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SPRING 2015
News
N E U R O L O G I C A L S U R G E R Y, P. C . – Q U A R T E R LY N E W S L E T T E R
ADVANCES IN BRAIN
TECHNOLOGIES
REVOLUTIONARY
DEVICES FOR
SPINE TREATMENT
NEW SPINAL
FUSION PROCEDURE
HELPS A RETIRED
NYC POLICE OFFICER
FASCINATING CASE
ON MENINGIONA
STUDY FROM
DR. LEE TESSLER
“I’M PAIN FREE”
PATIENT SAYS ABOUT
DR. MICHAEL BRISMAN
nspc.com
Dr. Ramin Rak discusses brain surgery with patient, Roger Sencer, after his successful surgery.
ADVANCES IN BRAIN TECHNOLOGIES
Long Island Gamma Knife® Perfexion™ at South Nassau Communities
Hospital can Treat Multiple Brain Metastases in One Session
Michael H. Brisman, M.D.
The Long Island Gamma Knife® at South Nassau Communities Hospital,
which has been upgraded to the Perfexion, the latest advancement in
Gamma Knife technology, offers significant advantages over whole brain
radiation therapy (WBRT) for patients whose cancer has metastasized to
their brain. The Gamma Knife center at South Nassau is Long Island’s most
experienced, and is led by two of the region’s top experts in
treating brain tumors and other neurological disorders.
Co-Medical Directors are Michael H. Brisman,
M.D., F.A.C.S., and radiation oncologist Edward E.
Mullen, M.D., Director of Radiation Oncology at
South Nassau Communities Hospital.
“While the earlier version of the Gamma Knife offered major advantages
over whole brain irradiation, the speed and accuracy of the Perfexion
system are unparalleled,” said Dr. Brisman. “Up to ten
metastases can be treated during one session, saving
the patient precious time and avoiding delays in starting
chemotherapy that can occur if multiple whole brain
radiation treatments are required.”
Gamma Knife® Perfexion™ © Elekta AB. – elekta.com
NeuroPace® RNS® – New Device to Reduce Seizures
Functional and restorative neurosurgeon Brian J. Snyder, M.D., of the Epilepsy Center at
Neurological Surgery, P.C. (NSPC), is the first physician on Long Island (and the second in
New York State) to implant the innovative new NeuroPace® RNS® System.
This device was recently approved by the Food & Drug Administration to help control
seizures in patients whose epilepsy is unresponsive to two or more medications.
Dr. Snyder implanted the RNS system at Winthrop-University Hospital, where he
serves as Director of Functional and Restorative Neurosurgery.
Brian J. Synder, M.D.
“This is truly a revolutionary device, which represents the future of medicine,”
said Dr. Snyder. “It will help countless patients who are unresponsive to medical
management, and are not candidates for other surgical treatments. It is the
most exciting development in epilepsy surgery in many years.”
“The way this device allows us to track the patient’s electrical activity, and
customize therapy based on these data, is an order of magnitude above what
were able to do before,” said Dr. Snyder. “There is truly nothing else like this out
there for epilepsy or other neurological disorders.”
mage: ©2014 NeuroPace,Inc. – neuropace.com
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NSPC NEWS | Spring 2015 |
The RNS System is a novel, therapeutic device that detects abnormal electrical
activity in the brain and responds by delivering imperceptible levels of electrical
stimulation before a patient experiences seizures. This stimulation normalizes
brain activity, and stops many seizures before they start.
REVOLUTIONARY DEVICES FOR SPINE
Dr. Matthew Kern Among the First to be Certified to Implant New
Artificial Spinal Disc for Two-Level Cervical Disc Replacement
Matthew B. Kern, M.D., F.A.A.N.S., a leading Long Island
neurosurgeon affiliated with Neurological Surgery, P.C., is among the
first metro New York-area surgeons to be certified to implant the
new Mobi-C® Disc, the first artificial spinal disc that can
be implanted at two adjacent levels of the cervical spine
(neck). The device, which can also be used for single-level
disc replacement, was approved by the FDA in August
2013 and studied in a large multicenter clinical trial, the
results of which were published in the November 2013
Journal of Neurosurgery: Spine.
Matthew B. Kern, M.D.
Mobi-C® Disc images:
©2014 LDR Spine USA, Inc.
