Treating Complex Conditions of the Spine and Brain

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Houston Methodist Sugar Land Hospital’s team of neurosurgeons is providing the most advanced surgical techniques to help Fort Bend patients.

COVER STORY –

For months, Sugar Land resident, Richard Rivera, had been experiencing pain in his lower back that traveled down his left leg, leaving his foot numb.

As the pain progressed, he struggled to walk. After a couple of falls, he realized it was time to see the doctor.

Rivera’s primary care physician ordered an MRI, and the results were surprising – rather than degenerative disc disease or bone spurs, the most common issues related to his symptoms – the 56-year-old had a tumor in the thoracic, or chest region, of his spine that was compressing his spinal cord.

Microsurgery for Complex Tumors

Rivera was referred to board-certified neurosurgeon Derrick Sun, M.D., at Houston Methodist Neuroscience & Spine Center at Sugar Land. Sun specializes in diseases and disorders of the spine. He is unique in that he completed both a neurosurgery residency as well as an orthopedic spine surgery fellowship, allowing him to focus on complex injuries and disorders of the brain and spine.

At the Houston Methodist Neuroscience & Spine Center, Sun is part of a highly skilled team that includes board-certified neurologists, neurosurgeons, orthopedic spine surgeons, pain management specialists, primary care sports medicine specialists and rehabilitation specialists who work together to provide comprehensive, personalized care, designed to help patients return to a productive lifestyle. Founded in 2010, the center treats common to complex cases using the most sophisticated techniques and technology, all close to home, for patients from Fort Bend and surrounding areas.

In November 2021, Sun performed surgery on Rivera to remove the tumor using a specialized operating microscope and micro instruments.

“Typically, tumors like this are very defined, almost floating,” said Sun. “They can be removed by just snipping both ends. But in this case, the tumor was attached to the spinal cord. So this was a much more complex surgery than we originally believed.”

Using microsurgery techniques, Sun identified the almost invisible border between the spinal cord and the tumor. Eventually, he was able to cut away the tumor in one piece without damaging the spinal cord. The pathology report showed that the tumor was a type of hemangioma, a non-cancerous vascular tumor.

After only two days in the hospital, Rivera was discharged to go home and continue his rehabilitation.

“He is doing very well now,” said Sun. “His leg strength has greatly improved, he is walking with reduced pain and the numbness.”

Relief from Challenging Conditions Tumors

One of Sun’s colleagues at the Houston Methodist Neuroscience & Spine Center, board-certified neurosurgeon Tsz Lau, M.D., specializes in cerebrovascular procedures, including those involving brain tumors, blood clots and aneurysms. With his specialized training – he completed fellowships in both skull base cerebrovascular surgery and neuro-endovascular surgery – he performs procedures that were previously unavailable in the Fort Bend area.

One recent case involved a patient in her 70s, Maria Campos Torres, who suffered from severe tinnitus, or ringing in the ear. The condition was caused by a tumor at the base of her skull that was compressing two cranial nerves, impacting both her hearing and her balance.

In an intensive, five-hour procedure, Lau removed the non-malignant tumor, providing immediate relief. The surgery required Lau to make an incision behind the ear, remove part of the skull and then cut out the tumor.

“This type of tumor, although benign, can severely impact a patient’s quality of life,” said Lau. “This patient couldn’t sleep at night due to the ringing in her ears, and she had lost her sense of balance which made walking dangerous. Now she is living with minimal symptoms.”

Lau also recently treated a patient who had suffered an intra-cranial hemorrhage several years ago, due to a rare condition known as Moyamoya disease. April Vernon received an earlier cerebral bypass surgery that was unsuccessful and was told nothing more could be done by her previous doctor.

But when she developed stroke-like symptoms due to continued bleeding in her brain, she made an appointment with Lau.

“Using our advanced diagnostic technology – a specialized surgical microscope and micro instruments – we were able to see that the blood vessels in her brain were now large enough to attempt a direct bypass,” said Lau. “I harvested an artery from under her scalp, identified the existing recipient artery in the brain that had been affected by the disease, and bypassed it using the harvested artery.”

These types of procedures are extremely intricate. The blood vessels involved are typically smaller than one millimeter in diameter.

“April is doing extremely well now,” said Lau. “It’s amazing to see her progress.”

Multidisciplinary Care for Diagnosis and Treatment

One of the keys to the Houston Methodist Neuroscience & Spine Center’s success in performing complex procedures previously unavailable in the Fort Bend area is Houston Methodist Sugar Land’s sophisticated imaging capabilities – enabling specialists to pinpoint issues and accurately diagnose each patient’s condition.

Houston Methodist Sugar Land will soon introduce a new biplane suite, which will allow Lau to perform all of the neuro-endovascular procedures. This will be the first and only comprehensive cerebrovascular service in Fort Bend County.

The hospital houses three whole-body, 3-Tesla MRI scanners – the industry’s most powerful technology typically found only in the nation’s top academic medical centers — as well as advanced CT scanners that provide more detailed views than traditional units.

Patients also benefit from the hospital’s highly trained and compassionate nursing staff, who are skilled in caring for patients both during and after complex neurosurgical procedures.

Houston Methodist Sugar Land also offers one of the country’s leading physical therapy/rehabilitation programs, with four convenient locations across Fort Bend County. Highly trained physical, occupational and speech therapists work directly with Neuroscience & Spine Center physicians to create and implement treatment plans that help patients overcome their injury or condition, reduce or eliminate pain and regain their mobility.

In addition to treating back and neck pain, the Houston Methodist Neuroscience & Spine Center is also a leader in neurological care, using the most advanced therapeutic options to minimize symptoms, delay progression and improve the quality of life for patients with conditions such as Parkinson’s disease, Alzheimer’s disease and memory disorders, multiple sclerosis, and much more.

Complex Care Close to Home

The hospital’s commitment to offering the latest, most advanced surgical techniques for complex or uncommon neurological conditions means that patients can receive the care they need close to home.

“We can effectively treat anyone with complex cranial or spinal tumors or conditions using techniques that simply aren’t available everywhere,” said Lau. “And we can do it all right here at Houston Methodist Sugar Land. That’s a tremendous benefit to the residents of Fort Bend County who no longer have to leave the area for comprehensive neurosurgical care.”

Sun encourages patients not to delay seeking treatment when unusual symptoms emerge.

“There is no need for people to suffer,” he said. “If you have pain or other neurologic symptoms, we can help. Our team works together to ensure that we have the right diagnosis – and the right treatment plan – regardless of your neurological condition.”