Portrait

In addition to the complete practice of general spine and brain neurosurgery, Dr. Schils offers tailored solutions to all surgical spine problems by using innovative, elegant and less invasive options (O-Arm, Neuro-navigation, Microscopes, new surgical techniques). These encompass all cervical, thoracic and lumbar pathologies. Dr. Schils has developed an expertise in minimally invasive neurosurgery, in new approaches to the anterior and lateral spine, and in micro-invasive treatments for spinal fractures.

With respect to this, he is known in the scientific community and within the medical industry. Medical companies regularly request his services for the elaboration of new medical techniques and solutions.

In the margin, an overview of the most frequently observed problems.

SPINE SURGERY

---

Cervical spine

The common denominator of surgical solutions is to remove compression on the nerve endings or on the spinal cord that is responsible for pain or neurologic signs.
The source of compression can be a spinal herniated disc, an osteophyte (arthrosis, foraminal stenosis, a reduced or stenotic cervical canal), a calcification of the ligaments or even a bone fracture, an abscess (an infected lesion) or a tumor.
The most frequent initial symptoms are pain (in the cervical spine or radiating in the arm, cervico-brachialgia, cervico-brachial nevralgia, torticolis), paresthesia (the sensation of tingling, tickling, pricking, or burning of a person’s skin) and the partial or complete loss of motricity (paresis, paralysis). The aim of decompression is to eliminate the pain or neurologic symptoms and to potentially permit recuperation of the nerve lesion or of the spinal cord by guaranteeing the stability of the spine after an operation which can lead to a return to social, professional and leisure activities.
The time needed for convalescence and the delay required to return to normal activities depends on the type of pathology, the surgical technique used and the specifics of each patient. In all cases, a personalized agenda for progressively undertaking different activities will be proposed.

• Cervical disc herniation

Either via an anterior approach with fusion, or via an anterior approach using a disc prosthesis in order to preserve mobility, or via a posterior approach. Rapid recovery (2-6 weeks), return home within 2-3 days, no neck brace, post-surgical physiotherapy recommended.

• Cervico-arthrosic medullopathy

Stenotic or reduced cervical canal, anterior and/or posterior approach with decompression (discectomy or corpectomy) and fusion.

• Cervical arthrosis, foramen stenosis

Anterior approach, decompression and fusion.

• Trauma and tumors

Fractures of the spine, instability, primary tumors or bone metastases.

---

Thoracic spine

• Thoracic disc herniation, tumors or fractures.

---

Lumbar spine

• Lumbar disc herniation

Microdiscectomy, micro-decompression. The symptoms are back pain or radiation in the legs (lumbago, sciatica) sometimes associated with paresthesia (the sensation of tingling, tickling, pricking, or burning of a person’s skin) or a motor deficit (loss of motricity in the leg or foot). The microscopy technique permits the removal of pieces of the disc that are in contact with a nerve and preserves all the muscle, bone and ligament structures. There is no loss of mobility after the surgery, the stay in the clinic is between 3-4 days, and the return to professional activity in generally within 3-4 weeks. As soon as you return home, physiotherapy can begin.

• Foraminal and extra-foraminal disc herniations
• Narrow lumbar canal / lumbar stenosis

Laminectomy and selective micro-decompression. An extremely frequent situation where progressive compression of the lumbar nerve roots occur in the spinal canal following wear on different spinal structures (intervertebral discs, ligaments, articulations). The symptoms can be either back or leg pain, an intolerance to prolonged standing, walking difficulties (neurogenic claudication), paresthesia or problems with motricity. The aim of the intervention is to make space for the nerve structures, thus permitting a rapid, important and durable improvement of the symptoms.

• Fractures

Traumatic, osteoporotic or tumor fractures (Kyphoplasty, Kivaplasty, Vertebroplasty), percutaneous fixation. Recently new techniques permit the treatment of these problems using skin micro-incisions and by single injection in the vertebra of biological cement.

• Lumbar Discopathies

Progressive wear of the disc (disc degeneration) is responsible for chronic pain in the lower back, lumbago, the loss of lumbar comfort or a reduction in quality of life.

