Mount Auburn Healthcare Connection

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In May 2006, Mount Auburn Hospital added a team of neurosurgeons to provide treatment for a spectrum of cranial, spine and peripheral nerve disorders. Before the new team arrived, many patients had to be referred to other facilities to receive the services currently available.

One neurosurgical team member, Marc Friedberg, M.D., Ph.D., F.A.C.S., neurosurgeon at Mount Auburn Hospital in Cambridge, a teaching hospital of Harvard Medical School, says since the team arrived, they’ve been able to provide comprehensive neurosurgical services 24/7.

The diagnosis and management of spinal diseases is one area of expertise. “We often treat degenerative disc disease, spondylosis, disc herniations, and spinal stenosis,” says Dr. Friedberg. These spinal conditions can often be treated with minimally invasive procedures that have been proven to be effective. The procedures include epidural steroid injections, sacroiliac injections, transforaminal steroid injections, trigger point injections, and facet injections.

An epidural steroid injection is a steroid anti-inflammatory drug injected into the space where the nerves are located. It is often used to treat pain due to nerve compression from a disc herniation. Other spinal conditions increase stress on the sacroiliac joint. Consequently, the region may become inflamed and induce pain in the lower back, buttocks, and proximal leg. Sacroiliac injections are often used to relieve this type of pain. Facet injections, which target a part of the spine prone to arthritis, can also ease pain for people with pain coming from the facet joint. All these pain-relieving procedures are performed in the outpatient setting and allow patients to go home 30 minutes after they are administered.

Dr. Friedberg says most patients can be treated conservatively but when surgery is necessary, they use the latest advances for optimal results. “Our goal is to provide the maximum benefit in pain relief, quality of life and neurological function with the least invasive and least risky procedure,” says Dr. Friedberg. “When medications and physical therapy fail, surgery is sometimes an option.”

Spinal stenosis of the lumbar region, referred to as lumbar stenosis, is an example of one spinal disease that may require surgery. The disease generally affects people age 70 or older. Lumbar stenosis occurs when joints and ligaments of the lumbar spine become enlarged due to stress placed on the spine. Eventually the opening in the spine reserved for nerves becomes too narrow and causes exertional leg pain termed “neurogenic claudication”.

Treatment for lumbar stenosis may involve more extensive surgical procedures that typically require removing bone, such as the spinous process and lamina, to relieve compression on the nerves. A new procedure used at Mount Auburn Hospital, called X-stop, does not require the extensive removal of bone to decompress pinched nerves. “If we determine that someone is an appropriate candidate, we can perform this relatively simple procedure, which takes less than an hour.” says Dr. Friedberg.

This minimally invasive surgery is just one type of treatment procedure offering pain relief and restoration of function. “One of our patients had extreme difficulty walking and could not walk more than a few yards,” explains Dr, Friedberg. “The day after X-stop surgery, she walked two miles with her daughter.”

At Mount Auburn Hospital, interventional radiologists and neurosurgeons perform other minimally invasive procedures to treat compression fractures such as vertebroplasty and kyphoplasty. Patients can have these done in an outpatient setting or may need to stay overnight in the hospital.

For a free Mount Auburn Hospital physician directory, please call us at 617-499-5094.