Neurosurgery is the medical specialty concerned with the diagnosis and treatment of conditions, illnesses and injuries involving the nervous system and its support structures. This includes various conditions involving the brain, the spinal cord, the actual nerves, the skull, the bones of the spine, spinal disks, as well as the blood vessels, ligaments and the protective coverings that offer support to the nervous tissues. Intervention by a Neurosurgeon can be surgical but is most often non-surgical and is determined by the condition or injury as well as the general health of the person. Such problems may be the result of abnormal development from birth (congenital), from aging or “wear and tear” (degenerative), traumatic from a definite injury, infectious, neoplastic from a tumor or it may be related to other medical conditions or disease.
Neurosurgeons are licensed physicians who have completed their college and medical school educations, completed a year of post-medical school training in general surgery and six to seven years of additional residency training specifically dedicated to neurosurgery. That training is very intense and comprehensive, exposing each neurosurgeon to the entire spectrum of neurosurgical problems and treatments. Neurological residency training programs are among the most competitive and difficult to enter and are highly regulated to ensure the quality of education and experience they offer to their residents.
Within the family of medical specialization, neurosurgery is relatively young. It has evolved into a true, independent surgical specialty only during the past century, developing from the ranks of general surgery. Our pioneers were courageous general surgeons who ventured into the previously forbidden area of treating disorders of the brain, spinal cord and nerves. Their results were limited by the lack of technology, limitations in surgical equipment and restricted knowledge of the unique tissues and functions that make up the nervous system. The advances that resulted from their monumental efforts have allowed a quantum leap in our knowledge, diagnostic abilities and surgical capabilities over the past fifty years. The technological advances of the surgical microscope, CT scan, MRI Scan and various surgical instruments have allowed us to successfully perform procedures that were not even envisioned by our predecessors. Today, Neurosurgery represents one of the most successful and prestigious specialties which continues to lead the way in research, education and advances in surgical technologies which serve all areas of Medicine.
A neurologist is a physician with training and expertise in the evaluation and medical management of neurological disorders. Neurosurgeons and neurologists share many of the same patients and often work together for the optimal care of the person. Many conditions are effectively treated by either specialist with some conditions being best managed without surgery and others with operations. When medical intervention fails or is not acceptable, the neurologist will frequently request the assistance of a Neurosurgeon to evaluate the potential for a surgical treatment. Many problems are structural in nature and may therefore respond best to neurosurgical intervention. It is much like the cardiologist who manages heart disease with medical intervention and the cardiac surgeon who offers surgery for those who have failed treatment with medications. Frequently, patients are sent to a neurologist by their primary care physician and, based upon the problem, subsequently referred to the Neurosurgeon for their surgical expertise.
In today’s medical environment, there is great overlap between specialties. Spinal surgery is one such endeavor. All Neurosurgeons and those selected orthopedic surgeons who have special training in spinal surgery are qualified and capable of performing spine related procedures. Historically, Neurosurgeons were among the first to operate on the spine and through their efforts, spinal surgery has evolved. As Neurosurgeons, we feel that our experience handling the delicate tissues of the brain, allow us to operate comfortably on the spine and the nerves that are involved. Our training and experience allows us to utilize various materials, implants and bone grafts to reconstruct or stabilize the boney structures of the spine while relieving compression on the adjacent nerves. Indeed, the vast majority of the operations performed by Neurosurgeons involve the spine and spine related procedures.
A Natural Method of Health Care
Chiropractic is a branch of healing arts. When body structures such as cells and organs are functioning normally, a state of health or normal physiology is said to exist. However, when the body’s physiology is abnormal, a disease state begins. Thus we begin to understand that abnormal physiology leads to abnormal function, predisposing the body to disease processes.
The spinal cord has 31 pairs of spinal nerves which exit from the spinal column (backbone). The most delicate and important organs of the nervous system (brain and spinal cord) are encased in a hard bony covering composed of the skull and spinal vertebrae. The spine has undergone marvelous adaptation in providing protection, mobility and weight bearing support for our upright position. The spine, in particular, offer protection to the delicate spinal cord and spinal nerves which exit from the spinal column. Irritation to the nervous system can occur when spinal bio-mechanics are compromised and thus not functioning properly.
Chiropractic teaches that within the body there are well-established “survival mechanisms” designed to maintain a state of good health. This innate intelligence is working in your body all the time, even when you are not aware of it. Did you have to tell your body to digest food? Did you tell your heart how many times to beat? Did you tell your lungs when to breathe? Did you have to direct your body to heal and repair a cut finger? The body has the ability to function and keep you well, provided it is not interfered with.
