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SPECIFIC DISORDERS OF PARTICULAR INTEREST TO THIS PRACTICE

Dr. Martin Lazar has been a pioneer in the development of new technology and Neurosurgical techniques throughout his career as he addressed the technical challenges associated with removing tumors in the region of the Vein of Galen as well as Skull Base lesions and Microvascular techniques. He was among the first to successfully carry out Extracranial to Intracranial Carotid Artery (EC-IC) Bypass grafting and helped develop the instruments used for these procedures.

Figure 1A (Left): Post-operative Right Carotid Cerebral Angiogram (Lateral View) Extracranial-Intracranial (EC-IC) Carotid Artery Bypass Graft. The "NEW" vessel (Arrow) was sewn to the Carotid Artery in the neck and brought through a Craniotomy opening to the Intracranial Supraclinoid portion of the Internal Carotid Artery.

Figure 1B (Right): Same Patient (Antero-posterior View) The "NEW" vessel (Arrow) supplies the Left & Right Anterior Arterial circulation to both Cerebral Hemispheres.

He was the first to successfully utilize small vessel arterial bypass grafting in a young child who suffered a rare congenital vascular (Moya Moya) disease resulting in Stroke. This 2-year old underwent successful reconstruction of her cerebral circulation using a 1/2 millimeter scalp artery that was sewn to one of her intracranial arteries in 1974.

Figure 2A (Left) & 2B (Right): Operative Photos. A Superficial Temporal Artery (Broad Arrows) is sutured to a Cortical Branch (Slender Arrows) of the Middle Cerebral Artery to create an EC-IC Bypass Graft.

In 2A the anastomosis lacks several more sutures before completion. There is a small stent in the Cortical Branch to keep it open during suturing.

In 2B the STA has been opened as has the MCA Cortical Branch.

Figure 3A (Left): Post-operative External Carotid Artery Angiogram (Early Arterial Phase). The Superficial Temporal Artery (STA indicated by the Large Arrow) ordinarily supplies blood to the scalp and is a branch of the External Carotid Artery. Its suture anastomosis (Slender Arrow) with a Cortical Branch of the Middle Cerebral Artery (MCA) demonstrates the difference in diameter between the two vessels.

Figure 3B (Right): Late Arterial Phase (Same Patient) demonstrates the extent of the arterial blood supply resulting from this "new" vessel.

WHAT ARE WE DOING NOW?

Dr. Lazar's special interests lie in the Advanced Microneurosurgical, Microvascular, Microendoscopic and Minimally Invasive techniques as they apply to Skull Base, Pituitary and Acoustic Tumors, Orbital Tumors, Complex Congenital Spinal Disorders, Spinal Cord Tumors, Trigeminal and Glossopharyngeal Neuralgia, Hemifacial Spasm as well as more common Spine conditions such as Herniated Intervertebral Disc and Spinal Stenosis.

Dr. Lazar is addressing the challenges in applying these highly refined Minimally Invasive surgical techniques to manage complex tumors of the Brain and Brain Stem as well as the Spinal Cord. Among his recent advances is the successful removal of a Calcified Meningioma from the Anterior Thoracic Spinal Cord region using Minimally Invasive Technique. (See Figures 4 & 5 below.)

Figure 4: Operating Room Photo

Dr. Lazar (Left) is assisted by Dr. James E. Bland (Right) while performing a Minimally Invasive Microsurgical Spine operation.

The surgeons are using a LEICA OH3 Neurosurgical Operating Microscope that is mounted on an automated stand. Dr. Lazar is able to control the movement of this microscope using a special "bite-switch" held between his teeth, thus reducing operating time and fatigue. (Look for the small "black switch".)

Figure 4A (Left): MRI Scan of a large Spinal Meningioma compresses the Spinal Cord (Arrow) within the Spinal Canal.

Figure 4B (Right): Operative Photo of a "Sonopet" ultrasonic Aspirator being used to remove this Meningioma through a 4 centimeter long Sofamor-Danek X-tube Retractor.

Figure 5A (Left): Operative Photo of the Minimally Invasive removal of the Calcified Intradural Thoracic Meningioma (Arrow). The Spinal Cord is compressed and displace by the tumor.

Figure 5B (Right): Operative Photo (Same case as Figures 4A&B & 5A). The Meningioma and its calcified portion have been removed allowing the Spinal Cord to move toward a more normal position within the Spinal Canal.

Figure 6A (Left): Dr. Lazar performing a Minimally Invasive Microendoscopic Image Guided removal of an Anterior Skull Base tumor.

Figure 6B (Right): Dr. Lazar is performing a Minimally Invasive Microendoscopic Transsphenoidal removal of a Pituitary Tumor.

Dr. Martin Lazar is the author of multiple scientific articles as well as a developer of Neurosurgical technology and techniques.



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This page last edited on 2/22

All content ©2016 by Neurosurgical Consultants, P.A.
Author, Martin L. Lazar, MD, FACS
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