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Once you decide to have surgery, you will be contacted by my coordinator, Tracy Barth, for the [...]

Experience Counts.

April 8th, 2010

Once you decide to have surgery, you will be contacted by my coordinator, Tracy Barth, for the details of the preoperative clearance process that includes medical clearance, laboratory and other diagnostic tests. After these have been completed, your surgical date will be determined and you will show up to the hospital at a specified time. You will be checked into the hospital the morning of surgery, and paperwork is verified for type of surgery, level and if there is a side (left or right).

Dr. John M. Abrahams is an experienced, fellowship-trained, spine surgeon who has constructed an experienced surgical team to take care of you during your surgery. The team consists of (1) Neuroanesthesiologists, (2) Neuro-Ortho Nurses, (3) Neurosurgical and Orthopedic Surgeons, and (4) Neuromonitoring. Our Neuroanesthesiologists are fellowship-trained physicians who focus on taking care of our spine patients on a daily basis. You will meet the Neuroanesthesiologists on the morning of surgery. They will go over your medical history with you again that day as they have reviewed your medical information prior to your surgery date. If you have any concerns or questions, you can review these at this time. The Nursing team then comes in to review your history, specific surgery, levels indicated, as well as side of surgery when indicated. As soon as you meet the Nurse, the Neuromonitoring team will then come in and meet with you to discuss their purpose during the surgery. The Neuromonitoring team will place electrodes on your arms and legs at this point but while you are sleeping during surgery, the technician is at a computer monitoring your nerve function to add another level of safety during your surgery. Next, as your surgeon, I will come in to speak with you and mark the surgical site with my initials. This has to be done prior to bringing you into the operating room. The Neuroanesthesiologist will put you to sleep in a matter of minutes; prior to going into the operating room, intravenous medication will be given to you to sedate you in case you are nervous.

Dr. Abrahams has constructed an experienced team of Neurosurgeons and Orthopedic Spine Surgeons to assist in surgery. In addition to the support team, two surgeons add another level of safety and significantly reduce errors and complications. During surgery, there are usually two key parts – the decompression of the spinal cord or nerves, and possibly a fusion of the vertebral bodies. Dr. Abrahams and his colleagues perform these parts of the surgery together. Prior to any significant bone removal or fusion, the level of surgery is confirmed by both surgeons by using “live” X-Ray also known as fluoroscopy. In complex cases, image guidance may be used which incorporates a CAT Scan or MRI image and imports these images into a computer system. This is particularly helpful to place pedicle screws into the bone.

Each part of the team adds another level of safety to your surgery. Quality control measures such as nursing “team leaders”, accurate multidisciplinary “time outs”, and a comprehensive team reduce complications and improve outcomes.

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TREATMENT OF CEREBRAL VASOSPASM WITH BIOCOMPATIBLE CONTROLLED-RELEASE SYSTEMS FOR INTRACRANIAL DRUG DELIVERY

February 16th, 2010

OBJECTIVE:

The pharmacological treatment of cerebral vasospasm (CVS) now includes the experimental use of controlled-release biocompatible compounds that deliver a desired drug locally into the subarachnoid space. A controlled-release system consists of an active material that is incorporated into a carrier, usually in the form of a pellet or a gel. With such systems, the desired agent is delivered slowly and continuously, for long periods of time, directly to the desired site. This technology makes it possible to achieve high local concentrations of therapeutic agents while minimizing systemic toxicity and circumventing the need to cross the blood-brain barrier. This review describes con- trolled-release systems developed to date for local drug delivery in the treatment of CVS in both animal models and humans.

Treatment of Cerebral Vasospasm With Biocompatible

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DE NOVO NEUROGENESIS AND ACUTE STROKE

February 12th, 2010

DE NOVO NEUROGENESIS AND ACUTE STROKE: ARE EXOGENOUS STEM CELLS REALLY NECESSARY?
RECENT STUDIES DOCUMENTING the phenomenon of de novo neurogenesis within the adult brain have propelled this area of research to the forefront of neuroscience investigations and stroke pathogenesis and treatment. Traditional theories have sug- gested that the central nervous system is incapable of neural regeneration; hence the emergence of the field of stem cell biology as a discipline devoted to uncovering novel forms of neural repair. However, several recent experimental observations have shown that the adult brain is capable of ongoing neurogenesis in discrete regions of the uninjured brain and additional forms of endogenous neural regeneration in the pres- ence of an inciting event (induction neurogenesis). Induction neurogenesis has the potential for providing new insights into the cause and treatment of acute stroke syndromes.
De Novo Neurogenesis and Acute Stroke

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Prevention of cerebral vasospasm by local delivery of cromakalim with a biodegradable controlled-release system in a rat model of subarachnoid hemorrhage

February 8th, 2010

Laboratory investigation

IbrahIm OmeIs, m.D.,1 WeIlIam Chen, Ph.D.,3 meena JhanWar-UnIyal, Ph.D.,1 renatO rOzental, m.D., Ph.D.,2 raJ mUralI, m.D.,1 anD JOhn m. abrahams, m.D.1
Departments of 1Neurosurgery and 2Cell Biology and Anatomy, New York Medical College, Valhalla; and 3Department of Biomedical Engineering, State University of New York, Stony Brook, New York

Laboratory investigationIbrahIm OmeIs, m.D.,1 WeIlIam Chen, Ph.D.,3 meena JhanWar-UnIyal, Ph.D.,1 renatO rOzental, m.D., Ph.D.,2 raJ mUralI, m.D.,1 anD JOhn m. abrahams, m.D.1Departments of 1Neurosurgery and 2Cell Biology and Anatomy, New York Medical College, Valhalla; and 3Department of Biomedical Engineering, State University of New York, Stony Brook, New York

Laboratory Investigation

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Extracranial-to-intracranial Bypass for Occlusive Cerebrovascular Disease and Intracranial Aneurysms in the United States, 1992–2001: A Population-based Study

February 3rd, 2010

INTRODUCTION: We assessed the results of extracranial-to- intracranial (EC-IC) bypass surgery in the treatment of occlusive cerebrovascular disease and intracranial aneurysms in the United States between 1992 and 2001 using population-based methods.
METHODS: This was a retrospective cohort study using the Na- tionwide Inpatient Sample (Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality, Rockville, MD). Statis- tical methods included multivariate ordinary and proportional-odds ordinal logistic regression with adjustment for clustering of outcomes.

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