The doctors of chiropractor are the only professionals who are trained to diagnose and treat what are called spinal subluxations. The word “subluxation” comes from the Latin words meaning “somewhat or slight” (sub) and “to dislocate” (luxate). So the term ‘vertebral subluxation’ literally means a slight dislocation or misalignment of the bones in the spine.
When a subluxation occurs, a chiropractor can correct the misaligned bone and allow it to return to its proper position. This procedure is appropriately called an adjustment, and the adjustment enables the body to heal. The chiropractic adjustment is a quick thrust applied to a vertebra for the purpose of correcting its position, movement or both. Adjustments are often accompanied by an audible release of gas that sounds like a “crack.” The sound sometimes shocks people a little bit the first couple times they get adjusted, but the sensation is usually relieving. Occasionally, minor discomfort is experienced, especially if the surrounding muscles are in spasm or the patient tenses up during the chiropractic procedure. There are times when the audible “cracking” does not occur. This is often due to either significant muscle tightness or that the patient may be having a hard time relaxing during their adjustments. However, the chiropractic adjustment is still important. Several adjustments over a course of time may be necessary, in addition to massage, physical therapy, stretching exercises, or strengthening exercises. In the chiropractic world, keeping the problem fixed and preventing its reoccurrence is just as important as the initial remedy.
There are actually five components that contribute to the vertebral subluxation complex (VSC).
Bone Component-where the vertebra is either out of position, not moving properly, or are undergoing degeneration. This frequently leads to a narrowing of the spaces between the bones through which the nerves pass; often resulting in irritation or impingement of the nerve itself.
Nervous Component-is the disruption of the normal flow of energy along the nerve fibers, causing the messages traveling along the nerves to become distorted. The result is that all of the tissues that are fed by those nerves receive distorted signals from the brain and, consequently, are not able to function normally. Over time, this can lead to a whole host of conditions, such as peptic ulcers, constipation and other organ system dysfunction.
Muscular Component-since nerves control the muscles that help hold the vertebrae in place, muscles have to be considered to be an integral part of the vertebral subluxation complex (VSC). In fact, muscles both affect, and are affected by the VSC. A subluxation can irritate a nerve, the irritated nerve can cause a muscle to spasm, the spasmed muscle pulls the attached vertebrae further out of place, which then further irritates the nerve and you have a vicious cycle. It is no wonder that very few subluxations just go away by themselves.
Soft Tissue Component-the VSC will also affect the surrounding tendons, ligaments, blood supply, and other tissues as the misaligned vertebrae tug and squeeze the connective tissue with tremendous force. Over time, the soft tissues can become stretched out or scarred, leaving the spine with either a permanent instability or restriction.
Chemical Component-is the change in the chemistry of the body due to the VSC. Most often, the chemical changes, such as the release of a class of chemicals called “kinins,” are pro-inflammatory; meaning that they increase inflammation in the affected area.
These changes get progressively worse over time if they are not treated correctly, leading to chronic pain, inflammation, arthritis, muscle trigger points, the formation of bone spurs, loss of movement, as well as muscle weakness and spasm. Chiropractors have known the dangers of the vertebral subluxation complex ever since the birth of the profession. More and more scientific research is demonstrating the tremendous detrimental impact that subluxation have on the tissue of the body. In order to be truly healthy, it is vital that your nervous system be functioning free of interference from subluxations. Chiropractors are the only health professionals trained in the detection, location, and correction of the vertebral subluxation complex through chiropractic care.
All doctors use a standard procedure of examination to diagnosis a patient’s condition in order to arrive at a plan of treatment. Chiropractor uses the same time honored methods of consultation, case history, physical examination (including neurological and orthopedic exam ), laboratory analysis , X-ray and MRI examination.
In addition, chiropractor provides a careful chiropractic structural examination, with emphasis on the spine. The examination of your spine to evaluate structure and function is what makes chiropractic different from other health care procedures.
The most common therapeutic procedure performed by doctors of chiropractic is known as “spinal manipulation,” also called “chiropractic adjustment.”
The purpose of manipulation is to restore joint mobility by manually applying a controlled force into joints that have become hypomobile – or restricted in their movement – as a result of a tissue injury. Tissue injury can be caused by a single traumatic event, such as improper lifting of a heavy object, or through repetitive stresses, such as sitting in an awkward position with poor spinal posture for an extended period of time. In either case, injured tissues undergo physical and chemical changes that can cause inflammation, pain, and diminished function for the sufferer. Manipulation, or adjustment of the affected joint and tissues, restores mobility, thereby alleviating pain and muscle tightness, and allowing tissues to heal.