve Stimulator (VNS) Placement

VNS is approved by the Federal Drug Administration (FDA) to reduce seizure frequency for patients with partial onset seizures that do not respond to medical treatment. This procedure applies electrodes around the vagus nerve in the neck. The electrodes are connected to an implanted programmable generator.

Surgical Procedures for the Spine

Anterior Cervical Discectomy and Fusion (ACDF)

A surgical procedure of the cervical spine that removes degenerative or herniated discs to relieve the spinal cord or nerve root compression. Typically, a small plate with screws and a cage are used to achieve fixation and fusion. 

Anterior Lumbar Interbody Fusion (ALIF)

This procedure approaches the lumbar vertebrae from the front of the abdomen to correct the alignment of the lumbar spine.  A general surgeon assists to expose the lumbar vertebrae.

ALIF is performed to remove a lumbar disc (discectomy) and fuse the spine.

Bone Graft Substitutes

There are a variety of bone graft substitutes available or are being evaluated in various stages of clinical trials for use in spine fusion surgery. In general, these types of bone graft are made of a synthetic or manipulated type of a naturally-occurring product.

Cervical Disc Replacement Surgery or Arthroplasty

A surgery involving removal of a generated or herniated cervical disc and replacing it with an artificial disc. It is done when the space between your vertebrae has become too narrow and part of your vertebrae or your cervical disc is pressing on your spinal cord or spinal nerves, causing you pain, numbness, or weakness. Candidates for this surgical approach are patients who must avoid fusion of the cervical spine.  

Cervical Foraminotomy

A cervical foraminotomy is a surgery performed to remove bone compressing on the exiting nerve to relieve arm pain.

Cervical Fusion

Cervical fusion is a surgical procedure in which two or more vertebrae of the neck are joined or fused together. Fusion surgeries typically require the use of bone graft to facilitate fusion and screws and plates or rods to stabilize the cervical spine.

Corpectomy

A corpectomy is a surgical procedure used to remove a vertebral body and adjacent vertebral discs in order to decompress the spinal cord and stabilize the spine.

 

Discectomy

A discectomy is the surgical removal of a herniated disc in the spine. A herniated disc can cause compression of the nerve root and cause pain, numbness, or weakness in the arms or legs. 

Extreme Lumbar Interbody Fusion (XLIF)

XLIF is a minimally-invasive fusion surgery of the lumbar spine in which the surgeon accesses the intervertebral disc space and fuses the lumbar spine (low back) from the side (lateral), rather than from the front (anterior) or the back (posterior). 

Kyphoplasty

Kyphoplasty is a spinal procedure in which a balloon is deployed in a vertebral body fracture in order to give height to the vertebral body. Bone cement is then injected to fractured vertebra.

The goal of kyphoplasty is to relieve back pain caused by vertebral compression fractures.

Laminectomy Surgery

Laminectomy is surgery that creates space by removing the lamina — the back part of the vertebra that covers your spinal canal. Also known as decompression surgery, laminectomy enlarges your spinal canal to relieve pressure on the spinal cord or nerves.

Laminoplasty

This is a procedure in which the lamina are hinged laterally to provide more room for the spinal cord and secure them into a new position using small screws.

 

Lateral Lumbar Interbody Fusion (LLIF)

This is a minimally invasive procedure used to treat leg or back pain generally caused by degenerative disc disease. The procedure is performed through the patient's side, avoiding the major muscles of the back.

 

Lumbar Fusion

Lumbar fusion is a surgical procedure in which two or more vertebrae of the lower back are joined or fused together. Fusion surgeries typically require the use of bone graft to facilitate fusion, and screws and rods to stabilize the lumbar spine.

Lumbar Laminectomy

This procedure is designed to remove a small portion of the bone over the nerve root and/or disc material from under the nerve root to give the nerve root more space, relieve pressure, and provide a better healing environment.

Microdiscectomy

This is a surgical procedure in which a portion of a herniated nucleus pulpolsus — the jelly like substance in the middle of the spinal disc — is removed by way of a surgical instrument or laser, while using an operating microscope for magnification.

Minimally Invasive Spine Surgery

With this procedure spine surgeons are able to perform spine surgery using minimally invasive techniques through a 1.5 - 2 inch incision. Because these incisions are small, patients have a quicker recovery time and less discomfort than with conventional surgery - all with the same benefits.

Minimally Invasive Microdiscectomy

Minimally invasive surgery is the least invasive and effective surgical technique for treating spinal disc herniation patients. Spine surgeons use the microscope to remove the herniated disc.

Oblique Lateral Interbody Fusion (OLIF)

This procedure approaches the lumbar vertebrae from the side of the abdomen to correct the alignment of the lumbar spine. A general surgeon assists to expose the lumbar vertebrae.

