Deep Brain Stimulation
A variety of neurologic conditions, including Parkinson’s disease and essential tremor, may be treated by applying electrical energy to specific areas of the brain. Deep brain stimulation entails placement of small electrode contacts into these brain regions. Intra-operative imaging (CAT scan or MRI) is commonly used during the surgery and patients typically stay in the hospital for one or two days. A neurosurgeon places the electrodes and after surgery a neurologist programs the system to best treat the patient’s condition. Dr. Merkow specializes in deep brain stimulation.
Read more about Deep brain stimulation on the AANS website.
Laser Thermal Ablation
Laser thermal ablation is a minimally invasive technique to treat brain tumors. Following placement of a small laser, heat is used to injure/destroy the brain tumor. Laser thermal ablation is made possible by MRI technology that allows a surgeon to see the temperature of the tumor and brain in real-time, enabling a precise treatment. Patients who undergo laser thermal ablation are commonly able to leave the hospital one or two days after their treatment. Dr. Merkow specializes in the use of laser thermal ablation to treat brain tumors.
Read more about Laser thermal ablation on the Johns Hopkins University website.
Minimally invasive spine surgery
Minimally invasive spine surgery refers to a variety of techniques to avoid tissue damage and postoperative pain. Two examples of minimally invasive spine surgery include the use of a tubular retractor system and intra-operative imaging/surgical navigation. By using a tubular retractor, as opposed to a traditional retractor, a surgeon is able to access the spine with less damage to the muscle and ligaments nearby. This leads to less postoperative pain, less time in the hospital, and less weakness of the muscles and ligaments. Intra-operative imaging acts like a “GPS-system”. For example, this technology allows a surgeon to place spinal hardware without performing dissection of the muscle surrounding the spine. These techniques are commonly used at East Bay Brain and Spine.
Read more about Minimally invasive spine surgery on the AANS website.
A navigation or “GPS” system in the operating room is based on CT or MRI imaging. Dr. Merkow uses surgical navigation to maximize precision when operating both in the brain and the spine. For example, when spinal stabilization is necessary, he uses surgical navigation to place the spinal instrumentation.
Neuro-endoscopy
There are many important uses for an imaging device in the operating room. Dr. Merkow has extensive experience using imaging in the operating room to perform safer, less invasive operations. At John Muir Medical Center, he uses an intra-operative CAT scan device to avoid tissue damage and maximize precision when performing both brain and spine operations.
Read more about Neuro-endoscopy on the Johns Hopkins University website.
Radiosurgery/stereotactic radiation
Radiosurgery/stereotactic radiation refers to a precise form of radiation used to treat brain and spine lesions. No incisions are made when performing radiosurgery. By using multiple beams of radiation, a tumor can be treated at a relatively high dose without damaging nearby tissue (because the nearby tissue receives relatively little radiation). A neurosurgeon, radiation oncologist, and medical physicist typically work together to provide this form treatment. Brain tumors, spine tumors, and trigeminal neuralgia are all conditions that may be treated with radiosurgery.
Read more about Radiosurgery/sterotactic radiation on the AANS website.