Possible techniques (every indication is the result of a detailed study of your clinical situation and your radiology file):

• ALIF: Anterior Lumbar Interbody Fusion
• TDR: Artificial Disc,Total Disc Remplacement
• XLIF: Extreme Lateral Interbody Fusion
• Lumbar Decompressions and Instrumentations
• PLIF: Posterior Lumbar Interbody Fusion
• TLIF: Transforaminal Interbody Fusion
• MISS: Minimally Invasive Spine Surgery
• Complex spine: revision spine surgery – degenerative scoliosis

SPINE SURGERY

---

Cervical spine

The common denominator of surgical solutions is to remove compression on the nerve endings or on the spinal cord that is responsible for pain or neurologic signs.
The source of compression can be a spinal herniated disc, an osteophyte (arthrosis, foraminal stenosis, a reduced or stenotic cervical canal), a calcification of the ligaments or even a bone fracture, an abscess (an infected lesion) or a tumor.
The most frequent initial symptoms are pain (in the cervical spine or radiating in the arm, cervico-brachialgia, cervico-brachial nevralgia, torticolis), paresthesia (the sensation of tingling, tickling, pricking, or burning of a person’s skin) and the partial or complete loss of motricity (paresis, paralysis). The aim of decompression is to eliminate the pain or neurologic symptoms and to potentially permit recuperation of the nerve lesion or of the spinal cord by guaranteeing the stability of the spine after an operation which can lead to a return to social, professional and leisure activities.
The time needed for convalescence and the delay required to return to normal activities depends on the type of pathology, the surgical technique used and the specifics of each patient. In all cases, a personalized agenda for progressively undertaking different activities will be proposed.

• Cervical disc herniation

Either via an anterior approach with fusion, or via an anterior approach using a disc prosthesis in order to preserve mobility, or via a posterior approach. Rapid recovery (2-6 weeks), return home within 2-3 days, no neck brace, post-surgical physiotherapy recommended.

• Cervico-arthrosic medullopathy

Stenotic or reduced cervical canal, anterior and/or posterior approach with decompression (discectomy or corpectomy) and fusion.

• Cervical arthrosis, foraminal stenosis

Anterior approach, decompression and fusion.

• Trauma and tumors

Fractures of the spine, instability, primary tumors or bone metastases.

SPINE SURGERY

---

Thoracic spine

Thoracic disc herniation, tumors or fractures.

SPINE SURGERY

---

Lumbar spine

• Lumbar disc herniation

Microdiscectomy, micro-decompression. The symptoms are back pain or radiation in the legs (lumbago, sciatica) sometimes associated with paresthesia (the sensation of tingling, tickling, pricking, or burning of a person’s skin) or a motor deficit (loss of motricity in the leg or foot). The microscopy technique permits the removal of pieces of the disc that are in contact with a nerve and preserves all the muscle, bone and ligament structures. There is no loss of mobility after the surgery, the stay in the clinic is between 3-4 days, and the return to professional activity in generally within 3-4 weeks. As soon as you return home, physiotherapy can begin.

• Foraminal and extra-foraminal disc herniations
• Narrow lumbar canal / lumbar stenosis

Laminectomy and selective micro-decompression. An extremely frequent situation where progressive compression of the lumbar nerve roots occur in the spinal canal following wear on different spinal structures (intervertebral discs, ligaments, articulations). The symptoms can be either back or leg pain, an intolerance to prolonged standing, walking difficulties (neurogenic claudication), paresthesia or problems with motricity. The aim of the intervention is to make space for the nerve structures, thus permitting a rapid, important and durable improvement of the symptoms.

• Fractures

Traumatic, osteoporotic or tumor fractures (Kyphoplasty, Kivaplasty, Vertebroplasty), percutaneous fixation. Recently new techniques permit the treatment of these problems using skin micro-incisions and by single injection in the vertebra of biological cement.

• Lumbar Discopathies

Progressive wear of the disc (disc degeneration) is responsible for chronic pain in the lower back, lumbago, the loss of lumbar comfort or a reduction in quality of life.

