Princeton Neurological Surgery

Products And Services

• Brain Surgery

  At Princeton Neurological Surgery, we offer excellence in treatments for brain tumors and other intracranial conditions to patients in New Jersey and surrounding areas. Dr. Lipani is a board certified, fellowship trained specialist in complex brain surgery and brain tumor surgery. Please see the list below to select which Brain Surgery Treatment Procedures you would like to learn more about. Brain Surgery Treatment Procedures: Burr Hole Drainage, Chiari Malformation, Cranioplasty, Craniotomy for Meningioma, Craniotomy for Subdural Hematoma, Craniotomy for Tumors, Diagnostic Cerebral Angiography, Microvascular Decompression for Trigeminal Neuralgia, Ommaya Reservoir Placement, Stereotactic Brain Biopsy, Suboccipital Craniectomy for Acoustic Neuroma, Transsphenoidal Surgery for Tumors, Ventriculoperitoneal Shunt for Hydrocephalus

  Link: Brain Surgery

• Spine Surgery

  At Princeton Neurological Surgery, we offer excellence in complex spine surgery and minimally invasive spine surgery to patients in New Jersey and surrounding areas. Dr. Lipani is a board certified, fellowship-trained top spine surgery specialist. Common procedures include spinal fusion surgery, laminectomy and microdiscectomy. Dr. Lipani also treats patients who require revision spinal surgery and spine surgery patients who are considered too challenging to be treated at other institutions. Deciding whether to undergo spine surgery can be a big decision for an individual. However, not all spine surgery is elective. For example, if the spinal cord is compromised to the point of interfering with neurologic function (e.g., arm or leg weakness and/or numbness), urgent spinal surgery may be recommended in an effort to preserve function. Delaying spine surgery in these cases may result in irreversible nerve damage. Often, non-urgent spinal conditions may develop into urgent conditions that gradually or suddenly compromise neurologic function. Typical symptoms that may require urgent spinal surgery include sudden onset of arm or leg weakness, numbness in the trunk, difficulty with fine hand motor control, gait clumsiness, spastic gait, bowel and/or bladder dysfunction and perianal numbness. In addition, debilitating back pain that does not respond to medication may also be an indication for urgent spine surgery, Chronic back pain can be debilitating and as a sufferer you will have likely been in regular consultation with a specialist regarding your options. It may be comforting to learn that the majority of back pain sufferers do not require spine surgery. Most back pain results from muscle strain or spasm. Other common etiologies include chronic degenerative arthritic changes that affect the spinal column and intervertebral discs. Chronic conditions like these may be treated initially with physical therapy, chiropractic manipulation, acupuncture, trigger point injections and epidural steroid injections. Unless the patient is suffering from a spinal condition that requires urgent surgical intervention, spine surgery is usually deferred until at least 6 weeks of conservative therapy that fails to control the patient’s symptoms. Our top expert spine surgeon, Dr. John Lipani, is capable of providing you with the advice, recommendations and spine surgery procedure to assist you in living a full and comfortable life again.

  Video: Spine Surgery

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• Radiosurgery

  Stereotactic Radiosurgery (SRS) is a non-invasive medical procedure designed to treat benign and malignant lesions within the body. SRS uses the principles of stereotaxy, or 3-D target localization, with multiple cross-fired beams from a high-energy radiation source to precisely irradiate the target. While a single beam of radiation is innocuous to the surrounding tissue, the culmination of cross-fired beams at the target is destructive. This technique allows for the delivery of aggressive dosing to the target, while protecting surrounding healthy tissue. Stereotactic Radiosurgery is also known as stereotactic radiotherapy (SRT) when used to target lesions in the brain, and stereotactic body radiotherapy (SBRT) when used to target lesions in the body. In addition to cancer, it has also been shown to be beneficial for the treatment of some non-cancerous conditions, including vascular disorders such as arteriovenous malformations (AVMs) and chronic pain disorders such as trigeminal neuralgia. Radiosurgery is used to destroy target tissue that is otherwise inaccessible or too risky for open surgery. In some cases, it can be used as an alternative treatment option for those who are unwilling or unable to undergo an open surgical procedure. There are many conditions for which conventional surgical treatment is difficult or inadvisable due to potential deleterious consequences for the patient, such as damage to nearby vascular structures, nerves, and other vital structures. Radiosurgery has thus been especially helpful for the localized, highly precise treatment of brain and spine tumors.

