In addition to extensive experience in general neurosurgical conditions, the efforts of the department are focused in several major programmatic areas. The faculty is organized into areas of sub-specialization, which gives the resident excellent exposure to each of these disciplines as well as the more general neurosurgical experience. The emphasis of the training program is to provide outstanding clinical experience and expertise in all fields appropriate for pursuing a career in academic or clinical neurosurgery. The volume and intensity of the exposure has enabled many graduates of the program to obtain positions without taking additional fellowship training.
All aspects of cerebrovascular disease are managed at the participating hospitals. Microsurgical management of aneurysms and arteriovenous malformations is an area of major interest. In addition, interventional neuroradiology with the availability of intra-arterial embolization, angioplasty, and stenting have increased our ability to manage the complex disorders that are referred to us at both hospital sites. Dr. Flamm and Dr. Gordon are responsible for the management of intracranial and extracranial cerebrovascular disorders.
Active programs in surgery and treatment of brain tumors exist at both Montefiore and Roosevelt Hospital. These include the management of benign and malignant tumors in both adult and pediatric populations. In addition to the neurosurgical management, emphasis is placed on the multidisciplinary management of these complex problems. Close interaction between Neurosurgery, Neurooncology and Radiation Oncology through the Tumor Board provides an opportunity for the residents to be exposed to current protocols and management strategies. The Department of Neurosurgery is also a participant in the Montefiore-Einstein Center for Cancer Care.
Diagnostic facilities include CT, MRI imaging and spectroscopy, and PET and SPECT scanning. Surgical management utilizes the latest surgical techniques including advanced microsurgical methods, frameless stereotactic guidance, ultrasound and endoscopic visualization. Radiosurgery is also available. Dr. Lasala, Dr. Abbott, and Dr. Tandon are responsible for supervision of the adult and pediatric tumor programs.
Pain / Functional
Dr. Goodrich works closely with the neurologists in determing which patient with trigeminal neuralgia may benefit from glycerol rhizolysis, radiosurgery, or a microvascular decompression. Dr. Abbott also works closely with the rehabilitation doctors to determine which patients may benefit from intrathecal pump implantantation for chronic spasticity. Dr. Goodman at Roosevelt Hospital directs much of the deep brain stimulation program for movement disorders. Epilepsy Patients with complex partial seizure disorders are evaluated for management and consideration for surgical treatment. Facilities for monitoring patients with implanted electrodes to aid in localization are available at both sites. PET scanning is used to complement the electrophysiologic localization of the seizure focus. Dr. Lasala and Dr. Abbott direct the adult and pediatric surgical program in epilepsy and collaborate with the Epilepsy Center of the department of neurology.
An extensive program utilizing the latest and most advanced techniques in spine surgery exists within the department. Stabilization, fusion, and decompression techniques are used for a wide array of spinal disorders. The spinal neurosurgery program deals with primary and metastatic spinal tumors and degenerative diseases utilizing minimally invasive and traditional spinal surgery techniques. Collaboration with orthopedics is encouraged. Drs. Houten, Yassari, Tandon, and Gordon have responsibility for this program.
Skull Base and Reconstructive Surgery
An integrated program in complex skull base surgery has been developed with the department of otorhinolaryngology. Surgical laboratory facilities are available to prepare the residents for involvement in adult and pediatric patients with tumors and congenital abnormalities. Dr. Gordon directs the efforts at Montefiore Medical Center.
Dr. Abbott and Dr. Goodrich see the general range of pediatric neurosurgical cases at The Children's Hospital at Montefiore, with special emphasis on craniofacial reconstruction for congenital abnormalities, brain, and spinal cord tumors.