Prof. Brian K. Owler is a Adult & Pediatric Neurosurgeon. His Treatments include:
Endoscopic Third Ventriculostomy
In ETV the endoscope is navigated from the lateral ventricle through the foramen of Munro into the third ventricle. The ventriculostomy is the production of a small hole in the bottom of the brain allowing CSF to bypass any obstruction to CSF outflow.
ETV involves introducing an endoscope through the skull and brain into the ventricles. A ventricular endoscope is a thin tube which contains a light source to illuminate inside the cerebral ventricles as well as an optic system for taking the light back to the video camera which is connected to the outer end of the ventricular endoscope. It is introduced through the brain into the ventricular system.
DBS Surgery for Parkinson's Disease
The core features of Parkinson’s Disease (PD), namely slowness, stiffness and shakiness, typically respond well to medication. However, PD progresses with time and the response to medications often becomes complicated by motor fluctuations (where the benefit of each dose of medication lasts only for as little as an hour) and dyskinesias (excessive involuntary movements). Patients fluctuate between OFF (medications not working, very stiff and immobile) and DYSKINESIAS (excessive involuntary movements) and very little quality ON time (medications working, mobile). Careful adjustments of medications can sometime help, but may not fix the problem, and the motor fluctuations and dyskinesias continue to reduce quality of life.
The most common reason to have DBS is to control motor fluctuations and dyskinesias. Other reasons include tremor that is resistant to medication, and inability to tolerate medications due to other side effects (e.g. severe L-DOPA induced sleepiness). Other options for treating motor fluctuations and dyskinesias include daytime infusion of apomorphine using a programmable pump connected to a needle that is inserted each day.
Anterior Cervical Discectomy and Fusion (ACDF)
What is an ACDF?
An ACDF is a common operation performed on the cervical spine through an anterior (front) approach. One or more cervical discs are removed to decompress the spinal cord and/or nerve root(s). The disc is replaced with a cage which is made of a very strong material (often composite carbon fibre / PEEK polymer). This cage has a cavity within it which is packed with a bone substitute which allows the bone above and below to grow through the cage thus joining the two vertebrae together, that is, a fusion.
Carpal Tunnel Decompression
This surgical procedure aims to relieve patient’s symptoms by taking away compression of the median nerve at the wrist. In the procedure, the flexor retinaculum which forms the roof of the carpal tunnel is divided to allow more room for the median nerve.
What is the carpal tunnel?
The bones of the wrist are called the carpal bones. They form the floor of the tunnel. The roof is formed by a ligament that joins these bones together and is called the flexor retinaculum. Through the tunnel run the median nerve as well as several other structures including several tendons. Over time the flexor retinaculum becomes thickened and compresses the median nerve.
Lumbar Microdiscectomy & Rhizolysis
What is a microdiscectomy?
A microdiscectomy is a minimally invasive procedure performed on the lumbar spine to remove a piece of protruding disc that is compressing a nerve root. Rhizolysis refers to decompression of the nerve root. The nerve root is the first part of the nerve that arises from the spine and after joining with other nerve roots will form a peripheral nerve that conducts messages for sensations such as pain as well as muscle movements.
Posterior Lumbar Interbody Fusion and Decompression (PLIF)
What is a posterior lumbar interbody fusion or PLIF?
A posterior lumbar interbody infusion (PLIF) is a surgical procedure designed to stabilise the lumbar spine. As part of the procedure the intervertebral disc is removed, the nerve roots are decompressed and the spine is realigned if required. The main reasons for performing this procedure are spinal stenosis, spondylolisthesis and discogenic mechanical back pain. However, there are other circumstances such as degenerative scoliosis where the procedure may also be indicated.
Extreme Lateral Lumbar Interbody Fusion and Decompression (XLIF)
An extreme lateral lumbar interbody infusion (XLIF) is a surgical procedure designed to stabilise the lumbar spine. It is a minimally invasive procedure that is performed from the lateral aspect of the body. The spine is approached by a path behind the abdominal contents (retroperitoneal) and through a muscle called the psoas muscle.
As part of the procedure the intervertebral disc is removed and a large cage inserted between the vertebrae. A plate may then be placed across the vertebrae to provide further stabilisation. Alternatively, posterior percutaneous pedicle screws may be placed to provide additional stability.