  Video: Radiosurgery

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• Neurosurgery

  What Is Neurosurgery? Neurosurgery is the medical specialty in which conditions and disorders of the spine and brain are diagnosed and treated with appropriate surgical intervention. In neurosurgery, we address problems that affect the nervous system, including the brain, spine, spinal cord, and skull. Reasons To See A Neurosurgeon Seeing a neurosurgeon doesn’t necessarily mean you need surgery. Your primary care physician may refer you to a neurosurgery specialist for a thorough consultation and examination regarding a suspected disorder or disease affecting your nervous system. Neurosurgeons are trained to perform brain surgery. However, specialists like Dr. Lipani also provide an extremely high level of care for spinal disorders. The majority of procedures performed by a neurosurgeon are related to spinal conditions. The extensive training obtained by a neurosurgeon facilitates exemplary care for the entire spine, including the spinal canal and spinal cord. What Conditions Does A Neurosurgeon Treat? A neurosurgeon is a specialist who diagnoses and performs surgical procedures to treat disorders of the nervous system, including brain and spinal conditions. Some of the conditions that a neurosurgeon may treat include: Brain or spinal injuries Infections of the brain or spine Stroke Seizure disorders Degenerative conditions of the spine Brain or spinal tumors Procedures A Neurosurgeon Performs A neurosurgeon performs a wide variety of tests and procedures that diagnose and treat conditions affecting the nervous system. Dr. Lipani is a board-certified neurosurgeon who has received extensive training in the performance of cranial and spinal procedures, including radiosurgery. His spectrum of care includes cranial procedures including but not limited to: Cranioplasty Diagnostic Cerebral Angiograph Ventriculoperitoneal Shunt for Hydrocephalus Microvascular Decompression for Trigeminal Neuralgia Craniotomy for Meningioma Craniotomy for Subdural Hematoma Craniotomy for Tumors Advanced education in spinal conditions and procedures includes but is not limited to: Minimally invasive spinal surgery Laminectomy Cervical discectomy and fusion Spinal fusion Revision spine surgery Lumbar disc microsurgery What Our Patients Say "The Doctor outstanding in every way possible. Explaining every detail and taking his time to do so. Amazing for a surgeon to be so informing of the procedure to me and my wife .After the surgery he came out and explained everything to me. My wife is doing great after the cervical spine fusion .moving her arm in ways she hasn’t in years and getting her feeling back in her fingers.” – Anthony R. How to Prepare for Your Consultation with a Neurosurgeon We would like your visit to Princeton Neurological Surgery to be a productive event that gives you peace of mind about your health and wellness. Preparedness on your part can help ease nerves related to your consultation. It helps us gain the best understanding of your symptoms and helps you absorb the details of the proposed treatment. Aspects of your visit that are important include: Medications. Discuss all medications you are currently taking when you visit our office. These include over-the-counter supplements, vitamins, pain relievers, and all prescription medications. Symptoms. The more precisely you can document your symptoms before your visit, the more efficiently we can identify the root cause. In addition to documenting the symptoms themselves, also make note of details such as frequency, severity, and any triggering stimuli. Think of questions such as: is pain worse first thing in the morning or later in the day? Do certain activities instigate pain? These details should be discussed with your doctor. Expectations. It is important for the doctor and patient to understand the potential outcome of treatment and to compare possibilities with expectations. What would you like to achieve with treatment? Are there certain activities that you would like to be able to do, such as biking or running, after treatment? Sharing your expectations for life after treatment enables your doctor to strive to meet those expectations and also thoroughly discuss the potential and limitations of recommended procedures. Questions. Most patients will have at least a few questions as we discuss treatment options. These include what to expect and what might be done to maximize the outcome of the proposed procedure. Every question that comes to mind is worth asking, because every answer can increase your peace of mind. Schedule A Consultation If you are in need of a Neurosurgeon in New Jersey, schedule a consultation with Dr. John Lipani. Contact us today at (609) 890-3400 for more information or fill out an online contact form and our office will be in touch in touch with you. Princeton Neurological Surgery serves areas in and around Princeton, Somerset, and Morristown in New Jersey.

