Expert Neurosurgery at Sentara Northern Virginia Medical Center

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Nikhil R. Nayak, M.D., attending neurosurgeon at Sentara Northern Virginia Medical Center, wants patients to know they do not need to travel far and wide to find high-quality neurosurgical care. There have been major advances in both cranial and spinal neurosurgery in recent years, and they can be found at Sentara Northern Virginia Medical Center.

An experienced neurosurgeon with Virginia Neurosurgeons, Nayak is also Vice Chairman of the Department of Neurological Surgery at Virginia Hospital Center and a Clinical Instructor of both medicine and neurology at the George Washington University School of Medicine. He performs all major general neurosurgical operations and covers general neurosurgery and trauma. His elective practice is largely focused on spinal surgery, covering everything from minimally invasive procedures to complex, open operations.

Those operations include some of the newest technology. When it comes to brain surgery, for example, Nayak says, “We now use image guidance for nearly all brain tumor operations, which acts as an intra-operative GPS system for the brain. Depending on the location of brain tumors, we are increasingly performing removal of the tumor with the patient wide awake during the surgery, which has been a major advancement and improvement in our ability to preserve function, especially language function.”

Nayak says with regard to spinal surgery, neurosurgeons use image guidance and intra-operative CT scans to ensure all hardware that may need to be placed into the spine is positioned with the utmost accuracy and precision. “More recently, we have been performing spinal fusion surgery with the aid of a surgical robotic system, which facilitates minimally invasive approaches to previously large, painful, open surgeries. In addition, we have performed more non-fusion alternatives to neck operations that previously required fusion of the neck bones. These techniques, such as artificial disc replacement and minimally invasive decompression, are demonstrating very promising results.”

Seeking a Neurosurgeon

Patients seeking a neurosurgeon typically experience symptoms that are severe or continuous. Nayak says symptoms that should prompt urgent evaluation include arm or leg weakness, bowel or bladder dysfunction or severe neck or back pain with a fever. Degenerative conditions that cause long-standing limb pain and/or neck and back pain can generally be evaluated non-urgently in the clinic. But those symptoms do not always end in surgery.

Most spinal surgeries are elective, according to Nayak. “The impetus to perform surgery is when a patient has unmanageable symptoms that aren’t responsive to non-surgical treatments, and when the symptoms correlate to abnormal MRI findings. Most of the symptoms that end up needing surgery are severe arm or leg pain or weakness. If a patient primarily has neck pain or back pain, we try to manage the symptoms without surgery.”

Most patients first get evaluated by their primary care physician, who may order basic imaging studies and start a course of physical therapy and medication trials. If those are ineffective, Nayak says, the next step is generally treatment by a pain management physician and advanced spinal imaging such as an MRI. If there are concerning findings on the imaging or if the patient continues to have intractable symptoms, they are finally referred to a neurosurgeon for evaluation of possible surgical treatments. This conservative approach works best for the vast majority of patients, according to Nayak.

If surgery is needed, Nayak says, “Patients should do their research prior to selecting a surgeon, and unless a problem needs emergency surgery, they should take their time to understand the available options before embarking on major surgery.”

When it is time to seek a neurosurgeon, patients can find Nayak and other neurosurgical experts in Woodbridge through Sentara Northern Virginia Medical Center. “Our goal is to bring specialized, academic-oriented neurosurgeons to the Woodbridge community,” says Nayak. “Our surgeons have been educated and trained at some of the most prestigious institutions in the country, and we want to make their services available locally to Prince William County residents.”

To find a Sentara doctor or provider, call 1-800-SENTARA (1-800-736-8272).

About Sentara Northern Virginia Medical Center

Sentara Northern Virginia Medical Center is a 183-bed, not-for-profit community hospital serving Prince William County and its surrounding communities. Our medical center combines the resources of a major health system with the compassionate, personalized care of a community hospital. SNVMC offers quiet, private rooms and high quality care focused on safety and patient satisfaction. We offer a wide range of medical specialties, a highly qualified medical and clinical staff and state-of-the-art technology. Clinical services include advanced imaging, cancer services, diabetes management, emergency care, heart and vascular care, lab services, neurosurgery, primary care, orthopedics, urology, weight loss surgery, women’s services and more.


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