Neurosurgery

The complex nature of brain tumors requires an extraordinarily experienced team of experts. Our brain tumor center is among the most active and sought-after in the nation, caring for more than 400 brain tumor patients every year. Here, neuro-oncologists and neurosurgeons work closely together to diagnose and treat benign and malignant brain tumors of all types, including gliomas, acoustic neuromas/schwannomas, meningiomas, colloid cysts, pituitary tumors, pineal tumors, skull base tumors, and pediatric tumors. Whenever possible, we employ minimally invasive treatment approaches using advanced guidance techniques such as stereotaxis, neuroendoscopy, awake brain mapping, and electrophysiological mapping. This enables us to remove many tumors that may have previously been considered inoperable, while at the same time minimizing surgical risks and complications. Thanks to our renowned neuro-oncology research program, we are also able to offer our patients access to the latest therapies, as well as experimental trials, before they are widely available.

Columbia University Irving Medical Center is one of the highest-volume centers for stroke care in the world, treating nearly 2,000 each year in a program ranked among the best in the nation. We are certified as a comprehensive stroke center, the most advanced level any center can achieve.  ColumbiaDoctors Cerebrovascular Neurosurgery Center, a team of specialty and subspecialty-trained neurosurgeons, neurologists, neurointerventionalists and neuroradiologists, offers comprehensive treatment for ischemic and hemorrhagic stroke, as well as brain aneurysm, arteriovenous malformation (AVM), cerebral bypass surgery, and carotid surgery. We use state-of-the-art microsurgical and endovascular techniques to treat hemorrhagic stroke, and endarterectomy or stent-angioplasty to revascularize blood vessels in the brain and prevent ischemic stroke. Patients are monitored around the clock in our state-of-the-art neurocritical intensive care units, and have access to early rehabilitation to maximize recovery as well as the latest trials of new therapies for stroke and other cerebrovascular disorders.

Recent advances in endovascular techniques and tools, such as microscopically sized catheters, have made it possible to treat an ever-growing range of complex neurological conditions, which may not be amenable to standard surgical methods, using minimally invasive approaches. Our endovascular surgeons have unparalleled levels of experience in treating stroke and other vascular disorders of the brain and spinal cord, brain tumors, hydrocephalus, and other complex conditions. Imaging tools such as x-ray fluoroscopy, ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) provide real-time guidance to our surgeons as they perform these procedures through tiny incisions in the skin. Today’s endovascular procedures can be used to treat conditions in virtually every area of the body, in many cases offering new options to patients who may previously have been told that their conditions were untreatable.

Many people who continue to have seizures despite ongoing medical therapy can benefit from epilepsy surgery to remove the area of focus of the seizures. In a significant number of cases, these patients can be cured of seizures entirely.  The epilepsy surgery team at Columbia Comprehensive Epilepsy Center (CCEC) is one of the most experienced and skilled in the world, with an unmatched reputation for their expertise in both adult and pediatric epilepsy. The group is made up of dedicated specialists in epilepsy neurology, neurophysiology, neuroradiology, neuropsychology, and neurosurgery. They use brain mapping to determine the precise area of the brain where seizures begin, and precision techniques to ensure that normal brain tissue is protected. All of this takes place in our state-of-the-art operating facilities and adult and pediatric epilepsy monitoring units at Columbia University Medical Center and Morgan Stanley Children’s Hospital.

Our neurological surgeons and radiation oncologists have successfully treated over 4,500 patients using the Gamma Knife, an advanced radiosurgery tool that has proven highly effective against brain tumors that are hard to reach and difficult to treat. With a highly focused laser beam composed of as many as 200 individual low-intensity beams, the Gamma Knife targets the tumor with a concentrated dose of radiation, sparing healthy brain tissue and preserving brain function for maximal recovery. Using three-dimensional computer modeling, our expert team plans an individualized course of Gamma Knife therapy for each patient. There is no need for anesthesia, and patients can go home shortly after the procedure.