OLIF is performed to remove a lumbar disc (discectomy) and fuse the spine.

Scoliosis Surgery

This procedure is used to treat patients with severe spinal curvature of the spine causing debilitating pain in the back or legs. The surgery requires multiple levels of the spine to be fused to correct the deformity of the spine.

Spinal Decompressions

This procedure relieves pressure of the nerves in the spine. Spinal decompression can be addressed with a laminectomy, foraminotomy or a discectomy.

Spinal Fusion and Instrumentation

This surgical procedure to implant titanium, titanium-alloy, or bone grafts into the spine. Instrumentation provides a permanent solution to spinal instability.

Spinal Tumor Surgery

This procedure may include a biopsy, partial removal, or gross total resection of the spinal tumor. If the spinal tumor has eroded away the support structures of the spine, a fusion surgery may be required.

Transforaminal Lumbar Interbody Fusion (TLIF)

This procedure approaches the lumbar vertebrae from the back of the spine. 

TLIF may be performed to treat degenerative lumbar spine with instability

Vertebral Corpectomy or Vertebrectomy

A surgical procedure involving the removal of part or all of the vertebral body to decompress the spinal cord or nerve roots of the spine.

Advanced Surgical Equipment and Technologies

CyberKnife System

CyberKnife System is a radiation therapy device used to deliver radiosurgery for the treatment of tumors in the brain and spine. The neurosurgeons and radiation oncologist use state-of-the- art imaging to plan the delivery of the radiation. The fully robotic CyberKnife delivers radiation safely by tracking patient’s anatomy and movement to avoid exposing radiation to healthy tissues. 

Deep Brain Stimulation (DBS) Neurosurgery

This is a neurosurgical technique that places electrodes deep in the brain to control abnormal impulses of the brain in patients with Parkinson’s disease, dystonia, and essential tremors who have unsuccessfully tried to control their symptoms with medications.

Learn More About DBS at Inova

Intraoperative Electrophysiologic Monitoring

An electroencephalography (EEG) and electromyography (EMG) are used during surgery to monitor the functional integrity of the brain or spinal nerves. This provides the surgeon real-time feedback allowing them to make adjustments in the surgical approach and treatment in order to reduce the risk of injury to the nervous system.

Laser Ablation

Laser Interstitial Thermal Therapy (LITT) | Laser Ablation

Laser Interstitial Thermal Therapy (LITT) 

A state-of-the-art MRI-guided, minimally invasive, laser ablation system with real-time monitoring of the brain tissue. LITT allows for treatment of deep brain tumors, which can be dangerous with traditional surgery. Using advanced computer imaging techniques, the laser is guided through the small inserted catheter with real-time MRI, and delivers thermal energy directly on tumor. 

Laser Ablation

Laser ablation neurosurgery is the latest technology in treatment of tumors. Neurosurgeons use an MRI-guided, high-intensity laser probe designed especially for the treatment of deep inoperable brain tumors allowing them to probe through the brain and into the tumor. Once inside the tumor, the probe discharges highly focused thermal energy to coagulate and kill cancer cells, while leaving surrounding brain tissue undamaged. 

This technology is Federal Drug Administration (FDA)-approved for neurosurgical procedures. Use of this technology was pioneered and adopted by two of Inova's neurosurgeons, Dr. Mateo Ziu and Dr. Mahesh Shenai. 

Meet Mateo Ziu, MD

Meet Mahesh Shenai, MD

O-Arm Surgical Navigation Suite

The O-armTM is a is a state-of-the-art surgical imaging system designed for imaging the spine while in the operating room. The imaging system provides neurosurgeons with real-time 3D images during the procedure.

Robotic-Assisted Brain Neurosurgery

Adopted by Inova in 2016, robotic-assisted brain surgery features tools allowing surgeons to see and evaluate critical brain pathways, using automated robotic cameras,  so they may plan the best surgical approach using real-time image guidance, visualization, and navigation informed by interactive 3-D planning and information system.

Learn more about Robotic-Assisted Surgery at Inova

Stereotactic Radiosurgery (SRS) | Stereotactic Radiation Therapy (SRT)

Stereotactic Radiosurgery (SRS) 

SRS is used for the treatment of tumors and arteriovenous malformation (AVM) in the brain. Stereotactic radiosurgery (SRS) uses many precisely focused radiation beams to treat tumors in the brain and spine. SRS delivers a large dose of radiation on a single day. Unlike traditional surgery, there is no incision.

Stereotactic Radiation Therapy (SRT)

SRT is used for the treatment of localized tumors in the brain. This treatment uses high energy x-ray beam to shrink, disrupt the ability of the cells to grow, and kill the tumor cells. SRT delivers the treatment in a fractionated schedule, spanning multiple days.