Unlike spinal fusion – the standard procedure for many patients who
have degenerative disc disease that affects two contiguous (adjacent)
damaged discs – implantation of this artificial disc doesn’t just relieve pain
but allows for good postoperative range of neck motion and is less likely
than fusion to cause degeneration of surrounding discs. Degenerative
disc disease in this region often causes neck pain and pain that radiates down
the arm (radiculopathy).
Ultrasonic Spine Institute: Safer Spine Surgery Devices
William J. Sonstein, M.D., F.A.C.S., senior partner at Neurological Surgery, P.C., and
chief of neurosurgery at North Shore-LIJ Hospital at Plainview (N.Y.) is among the early
adopters of new technologies that may help prevent complications for spine surgery:
the Medtronic Aquamantys® System and Misonix Ultrasonic Bone Aspiration System.
“These tools have been created to make spine surgery safer and more efficient,” says
Dr. Sonstein. “They afford the safest conditions required for spinal
surgery. I am pleased to offer these technologies to my patients.”
William J. Sonstein, M.D.
The Aquamantys® System utilizes Transcollation® technology
that combines radiofrequency (RF) energy and saline to
stop bleeding quickly by shrinking blood vessels. This helps to minimize blood loss
and reduce transfusion rates during spine surgery. The Misonix Ultrasonic device
effectively emulsifies or “melts” bone during laminectomy for discectomy or stenosis.
This preserves soft tissue such as the spinal membrane, reducing the possibility of
complications such as spinal fluid leakage.
Aquamantys® System – ©2014 medtronic.com
“These systems are revolutionary in the treatment of spine surgery.
These technologies allow us to do spine surgery much
more safely than before. You can also perform surgery
faster because you have improved ability to stop
bleeding and reduce complications of working within
the spinal canal,” states Dr. Sonstein.
SonaStar® Ultrasonic Aspiration System –©2014 misonix.com
NSPC NEWS | Spring 2015 |
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FROM DAILY PAIN TO COACHING BASEBALL:
New Spinal Fusion Procedure
Takes Herniated Disc Treatment
to a New Level of Success
“I’m Glad I Got This Surgery. . .
I Have No Pain Now, And I Can
Walk Again With No Problem.”
— Gregory Slator
Twenty years as a New York City police officer took their toll on Gregory Slator’s back. Still a
young man of 50, his low back pain progressed to the point where he could barely walk, and
standing up straight was nearly impossible. He said the pain that radiated down his right leg
felt like an “electric shock.” He described his pain level as a “10” on a 10-point scale.
Typical medicines and therapies, including steroid injections, did not help. This Long Island
father of two was being dominated by his pain. Fortunately for Mr. Slator, a neighbor
recommended that he see NSPC spine neurosurgeon, Dr. Artem Y. Vaynman.
Artem Y. Vaynman, M.D.
“The weakness on Mr. Slator’s right side was significant,” says Dr. Vaynman. “He had three
disc herniations in his lower spine that were actually causing him to lean to the side, and
making him limp. Mr. Slator is young, and otherwise healthy and fit. This was interfering
significantly with his quality of life.”
“Dr. Vaynman went right in and told me what needs to be done,” says Mr. Slator. “I didn’t have to think too long
about this. I decided that I didn’t want to be like other people I knew, taking drugs for years but getting no relief.
There was no getting around it.” Dr. Vaynman scheduled the surgery at Mercy Medical Center: a three-level
decompression and fusion. Spinal fusion helps restore disc height and immobilizes vertebrae to stop motion at
painful joints and reduce any unnatural pressure on the neighboring nerve roots. These treatments use surgical
implants and natural bone graft material that is placed between vertebrae after the surgical removal of the
damaged intervertebral discs. In healing, the graft material grows in the disc space, joining the two vertebrae
together, effectively eliminating the painful motion.
Although full fusion of his spine will take about two years, Mr. Slator has already gone back to coaching
baseball. “His spine is almost fused now, and he doesn’t have back or leg pain,” says the doctor.
The techniques necessary for successful three-level decompression have become available only recently, and
Dr. Vaynman has had great success in doing this procedure in cases like Mr. Slator’s. “This procedure addresses
the problem completely,” he says. “If you do a less extensive procedure such as a laminectomy in a case like
this, the patient will be far more likely to require a second surgery.”
“I’m glad I got this surgery,” says Mr. Slator. “All things considered it’s a success, and I’m very happy with how
things turned out. I have no pain now, and I can walk again with no problem. I’d recommend this surgery with
Dr. Vaynman for other people with this problem.”
Scan this QR code or visit http://nspc.com/dr.vaynman-testimonial.html to see Gregory Slator’s testimonial video.
