This week I was in Neurosurgery, which introduced me to many new characters around the hospital and led to patient interactions where the patients were usually twice my age or older. Dr. Cruz was very interesting man who truly is fascinated by the brain. Unfortunately, the more routine consults and surgical procedures focus on the spine, which is barely neurosurgery in his eyes. Since there is not a large volume of patients with neuro disorders that require surgery, the small population limits the number of surgeries. Unlike Los Angeles which has a population of about 3 million and LA county which was upwards of 9 million, The Azores have only 250,000; 150,000 of those are on São Miguel, the largest island. Regardless of my doctor’s outlook on life, I was able to see a surgery and learn from him.
I watched a surgery of a herniated disk removed. A herniated disk requires surgery when the disk applies pressure onto the nerve root in the spinal canal. Surgery is quite an ordeal since you have to go in to the space between the appropriate vertebrae and pull out the dislocated piece of bone. Dr. Cruz tries to avoid surgery because afterwards it is common for the body to treat the surgical area like a break and try to mend it fusing the back through osteophytes. The surgery took about 1 hour and 15 minutes and it looked like the incision would heal very nicely with little scarring.
- Hernia (multiple)
- Degenerative lesions in the lumbar spine
- Osteoligamentous Hypertrophy (lumbar)
- Dislocated lumbar disk
- Spinal listesis
- Nodules of Schmorl
- Disk Prolapse and Hernia
During each consult Dr. Cruz would go through CT scans of patients called (TC scans here) and would follow with either pain management, another consult, or schedule surgery.