General Practitioners

• Primary Care
  Ask your physician for a referral today!. Our office sees patients referred by other physicians. Every referred patient must have a current primary care physician.

Gynecologists

• Labor and Delivery
  Dr. Brennan perscribes epidural steroid injections initially in the management of many spinal problems in the patients he sees. The procedure is very similar to the epidural used in childbirth but the medicine injected is different. Instead of numbing medicine, they use a steroid mixture that reduces inflammation in the soft tissue and nerve roots. These medicines are referred to in everyday language as “cortisone shots” but the actual medicine is slightly different. Many practitioners use Depo-Medrol. This is a similar medicine to Cortisone but lingers in the tissue much longer and provides longer lasting relief of symptoms. Dr. Brennan cautions his patients that doctors sometimes disagree about how many injections may be required for each patient. Dr. Brennan believes that each patient should assess the effectiveness of each injection each time and if there is only relief that lasts a little while, then more injections may not be worthwhile.

Radiologist

• MRI
  Over the past few years much research has been done on the Lumbar Artificial Disc Replacement or “Lumbar ADR”.. In Europe, the procedure has been done for 10 years but the FDA is slowly adopting these devices here in the United States. The idea is to completely remove the disc from the disc space from the front and replace it with a device which takes up the same amount of room and continues to provide the shock absorber effect of the disc and allowing range of motion preservation. The ideal candidate for this procedure is someone whose back pain can be narrowed down to being due to the disc material itself. Dr. Brennan will always be looking for these patients and will discuss this as a possibility if the MRI shoes no herniations to treat but simply a dried out painful disc. He will also recommend diagnostic tests to firm up the disc as the cause of the patients’ pain. “If you find the right patient, they are very happy with the result” says Dr. Brennan. “The trick is that not all back pain patients have only the disc to blame for their pain”.
• Radiology
  Once the most feared of all neurosurgical problems, the aneurysm today has found itself the focus of a revolution in treatment with the advancement of interventional radiology to treat approximately 50% of the aneurysms in the United States. This specialized field uses titanium coils that resemble microscopic steel wool to fill aneurysms through a catheter without even opening the patients head. The catheters are the same ones used for doing angiograms and this technology has saved countless lives over the years. Occasionally, a patient will be a better candidate for open surgical clipping. In a patient who has had a hemorrhage from an aneurysm, time is of the essence and one approach or the other will be considered on an urgent basis. With the advent of MRI, now more and more people are discovering aneurysms on routine MRI studies and such a patient has some time to organize and make careful, well thought through decisions regarding the treatment they wish and the risks they are comfortable with. Dr. Brennan has had extensive experience at Vanderbilt with complex as well as simple aneurysms and will always counsel the family of the patient with what he recommends from the moment an event occurs. In some situations, surgery needs to be performed as an emergency while in other cases, consultation with specialized radiologists may be appropriate.
• X-Rays
• Computed Tomography
  You'll experience every modern technology advantage whether it is CT scan, MRI, surgical navigation technology or digital intensive care units.
• Chemotherapy
  This is a relatively rare condition that can happen to individuals with either reduced immune systems from chemotherapy, HIV, AIDS or some rare immune diseases. In healthy individuals it can occur simply from bacteria entering the blood stream during a procedure such as dental work, or the treatment of an abscess somewhere else in the body. Sometimes, foreign travel can result in the ingestion of uninspected meat products and the ingestion of meat contaminated with parasitic organisms can result. The most common world-wide being a parasite called cysticercosis. The presence of the parasite in the brain is the leading cause of seizures in third world countries. The surgery to treat this condition involves opening the head and exposing the brain and dissecting down to the cyst containing the parasite and removing it like you would a brain tumor. Patients are then started on anti-parasitic medicines to combat the organism elsewhere in the body.
• Interventional Radiology

Surgeons

• Pinched Nerve
  Dr. Brennan believes in trying everything to avoid surgery and cervical traction is one of the methods patients can use to reduce their symptoms of a pinched nerve in the neck. These kits can be found at many local medical supply stores and some pharmacies. They cost about $25-35 and can be effective if used properly. If Dr. Brennan has reviewed the MRI and feels it’s safe to proceed, he usually recommends no more than 10 pounds of weight and 30 minutes of traction twice a day. Most patients can manage to fit this into their daily schedule and this is done sitting down in a chair with the apparatus attached to a door in the house. Dr. Brennan has noticed that approximately half of the patients that have come to see him have been able to avoid surgery with this simple and effective treatment plan.
• Minimally Invasive Surgery
  Surgery for this condition usually involves taking off the shingle-like portion of the vertebrae covering the back of the canal called the lamina. The procedure is called a lumbar laminectomy and Dr. Brennan often uses minimally invasive surgery to remove this blockage and patients can expect a surgery for 1-2 hours and to return to work or recreation in 2-4 weeks.
• Neurosurgery
  As a third year student in medical school, Dr. Brennan was introduced to the world of Neurosurgery. “I’ll never forget the first neurosurgery cases I was invited to scrub on. It was a man in his 40’s who fell off a motorcycle and had a skull fracture” recalls Dr. Brennan. “All I can remember is the feeling that I was somewhere I needed to be, doing what I needed to be doing”. Dr. Brennan was awarded the Surgery Medal from the University at graduation and was inducted into the medical honor society Alpha Omega Alpha. He was accepted into the Neurosurgery training program at Vanderbilt University Medical Center in Nashville where he spent the next seven years mastering the field and preparing for private practice. Since then Dr. Brennan has performed over 3000 surgeries and was made a Fellow in the American College of Surgeons. He is also a member of the American Association of Neurological Surgeons and Congress of Neurological Surgeons.

Physical Therapists

• Physical Therapy
  In the lumbar spine, the lumbar discs are larger but also carry more weight on them every day and with every step. Lumbar disc symptoms can come about due to a gradual loss of water in the disc space and a loss of the elastic qualitiy of the disc outer ring or annulus. Lifting and twisting can put shear stress on the disc and cause the outer ring to fail and a portion of the soft gel-like center of the disc to push out near the adjacent nerve roots. This can cause back pain, buttock pain or pain shooting down the leg to the foot along with numbness or weakness. Many conditions like this can be treated with non-surgical measures like physical therapy, diet, exercise, traction or steroids. Only about 50% of the symptomatic lumbar disc patients ever end up needing surgery to relieve their symptoms. Dr. Brennan will always try non-surgical measures first unless there is evidence of progressive muscle weakness or the pain is severe, disabling and not improving with other treatments. Most commonly, Dr. Brennan performs the minimally invasive micro-endoscopic discetomy which is a very small incision and uses a microscope to remove the portion of the disc putting pressure on the nerve roots.
• Neck Pain
• Back Pain