Dr. Cyril DeSilva provides advanced treatment for brain and spine injuries and disorders with additional expertise in:
- Brain tumors
- Spinal tumors
- Cervical arthroplasty
- Sacroiliac joint fusion
- Vertebroplasty and kyphoplasty
- Computer-guided spinal surgery
- Spinal surgery revisions
- Minimally invasive spinal surgery
- Spinal cord stimulation
Dr. DeSilva perform numerous specialized surgeries for the treatment of various brain and spine conditions. Some of the more common procedures include:
A laminectomy is a surgical procedure that involves relieving pressure on the spinal canal or spinal nerves by widening the spinal canal. This is usually achieved by removing or trimming down the lamina of the vertebrae. Pressure within the canal can be caused by several factors; including bone spurs or tumors, spinal stenosis, disc degeneration, spondylolisthesis (slipping of one vertebrae onto another) and disc bulges.
Lumbar or cervical fusions
A fusion is indicated to stop the movement of a painful vertebral segment or group of vertebral segments. For most cases, a synthetic bone graft is utilized to enable the vertebral segments to fuse together as one long bone. Fusions can be single level (involving two vertebral discs) or multi-level (involving three or more discs).
Kyphoplasty is is a minimally invasive surgery technique used to treat a vertebral fracture. It is usually needed when an individual has attained a vertebral fracture that has caused the vertebral disc to collapse. (This is a VCF or vertebral compression fracture.) Many individuals will develop a forward curvature of the spine above the level of fracture called kyphosis. A kyphoplasty involves the inflation of a balloon to lift the disc back to its original position. This also creates a cavity, which is filled with bone cement. Kyphoplasty will restore the vertebral body’s height and size and keep the spine in proper alignment. This type of surgery is most useful and successful with patients who suffer vertebral fracture due to diminished bone strength. The purpose of this surgery is to stop the pain associated with the fracture, stabilize the vertebra and restore vertebral body height.
ACDF – Anterior Cervical Discectomy and Fusion
A discectomy involves removal of the vertebral disc. With an ACDF, the disc is approached from the front of the spine, or the anterior. This approach requires moving aside the neck muscles, trachea and esophagus to assess the bony vertebrae and disc. The anterior approach allows for an easier access to the disc, compared to the posterior approach, without disturbing the spinal cord and nerves, and the strong muscles of the back. After the disc is removed, the space between the vertebrae is filled with a synthetic bone graft which prevents the vertebrae from collapsing and rubbing together, and creates a bridge where the spine can be fused. Fusion requires stabilization with titanium/metal plates and screws. The body’s natural healing process will form new bone cells around the graft and eventually join the vertebrae to form one bone. This procedure can be a single or multi-level surgery.
A discectomy is the removal of a portion of the disc in order to relieve pressure on the adjacent nerve fibers.
VP shunt – Ventriculoperitoneal Shunt
A VP shunt is a surgical procedure preformed to relieve increased pressure inside the skull due to excess cerebrospinal fluid on the brain, called hydrocephalus. The procedure involves making an incision behind the ear into the scalp, as well as the abdomen, and creating a hole in the skull. A catheter is inserted through the hole and placed in the ventricle of the brain. Another catheter is placed under the skin in the incision made in the scalp and detoured down the neck and chest into the abdomen. A fluid pump is inserted behind the ear which connects to both catheters and monitors the intracranial pressure. When excess fluid accumulates, the pump drains the fluid into the stomach.
A burr hole is a surgical procedure used to drain blood that has accumulated within the layers of the skull. Typically, a bleed occurs due to a direct trauma or injury to the blood vessels within the brain. An active bleed is called a hemorrhage; blood that has been allowed to clot is called a hematoma. The blood and/or blood clots can be drained by inserting a thin flexible catheter into the burr hole. Once the blood is drained, the catheter is removed and the hole is enclosed with either sutures or staples.
This surgical procedure requires making a cut into the skull. Once the cut is made, a section of the skull called a bone flap is removed to expose the brain underneath. A craniotomy can be small or large depending on the problem.