8 conditions
Spine
Conditions of the cervical, thoracic and lumbar spine.
Spine surgeryLumbar spinal stenosis
Narrowing of the spinal canal in the low back that causes leg pain, heaviness or numbness with walking or standing, often eased by sitting or bending forward.
OptionsDecompression (laminectomy or laminotomy), with fusion if the spine is unstable
Disc herniation and sciatica
Disc material pressing on a nerve root, causing pain that spreads down the leg (sciatica) or, in the neck, into the arm. Many cases improve within weeks.
OptionsMicrodiscectomy when pain persists or weakness develops
Degenerative cervical myelopathy
Compression of the spinal cord in the neck that can cause hand clumsiness, imbalance and difficulty walking. It tends to progress, so early assessment matters.
OptionsACDF, corpectomy, laminoplasty, or laminectomy and fusion
Radiculopathy (pinched nerve)
Compression of a nerve root causing pain, numbness, tingling or weakness in an arm or leg.
OptionsIn the neck, ACDF or posterior foraminotomy. In the low back, microdiscectomy or decompression
Spondylolisthesis
Slippage of one vertebra relative to the next, which can narrow the space for nerves and cause back and leg pain.
OptionsDecompression, with or without fusion
Degenerative disc disease
Age-related changes in the discs and joints of the spine. These are very common on imaging and often cause no symptoms. Surgery is considered when they compress the nerves or spinal cord.
OptionsTreated according to the resulting nerve or spinal cord compression
Spinal fractures
Traumatic or osteoporotic fractures of the vertebrae, assessed for stability and for pressure on the nerves.
OptionsObservation, bracing, or surgical stabilization
Chronic neck and back pain
Long-standing pain without nerve compression rarely improves with surgery. We assess whether a structural, treatable cause is present and recommend non-surgical care when it is not.
OptionsUsually non-surgical care
6 conditions
Neuro-oncology
Tumours of the brain and spine.
Neuro-oncologyMeningioma
Usually benign tumours arising from the membranes that cover the brain and spinal cord. Many grow slowly.
OptionsObservation with serial imaging, surgical resection or stereotactic radiosurgery
Glioma and glioblastoma
Tumours arising from the brain’s glial cells, ranging from slow-growing low-grade gliomas to glioblastoma.
OptionsBiopsy or maximal safe resection, followed by radiation and chemotherapy as indicated
Brain metastases
Tumours that have spread to the brain from cancer elsewhere in the body.
OptionsSurgical resection, stereotactic radiosurgery or both
Intradural spinal tumours
Tumours inside the covering of the spinal cord, such as meningiomas and nerve sheath tumours, which can cause pain, numbness or weakness.
OptionsMicrosurgical resection
Spinal metastases
Cancer that has spread to the vertebrae, which may cause pain, instability or spinal cord compression.
OptionsDecompression and stabilization, usually combined with radiation
Incidental brain findings
Lesions found on a scan done for another reason.
OptionsAssessment, surveillance imaging or biopsy
8 conditions
Cerebrovascular
Conditions of the blood vessels of the brain and neck.
Cerebrovascular careBrain aneurysm
A weak, bulging area of a brain artery. Many are found incidentally, and small aneurysms are often safely monitored.
OptionsSurveillance imaging, coiling (with balloon or stent assistance) or flow diversion
Carotid stenosis
Narrowing of the carotid artery in the neck, which raises the risk of stroke.
OptionsMedical therapy, with carotid stenting for selected patients
AVM and dural arteriovenous fistula
Abnormal connections between arteries and veins in or around the brain that can cause bleeding, seizures or pulsatile tinnitus.
OptionsObservation, embolization, surgery or radiosurgery, often in combination
Pulsatile tinnitus
A rhythmic sound in the ear that keeps time with the heartbeat. In some patients it is caused by venous sinus stenosis or a dural fistula.
OptionsVenous sinus stenting or embolization when a treatable cause is found
Idiopathic intracranial hypertension (IIH)
Raised pressure around the brain without another identifiable cause. It typically causes headaches and can threaten vision.
OptionsVenous sinus stenting for selected patients with venous sinus stenosis, alongside care from neurology and ophthalmology
Acute ischemic stroke
A blocked artery supplying the brain. Suspected stroke is an emergency. Call 911.
OptionsEndovascular thrombectomy for large-artery blockages, through the emergency department
Aneurysmal subarachnoid hemorrhage
Bleeding around the brain from a ruptured aneurysm. This is a medical emergency.
OptionsEmergency aneurysm treatment, usually by coiling, through the emergency department
Intracerebral hemorrhage
Bleeding within the brain tissue.
OptionsAssessment for an underlying vascular cause, and follow-up
5 conditions
Trauma and general
Injury, bleeding and cerebrospinal fluid disorders.
Trauma and urgent careHead injury
Traumatic brain injury that needs neurosurgical assessment, imaging review or follow-up.
OptionsAssessment and follow-up. Surgery when there is significant bleeding or pressure on the brain
Chronic subdural hematoma
A collection of old blood between the brain and its covering, often after a minor fall and most common in older adults.
OptionsObservation, burr-hole drainage, or middle meningeal artery embolization in selected patients
Hydrocephalus
A build-up of cerebrospinal fluid in the brain’s ventricles.
OptionsVentriculoperitoneal shunt or endoscopic third ventriculostomy
Shunt malfunction
Blockage or failure of a shunt that drains cerebrospinal fluid, which can cause headache, drowsiness or vomiting.
OptionsShunt assessment and revision
Spinal cord injury
Injury to the spinal cord from trauma.
OptionsAssessment and follow-up after acute care
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A sudden severe headache, new weakness or numbness, trouble speaking, loss of bladder or bowel control, or loss of consciousness is an emergency. Call 911 or go to the nearest emergency department.
Referrals
Refer a patient
A brief referral with the relevant imaging is enough. Our office calls the patient to book the consultation.