Since 1998, the Center for Movement Disorder Surgery has been providing deep brain stimulation (DBS) and other state-of-the-art procedures that have proven highly successful against debilitating neurological conditions such as Parkinson disease, essential tremor, and dystonia. To date, more than 400 patients who have exhausted their medical treatment options for these conditions—at least 50 every year—have undergone deep brain stimulation at Columbia, making our center one of the most experienced and active in the nation. In DBS surgery, a small, battery-operated device is implanted in the brain to deliver targeted doses of electricity to areas of the brain that control movement, blocking the abnormal signals that can cause symptoms like tremor, stiffness, and rigidity. Intra-operative brain mapping provides guidance throughout the surgical process, while after surgery, our team works with each individual patient to adjust the stimulator to provide them with the best results. The Center for Movement Disorder Surgery provides complete care to all patients through every stage of the surgical procedures, from patient education and pre-operative screening, to intra-operative brain mapping and surgery, to careful post-operative care, and stimulator adjustments.

According to the National Institutes of Health, more than one in ten adults in the US is living with chronic pain—that is, pain every day for at least three months. For patients who have exhausted all conservative pain management strategies, including injection therapies and complementary approaches such as acupuncture, chiropractic and biofeedback, our neurosurgical pain management program offers specialized expertise in neurostimulation devices, such as spinal cord stimulation, peripheral nerve stimulation, and motor cortex stimulation. When successful, these approaches can make a dramatic difference in the day-to-day quality of life for people with chronic pain, often allowing them to significantly cut back on their daily doses of pain medications or even give up those medications altogether. When neurostimulation is unsuccessful in significantly reducing pain levels, our experts may recommend intrathecal pain medication, which delivers analgesia directly to the spine, or a new technique we are developing at ColumbiaDoctors called laser cingulotomy. An option of last resort for patients with persistent pain that does not respond to any other treatment, this therapy targets the area of the brain that recognizes pain as unpleasant, allowing patients to go on with their daily lives without the pain constantly intruding into their consciousness.

Our team of top pediatric neurosurgeons is renowned throughout the world for its expert, compassionate care for infants, children, and adolescents with all types of neurological disorders. Working with a multidisciplinary team of specialists in disciplines such as pediatrics, surgery, radiation therapy, oncology, physical therapy, orthopedics, and plastic surgery, our team provides the latest surgical options for the treatment of brain tumors, spasticity, movement disorders, intractable epilepsy, hydrocephalus, craniosynostosis, head injuries, and spina bifida, as well as other cranial malformations and spinal deformities. Our highly advanced surgical facilities are located in the Morgan Stanley Children’s Hospital, one of the nation’s finest children’s hospitals, offering our patients and their families access to novel surgical approaches and experimental therapies in the setting of a warm, child-centered, comforting facility.

Damage to the nerves that run through the arms and hands, legs and feet can result in peripheral nerve disorders, sensations of pain, numbness, tingling or paralysis in these areas. This can result from causes ranging from injury to diabetes to neurologic conditions such as amyotrophic lateral sclerosis. Our Center for Peripheral Nerve Surgery takes a multidisciplinary approach to diagnosing and managing the full range of peripheral nerve problems. We can specialize in the diagnosis and neurosurgical management of a variety of peripheral nerve problems, using approaches such as peripheral nerve decompressions, peripheral nerve repairs, graft repairs, conduit repairs, nerve transfers, and nerve tumor removals. Our team is one of the most experienced in the world in these techniques, offering our patients the best opportunity for pain relief, improved function, and an overall better quality of life.

Our team of board-certified, specialty-trained spinal neurosurgeons has expertise in the surgical management of the full range of spinal conditions, including stenosis, herniated discs, degenerative spine conditions, trauma, and tumors, as well as other conditions involving the spine such as scoliosis, kyphosis, spondylolisthesis, degeneration, trauma, and instability. Many of these conditions can threaten spinal nerve or spinal cord function, potentially causing nerve pain and sciatica, numbness, weakness or even paralysis. Our neurosurgeons are highly trained in the delicate, complex surgical approaches necessary to operate on and around the nervous system. Their microsurgical precision, combined with access to the most advanced surgical facilities and tools in our new, state-of-the-art spine hospital, allow them to operate safely on the spine and intervertebral disc structures to protect, decompress, and repair the spinal nerves and spinal cord, alleviating pain and restoring function.