Possible techniques (every indication is the result of a detailed study of your clinical situation and your radiology file):

• ALIF: Anterior Lumbar Interbody Fusion
• TDR: Artificial Disc,Total Disc Remplacement
• XLIF: Extreme Lateral Interbody Fusion
• Lumbar Decompressions and Instrumentations
• PLIF: Posterior Lumbar Interbody Fusion
• TLIF: Transforaminal Interbody Fusion
• MISS: Minimally Invasive Spine Surgery
• Complex spine: revision spine surgery – degenerative scoliosis

BRAIN SURGERY

---

Interventions for tumors

Benign or malignant tumors, meningiomas, gliomas, bone tumors of the skull, cerebral metastases; using neuro-navigation techniques.

After a complete surgical work-up, the lesion can be removed by opening the skull (craniotomy) and by using neuro-navigation. All interventions can be programmed and followed in real time on a computer thus increasing the surgical precision. This can be compared to an ultra-performance GPS. Any resected lesion is systematically sent to the laboratory in order to establish the diagnosis with certainty according to the nature of the process.

---

Intervention for hydrocephaly

Ventriculo-peritoneal derivation / shunt
This is a benign intervention that requires only 2-3 days in the clinic and slows down the evolution of the symptoms. All follow-up concerning the fine-tuning of the valve can secondarily be performed on an out-patient basis.

---

Cerebral biopsy

---

Evacuation of hematomas (sub-dural, intra-cerebral)

BRAIN SURGERY

---

Interventions for tumors

Benign or malignant tumors, meningiomas, gliomas, bone tumors of the skull, cerebral metastases; using neuro-navigation techniques.

After a complete surgical work-up, the lesion can be removed by opening the skull (craniotomy) and by using neuro-navigation. All interventions can be programmed and followed in real time on a computer thus increasing the surgical precision. This can be compared to an ultra-performance GPS. Any resected lesion is systematically sent to the laboratory in order to establish the diagnosis with certainty according to the nature of the process.

BRAIN SURGERY

---

Intervention for hydrocephaly

Ventriculo-peritoneal derivation / shunt
This is a benign intervention that requires only 2-3 days in the clinic and slows down the evolution of the symptoms. All follow-up concerning the fine-tuning of the valve can secondarily be performed on an out-patient basis.

BRAIN SURGERY

---

Cerebral biopsy

BRAIN SURGERY

---

Evacuation of hematomas (sub-dural, intra-cerebral)

NEUROSURGERY FOR PAIN

---

Posterior spinal cord neurostimulation
also at high frequency

Chronic back pain can appear either in patients who already underwent surgery and are still in pain or in patients for whom no therapeutic etiologic intervention is possible. When classical treatment (medication, infiltration, manual therapy, etc.) has been tried without success and when the impact on quality of life becomes significant, a surgical treatment of the pain symptoms can be considered. In well selected patients, small electrodes can be placed by a neurosurgeon in contact with the spinal cord and can mask the pain signal that goes to the brain (a system that can be slightly compared to a Pacemaker). These treatments require a multi-disciplinary evaluation and follow-up but within the last few years have known a substantial development.

PLAGIOCEPHALY

---

Our present lifestyles (Maxi-cosy, car seats, active and mobile parents), in addition to the evolution in medicine (the recommendation to lay children on their back in order to avoid sudden death syndrome) lead to an increased frequency of babies with flat heads (phagiocephaly). Often the medical community gives a reassuring message to parents of its systematic spontaneous correction. However, certain severe forms or late diagnosis can lead to resistance with respect to classical treatment (kinesitherapy, osteopath, changing of position) and a treatment by dynamic cranial orthesis must be considered. Our team (neurosurgeon, ergotherapist, osteopath and kinesitherapist) is specialized since 10 years in the treatment of this frequent problem which often causes parental anxiety.

Contacts and Additional Information
The treatment protocol comprises a diagnostic consultation, a phase where the orthesis is created and a follow-up period.
The consultation and the follow-up examinations are performed in Belgium and Switzerland.
The phase for creating the orthesis is currently done only in Belgium (2 required consultations).
For appointments:
By telephone: +32-472-80.81.32
By e-mail: plagiodocteurschils@gmail.com

Plagiocephaly office:
Dr Schils- Mmes Jehaes et Bradfer
Rue Libon 5
4800 Verviers
Belgium