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NSPC NEWS | Spring 2015 |
FASCINATING CASE STUDY FROM DR. LEE TESSLER
Meningioma
The patient is a 38 year old right handed male who initially
complained of severe headache on April 30, 2014 followed by
an episode of expressive aphasia lasting several minutes. He had
no loss of consciousness during this event. An MRI of the brain
with and without contrast showed a 6.5 cm left frontal convexity
enhancing extra-axial mass consistent with a meningioma
with edema, mass effect, and shift. On exam at the time of
presentation he was neurologically intact. He was taken to the
operating room on May 1, 2014 at Winthrop University hospital
for a left frontal craniotomy and stereotactic resection of this
mass. It was densely adherent to the underlying brain which
corresponded to Broca’s area.
Pre-op coronal weighted gadolinium
Post-op image
A gross total resection was performed including resection of
the attached dura for a Simpson 1 resection. The pathology
was consistent with atypical meningioma WHO grade 2.
Postoperatively he had a partial expressive aphasia, which
improved while he was in the hospital. Based on the atypical
nature of the meningioma he underwent
external beam radiation receiving
4500 cGy given in 25 fractions with
an additional coned down boost to the
tumor bed of 900 cGy. He completed
his radiation on August 5, 2014. He was
seen in the office in followup with his
speech back to normal. Otherwise he
had no headache, no weakness, and no
neurologic complaints. He had a new
MRI dated October 18, 2014 which
showed no evidence of residual or
recurrent disease.
Lee Tessler, M.D.
Pre-op axial weighted
T2 image
Post-op image
Pre-op axial T1
gadolinium image
Post-op image
NSPC NEWS | Spring 2015 |
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“I’M PAIN FREE” PATIENT SAYS ABOUT DR. MICHAEL BRISMAN
Shooting Jaw Pain Causes Sleepless Nights:
Trigeminal Neuralgia Surgery
NSPC’s Experts in
Trigeminal Neuralgia
Michael H. Brisman, M.D.
“I was Thrilled… I Was Able to Eat,
I was Able to Touch My Face,
I’m Drug Free, I Feel Super, and…
Dr. Brisman, he’s Wonderful.
He Just Gave me Back my Life.
I’m Pain Free.“
— Cira Samuels
When Cira Samuels’ severe shooting trigeminal neuralgia pains kept her awake
and destroyed her quality of life, her neurologist provided medication. As the
medication stopped working and zapped her vitality, she found relief with Michael
Brisman, M.D., F.A.C.S., a board certified neurosurgeon with extensive experience
treating trigeminal neuralgia.
Cira Samuels’ ordeal began with flashing lights. “I thought a car was coming
towards me, but… it was nothing,” Cira said. The flashing lights led her to an eye
doctor who found nothing wrong. Then, the jaw pain started. “I slept sitting up. I
was drooling. It was horrible,” Cira said. She saw a dentist, who also found nothing.
Jeffrey A. Brown, M.D.
Cira’s recurring pains shot through her head and face. She saw a neurologist, who
put her on anti-seizure medication for five years. Eventually, she needed more and
more medication. “I was zombified. I couldn’t drive. My quality of living was down.
I couldn’t eat…anything hot or cold. I couldn’t have anything touch my face,” she
said. She found Dr. Brisman through an Internet search for neurosurgeons, and he
was able to get her into the hospital quickly.
For the estimated 1 in 15,000 people with trigeminal neuralgia, episodes of intense
facial pain occur hundreds of times a day, lasting several seconds or longer.
Trigeminal neuralgia treatment relieves pain in the lips, nose, eyes, forehead, scalp,
and/or jaw. Dr. Brisman and his colleagues at NSPC have successfully treated
thousands of trigeminal neuralgia patients. Dr. Brisman has written many articles
and book chapters about neurosurgery, and he specializes in brain tumors and
trigeminal neuralgia treatment.
Alan Mechanic, M.D.
“When I first woke up, no pain,” Cira said. Expressing gratitude to Dr. Brisman and
his staff, she said that the level of care was “beyond the best. On a one to ten, goes
way over ten. You’re in the best of care; you’re treated tenderly.” After surgery, her
facial pain was gone, her anti-seizure drugs were gone, and she was able to use her
face normally again.
Scan this QR code or visit http://nspc.com/testimonial-cirasamuels.html to see Cira Sammuels’s testimonial video.
