Ongoing Research
Spine Case of the Month
Come Join Us We encourage any and all
The Carilion Clinic Neurosurgery team of attending and resident surgeons and neurosurgical physician assistants has steadily ramped up investigational activities. The team currently is running multiple institutional review board (IRB) approved clinical and bench studies in the fields of patient education in spinal disorders, surgical fine motor performance, spinal fractures, intracra-
nial pressure (ICP) monitoring in head injury, depression in brain tumor patients, and several others. The team has also entered into collaborative partnership with researchers at the Virginia Tech-Carilion School of Medicine and Research Institute (VTCSOMRI) to study markers in malignant brain tumors and potential therapeutic interventions. The team is also launching studies in
spinal instrumentation in conjunction with Globus Medical, the world’s largest privately held spinal company, and is opening up research channels with Edward Via College of Osteopathic Medicine (VCOM). The hope is to bring cutting edge care to the population of southwestern Virginia.
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The patient developed severe lumbar pain and weakness of both legs. MRI and computer tomography (CT) imaging disclosed possible osteomyelitis of L4 and L5 with severe destructive changes of the L5 vertebral body and severe cauda equina compression. In surgery, the patient’s L5 vertebral body and associated discs were resected and
an expandable titanium cage was placed. Pedicle screws were then placed from L2 to the ilium and connected to titanium rods. The infectious agent proved to be methicillin-sensitive staphylococcus aureus (MSSA), and the patient is making a remarkable recovery on eight weeks of intravenous antibiotic therapy.
Outreach Clinics
Cranial Case of the Month A 59-year-old patient began experiencing transient ischemia-like events. Magnetic resonance imaging (MRI) disclosed some small strokes in the right middle cerebral artery distribution. In the region of the right Sylvian fissure a giant, partially thrombosed aneurysm was detected. The aneurysm was studied via angiography and reviewed by the integrated neurovascular team at VTCSOMRI. The aneurysm was deemed untreatable via endovascular methods. Surgery required either reconstructing the patient arteries or bypassing the affected region. In surgery, the aneurysm was isolated microscopically and temporarily blocked of blood flow. Multiple “clips” were then used to re-
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construct the middle cerebral artery and obliterate the aneurysm. The patient made a great recovery, with no residual deficits.
Complete obliteration of aneurysm on post-op angiogram.
Aneurysm identified by 3-D imaging.
members of the medical community to come to our campus and spend time with the neurosurgery team. On any given day, several operations can be observed. On Tuesday afternoons, you can participate in academic sessions with our residents, attending neurosurgeons, neuroradiologists, pathologists, traumatologists, critical care specialists, anatomists, and other providers. The experience includes traditional “walk rounds” filled with fascinating cases, exceptional neurologic exams, stunning radiographic findings, and a lot of open discourse and hearty discussions. You are always welcome! Furthermore, if you know of interested medical students, college students, or high school students, we routinely support their involvement in our surgeries, clinics, and rounds. If this sort of activity interests you, please call us at 540-526-1200.
Carilion Clinic Neurosurgery is delighted to announce the institution of two regular “outreach clinics.” Responding to patient and primary care provider requests, outreach neurosurgery clinics have been established in Martinsville and Blacksburg. The clinics have been very warmly received. Patients are grateful for not having to travel to Roanoke to see a neurosurgeon. Appointments can be made by calling 540-526-1200 and requesting a location. 3