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• Revision Spinal Surgery

  What Is Revision Spinal Surgery? Revision spinal surgery is a procedure that takes place on a patient who has already undergone some form of spine surgery. Typically, by three months following surgery, any lingering pain is resolved. When a patient reports persistent, recurrent, or new chronic pain symptoms, revision spinal surgery is sometimes considered. Revision spine surgery is typically performed on the cervical or lumbar spine areas. In the cervical spine, patients may be suffering from failed cervical disc replacement surgery whereas in the lumbar spine patients may be suffering from a failed fusion or pseudoarthrosis. Revision spinal surgery may also be related to the re-herniation of a disc, infection, hardware failure, non-surgery-related spine degeneration, instability, adjacent segment degeneration, or pseudarthrosis (failure to achieve solid fusion). Failed spine surgery can occur due to an inaccurate diagnosis that results in the wrong surgical approach and/or inadequate surgical correction. At Princeton Neurological Surgery, Dr. Lipani often corrects patients who’ve suffered failed spine surgery at other institutions. His extensive experience includes correcting failed cervical and lumbar decompression (e.g., discectomy, laminectomy), cervical and lumbar fusion, and failed cervical artificial disc surgery. What are the symptoms that I may need revision spine surgery? The symptoms a patient may need revision surgery typically involve pain that wasn’t resolved by the previous surgery or new pain that comes from something like hardware in a fusion procedure breaking or coming loose. These could be symptoms that you could require revision spine surgery: New or worsening nerve problems like shooting pain, numbness, or muscle weakness Bladder or bowel dysfunction Cauda equina syndrome Increased spinal instability or pseudoarthrosis Spinal instrumentation that has broken or moves out of place A spinal infection Do You Need Repeat Spine Surgery? In other instances, factors besides pain can necessitate revision spinal surgery. These may include persistent or worsening numbness, tingling, or weakness involving one or more extremities due to improper diagnosis by a previous surgeon. In this case, revision surgery may be warranted because an earlier surgery did not correct the existing problem. “Dr. Lipani is the finest neurosurgeon! Compassionate, Caring, Down to Earth with his professionalism; he is the best! My son Alan, had an L-4/ L/5 Spine Fusion, 7.5 hour surgery and I can not thank the “Great Doctor”/Surgeon for his dedication, kindness and caring.” – Alan B. “The Doctor outstanding in every way possible. Explaining every detail and taking his time to do so. Amazing for a surgeon to be so informing of the procedure to me and my wife. After the surgery he came out and explained everything to me. My wife is doing great after the cervical spine fusion, moving her arm in ways she hasn’t in years and getting her feeling back in her fingers” – Anthony R. “Dr. Lipani and his staff are excellent. Dr. Lipani was very thorough. He explained what needed to be treated and why. He has terrific bedside manners. He answered all my questions patiently. Did not rush me at any time. I recommended him to one of my friends and she was extremely happy with him too.” – Poornima S. What are the benefits of having revision spine surgery? When a patient has opted to have spine surgery, they are usually at the end of their proverbial rope. Chronic pain has become debilitating and has begun to impact various aspects of their life. From difficulty sleeping to the inability to walk the dog around the block to barely being able to make it around the grocery store, chronic pain usually caused by a compressed spinal nerve or nerve root can make every day a chore. So, the patient has chosen to have spine surgery, such as a laminectomy, fusion, or a cervical microdiscectomy, to address the pain. When a procedure fails to put much of a dent in the pain, or when tingling or weakness in the arms or legs remains, there is a good chance your original spine surgery failed. Revision spine surgery with Dr. Lipani can get things right. Different aspects of the previous procedure could have failed, or the patient could have actually had a re-herniation of a disc or another issue. Regardless of what’s happened before, revision spine surgery can get things right. Sometimes the previous surgery involved an inaccurate diagnosis. Sometimes the decompression wasn’t fully achieved and the nerve in question is still under some pressure. Dr. Lipani approaches these cases as if this is a first-time surgery, seeking to successfully address the patient’s ongoing pain.

  Link: Revision Spinal Surgery

• JD Lipani Radiosurgery Institute

  Welcome to the JD Lipani Radiosurgery Institute, the nation’s first dedicated institute for non-invasive neurosurgery! Formerly known as the Brain and Spine Radiosurgery Institute, we are leading experts in non-invasive or bladeless brain and spine surgery located in Greater Princeton, New Jersey. Our Neurosurgeon-In-Chief, Dr. John Lipani, offers definitive brain and spine tumor treatment, as well as treatment for trigeminal neuralgia with no pain, no anesthesia, no incisions and no recovery time. For conventional brain and spine surgery, please visit Princeton Neurological Surgery Home Page or click on Brain Surgery or Spinal Surgery. To learn more about non-invasive stereotactic radiosurgery, follow one of the links below. Scroll down to learn about our radiosurgery Treatment Tools and Conditions we treat with radiosurgery! Treatment Tools CyberKnife® Elekta Synergy® S Gamma Knife Varian TrueBeam™ Conditions Acoustic Neuroma Brain Tumors Metastatic Brain Tumors Metastatic Spinal Tumors Trigeminal Neuralgia Metastatic Lung Cancer Metastatic Colon Cancer Metastatic Breast Cancer Metastatic Prostate Cancer Metastatic Renal Cell Cancer Metastatic Melanoma Cancer

  Link: JD Lipani Radiosurgery Institute