Neurosurgeon Works on Cutting Edge

Daily Herald

Microvascular decompressions, herniated lumbar disks and vegal nerve stimulators may sound like words from the script of NBC's hit TV series “ER”.

Instead, these are just some of the cutting-edge procedures performed by Dr. Jonathan Citow and his team of neurosurgeons at Condell Medical Center in Libertyville.

Citow, who was hired 13 months ago as head of the neurosurgery department, has raised a few eyebrows with the progressive work his department is doing. Some of the procedures performed by Citow's neurosurgery department are unique to Condell.

“We're doing things as they're being presented out in the literature,” Citow said. “Many of these procedures are not being done at other Lake County hospitals.”

The 36-years-old Lake Forest resident is a graduate of New Trier High School in Wilmette and Johns Hopkins University School of Medicine in Baltimore. He trained in neurosurgery at the University of Chicago.

Citow achieved the second highest score in the country on his neurosurgery board exam. Prior to joining Condell, he worked in the neurosurgery department at Rush North Shore Hospital in Skokie and St. Francis Hospital in Evanston. He's written and published three neurosurgery text books, with two more on the way.

“When we got (Condell) they weren't doing very much neurosurgery at all”, Citow said.

So he authorized the purchase of state-of-the-art equipment for complicated brain and spine procedures.

There were only a few neurosurgeons on staff at the time Citow came on board at Condell. Today there are six at the hospital. His surgery partners are Dr. Jeffrey Karasick and Dr. Sheldon Lazar.

“The three of us are a very close-knit group and we do all of these (procedures) together,” Citow said. “We've done complicated brain aneurysms and brain tumors and chiari decompressions”.

The latter, Citow explained, is a surgical procedure done when someone's cerebellum is misshaped and protrudes through the hole at the base of the skull where the spinal cord exists.

All three surgeons work nearly 28 out of the 30 days of the month. The department performed 400 procedures last year. Citow said.

Other brain procedures the team has tackled include microvascular decompressions, performed for a disease called trigeminal neuralgia, which translated means “debilitating facial pain”.

“With an operation that takes about an hour and a half, we were able to cure it”, Citow said. “We got rid of all of their facial pain, and the patients generally do so well they don't need any medication after that.”

The hospital has the capability of doing endoscopic brain surgery procedures for hydrocephalus and brain cysts. These neurosurgeons are also able to treat any disorder of the spine.

“One of the most gratifying things is the ability to operate on a herniated lumbar disk with an incision as long as your thumb nail,” Citow said. A lumbar disk is the cushioning between two of the spinal vertebrae.

Another high-tech procedure is cervical disk surgery, which is done to cure arm pain, numbness or weakness in the legs caused by the disk pushing on the spinal cord.

“For chronic pain patients, we implant something called a morphine pump. These are wonderful for people who have severe pain and nothing else is working for them”, Citow said.

This method also allows severe pain to be controlled with a much smaller dose of narcotics – 1 milligram of morphine instead of 300 milligrams taken orally.

Another notable procedure is the vegal nerve stimulator, which is used to treat seizures on patients who cannot be controlled on medications.

“The stimulator basically accentuates the vegal nerve,” Citow said.

“Essentially it tells the brain not to allow the seizures to spread when they start”.

Condell neurosurgeons have done all these procedures a number of times.

“And it's wonderful to have the technology to be able to do it”, Citow said.

Medical progress allows doctors to do spinal surgery – which used to be associated with high complication rates – safely with a high success rate and a more comfortable recovery.

“The best thing about it is you're able to make a huge difference in someone's life in a relatively short time”, Citow said. “Basically you're able to do something about how they are living their life and make a nice contribution”.

Hospital officials say their vision is to create a brain and spine institute with Citow as the medical director.

“The best thing about it (medical progress in spinal surgeries) is you're able to make a huge difference in someone's life in a relatively short time. Basically you're able to do something about how they are living their life and make a nice contribution.” – Dr. Jonathan Citow