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NSPC NEWS | Spring 2015 |
NSPC Brain & Spine Care Office Locations
Great Neck
600 Northern Blvd.
Suite 118
Great Neck, NY 11021
(516) 478-0008
West Islip
500 Montauk Hwy.
Suite K
West Islip, NY 11795
(631) 983-8400
Rockville Centre
100 Merrick Road
Suite 128W
Rockville Centre, NY 11570
(516) 255-9031
Patchogue
55 Medford Ave. / Rte. 112
Patchogue, NY 11801
(631) 569-8325
Lake Success
1991 Marcus Ave.
Suite 108
Lake Success, NY 11042
(516) 442-2250
Port Jefferson Station
1500-8A Rte. 112
Port Jefferson Sta., NY 11776
(631) 828-3001
Bethpage
4230 Hempstead Tpke.
Suite 205
Bethpage, NY 11714
(516) 605-2720
Riverhead
788 Harrison Avenue
Riverhead, NY 11901
631-591-3161
Commack
353 Veterans Memorial Hwy.
Suite 303
Commack, NY 11725
(631) 864-3900
Need directions?
Scan this QR code or visit
nspc.com and click Contact Us.
Exceptional Doctors. Exceptional Care.
For more information, call (855) 263-0000 or visit nspc.com.
NSPC NEWS | Spring 2015 |
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100 Merrick Road • Suite 128W
Rockville Centre, NY 11570 Neurosurgeons
Stephen D. Burstein, M.D.
Michael H. Brisman, M.D.
William J. Sonstein, M.D.
Jeffrey A. Brown, M.D.
Benjamin R. Cohen, M.D.
Artem Y. Vaynman, M.D.
Lee Eric Tessler, M.D.
Jonathan L. Brisman, M.D.
Ramin Rak, M.D.
Alan Mechanic, M.D.
Donald S. Krieff, D.O.
Brian J. Snyder, M.D.
Elizabeth M. Trinidad, M.D.
Mihai D. Dimancescu, M.D.
Robert N. Holtzman, M.D.
Stephen T. Onesti, M.D.
Matthew B. Kern, M.D.
Sachin N. Shah, M.D.
Vladimir Dadashev, M.D.
John A. Grant, M.D.
Zachariah M. George, M.D.
Gerald M. Zupruk, M.D.
Paolo A. Bolognese, M.D.
Endovascular
Neuroradiologists
John Pile-Spellman, M.D.
Sundeep Mangla, M.D.
Neuro-Oncologists
Paul Duic, M.D.
Jai Grewal, M.D.
Neuro-Ophthalmologist
Geoffrey H. Basson, M.D.
Epilepsy Neurologist
Alan B. Ettinger, M.D.
Pain Management
Madan K. Raj, M.D.
Neuro-Intensivist
Ivan Mikolaenko, M.D.
Neurophysiologists
Joseph Moreira, M.D.
Puneet Singh, D.O. Marat Avshalumov, Ph.D. Neuropsychologist
Gad E. Klein, Ph.D.
About Neurological Surgery, P.C.
As one of the New York City area’s premier neurosurgical groups, Neurological
Surgery, P.C. (NSPC), is the destination for patients seeking cutting-edge
treatment of brain and spine disorders. Our award-winning surgeons and
specialists are leaders in the region’s medical community, with appointments as
chiefs of neurosurgery in some of Long Island’s best hospitals.
At NSPC, we treat the whole person, not just the disease. Our skilled team
of physicians coordinates and collaborates, providing a comprehensive,
multidisciplinary approach to each patient’s diagnosis and care.
We specialize in multi-modality treatments and are leaders in the latest
minimally invasive procedures. We are committed to our patients and the
communities we serve, and continually strive to discover new, more advanced
treatments through robust clinical research programs.
The mission of NSPC provides patients:
• a n environment of medical excellence
• a reassuring, easy-to-navigate patient experience
• a technologically advanced environment which provides patients
with world class care and the most successful outcomes
Our services:
•
•
•
•
Multidisciplinary Consultative Services
Advanced Treatments of Brain and Spine Disorders
Support and Coping
Clinical Trials and Research – http://grow-your-practice.net/clinical-trials/
First opinions, second opinions and referrals
Our leading-edge research, as well as our outreach and education programs for
healthcare professionals, set us apart. These make us the destination for brain
and spine initial diagnoses and second opinions, and a referral source trusted
by PCPs throughout the region.
Make an appointment or refer a patient today
NSPC offers 9 convenient locations in Nassau and Suffolk Counties.
For more information, call (855) 263-0000 or visit nspc.com.