Deep Brain Stimulation for Parkinson's Disease and Essential Tremor
Activa Parkinson's Control Therapy and Essential Tremor Therapy uses one or two surgically implanted medical devices, similar to cardiac pacemakers, to deliver electrical stimulation to precisely targeted areas of the brain. Continuous stimulation of these areas blocks the signals that cause the disabling motor symptoms of the disease. As a result, many patients achieve greater control over their body movements, or have a significant reduction of tremors.
The Activa System consists of three implantable components: lead, extension, and neurostimulator. The neurostimulator which is placed in the chest wall, generates electrical pulses that are delivered through the extension to the lead to the defined target in the brain.
We utilize the advanced techniques of frameless radiosurgery for minimally invasive treatment of a variety of intracranial
and spinal
lesions. Radiosurgery has been proven to be a safe and effective treatment modality for a subset of metastatic brain tumors, meningiomas, vestibular schwannomas and arteriovenous malformations. Radiosurgery for the treatment of trigeminal neuralgia has also proven to be successful in a high percentage of cases.
Frameless radiosurgery has the same degree of accuracy and precision as frame based radiosurgery without the patient discomfort associated with the stereotactic head frame.
Spinal radiosurgery is also a safe and effective treatment modality for spinal tumors and other lesions throughout the spinal axis.
The goals of spinal radiosurgery are:
Prevention of further growth of spinal tumors and avoidance of the development of spinal cord compression
Shrinkage of already present tumors throughout the spine through non-invasive cost effective method
Palliative treatment of spinal tumors and
vascular
lesions in an attempt to reduce the pain associated with the presence of these tumors throughout the spinal axis and improving the quality of life for the patient
Dr. Massoudi was the first in the world to treat trigeminal neuralgia using frameless radiosurgery. He recently presented one of the largest series of frameless radiosurgical treatment of patients with trigeminal neuralgia with the longest clinical follow ups in the world. He authored a chapter on the treatment and clinical outcomes of frameless radiosurgery of trigeminal neuralgia titled "Pioneering Techniques in Robotic Radiosurgery".
Dr. Massoudi was the first and only thus far that has successfully treated a patient with intractable glossopharyngeal neuralgia with CyberKnife frameless radiosurgery.
Drs. Jackson and Massoudi were among the very first clinical investigators who enrolled patients into the frameless radiosurgical investigational protocol for treatment of spinal metastases. His data and follow-ups of these patients were contributing factors to the FDA approval of the use of CyberKnife frameless radiosurgery in the treatment of spinal metastases.
The surgical treatment of brain tumors has undergone significant advances in the past decade. We utilize the most up-to-date neurosurgical techniques combined with state of the art intraoperative tumor localization technologies to optimize our surgical outcomes. As a result, we have been performing more accurate and precise tumor resections with shortened post- operative recovery periods. We have extensive experience in the surgical resection of benign and malignant brain tumors.
Minimally Invasive Spine Surgery
Advances in surgical techniques and instrumentation have led to the emergence of the field of minimally invasive spine surgery. We perform outpatient discectomies with quick patient recovery and return to daily activities. Minimally invasive lumbar decompression surgeries for spinal stenosis have also reduced length of hospital stay and have led to expedient patient recovery.
Vertebroplasty and Kyphoplasty are effective treatment options for patients who are suffering from unremitting pain and medically intractable back pain caused by osteoporotic and pathological compression fractures of the spine. For those patients who meet the surgical criteria, these methods of stabilizing the vertebral fractures of the spine have resulted in rapid and significant reduction in incapacitating pain. The potential candidates for this operation must undergo careful screening and diagnostic work-up before surgery. The operation is usually associated with an overnight hospital stay.
These two techniques can sometimes be used in conjunction with spinal frameless radiosurgery.
Cervical Microforaminotomies
Posterior Cervical Microforaminotomies is for select patients who present with isolated compression of nerve roots exiting the spinal cord in the neck there is a new surgical technique available which represents the latest treatment option. This group of patients routinely underwent complete discectomies at the affected levels of the neck from the front. The technique of posterior microforaminotomy allows for limited and yet effective decompression of nerve roots without committing the patient to a fusion operation. This type of operation is performed from the back of the neck and is associated with significantly less structural modifications of the spine which in the long run lessens the likelihood of accelerated degenerative disc disease and bone spur formation in adjacent levels of the spine. Potential candidates for this surgery need to undergo a thorough neurological evaluation, as not every patient is an appropriate candidate for this type of operation.
Artificial Disc
Lumbar artificial disc replacement (spinal arthroplasty) is a promising new surgical technique that has been demonstrated to be an effective treatment option for patients suffering from intractable back pain caused by degenerative disc disease. The artificial disc allows for motion preservation and avoids the potential future problems with accelerated degeneration at the adjacent levels of the spine sometimes seen in spinal fusion.
Complex Spine Surgery
Anterior and posterior, cervical, thoracic, and lumbosacral instrumented spinal fusion operations are examples of complex spine surgery that we perform on a regular basis. Spinal fusion operations are procedures of choice for a carefully selected sub-group of patients who have progressive and medically intractable back pain. Spinal fusion and instrumentation operations are often effective treatment modalities for spinal instability caused by degenerative processes, spinal infections, tumors and severe trauma to the spine. We have extensive experience and training in complex spinal fusion and instrumentation and treat a large number of patients with these forms of spinal disorders.
X-STOP IPD Implant
Drs. Robert Jackson and Farzad Massoudi were among the first spine surgeons
in Orange County to implant the Xstop device, and have extensive experience
in the treatment of spinal stenosis. For more information click here.
Cervical Disc Replacement with Mobi-C Artificial Disc Prosthesis
Drs. Robert Jackson and Farzad Massoudi are currently enrolling patients for
an FDA trial comparing the safety and efficacy of cervical disc replacement
versus traditional anterior cervical discectomy and fusion. For more information click here.
The XLIF® Surgical Procedure
After you have been positioned, an X-ray will be taken to help your doctor
precisely locate the operative space. Next, your skin will be marked at the site
where the two small incisions will be made. Your surgeon will use the latest
instrumentation to access the spine in a minimally disruptive manner. Disc preparation
is the next step. This is done by removing the disc tissue which will allow
the bones to be fused together. Several X-rays will be taken during this stage
to ensure the preparation is correct. Once the disc has been prepared, the surgeon
will then place a stabilizing implant into the space to restore the disc height
and enable the spine to once again support necessary loads. Once in position,
a final X-ray will be taken to confirm correct implant placement. In the event
that further stabilization is necessary, the surgeon may choose to insert additional
screws, rods, or plates into the vertebrae.
We utilize the advanced techniques of frameless radiosurgery for minimally invasive treatment of a variety of intracranial
and spinal
lesions. Radiosurgery has been proven to be a safe and effective treatment modality for a subset of metastatic brain tumors, meningiomas, vestibular schwannomas and arteriovenous malformations. Radiosurgery for the treatment of trigeminal neuralgia has also proven to be successful in a high percentage of cases. 
Dr. Massoudi was the first in the world to treat trigeminal neuralgia using frameless radiosurgery. He recently presented one of the largest series of frameless radiosurgical treatment of patients with trigeminal neuralgia with the longest clinical follow ups in the world. He authored a chapter on the treatment and clinical outcomes of frameless radiosurgery of trigeminal neuralgia titled "Pioneering Techniques in Robotic Radiosurgery". 
