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Neuro Spine Surgery

Neuro Spine Surgery is primarily concerned with diagnosis, prevention and treatment of disorders that affect any part of the nervous system comprising  brain, peripheral nerves, spinal cord and extra-cranial cerebrovascular system. Neuro spine surgery is performed for correcting diseases and injuries of the spinal cord. The procedure relieves pain in the spinal cord and also restores the function of the suppressed nerves. Lower back and neck conditions can also be corrected through these set of  procedures.

Neurologists help patients manage neuro-spinal conditions through physiotherapy, medication, lifestyle modifications or other non-surgical treatments. However, in certain circumstances, surgical intervention is required. Operating on the spine is complex and Doctor’s rely on information gathered from various imaging modalities such as MRI (Magnetic Resonance Imaging) or CT (Computed Tomography) scans to carefully plan and execute these procedures. Now a days mostly Neuro Spine surgery is done using Minimally Invasive procedures.  

TYPES OF NEURO SPINE SURGERIES

Neurosurgeons perform different kinds of Neuro-spine surgeries to achieve one or more of the following objectives: 

  • to reduce uncomfortable symptoms.

  • to correct misalignment.

  • to repair spinal structures. 

  • to correct unhealthy abnormalities in the spinal cord, nerves, ligaments, vertebrae, discs .

  • to address  cervical, thoracic, lumbar disorders.

  • mostly through minimally invasive procedures.

PROCEDURES OF NEURO SPINE

DISCECTOMY. The discs between vertebrae can become herniated, meaning that part of their center protrudes through their tough exterior, or is otherwise damaged causing pain and weakness. Herniated discs can also lead to other spinal disorders. During discectomy, a neurosurgeon excises a portion or the entirety of the damaged disc to alleviate these symptoms. 

DISC REPLACEMENT. This procedure is the same as discectomy, except that the neurosurgeon inserts a prosthetic spinal disc after removing the natural tissue. 

SPINAL FUSION. Patients with scoliosis, kyphosis, fractures, herniated discs  or other spinal disorders may benefit from spinal fusion surgery. This technique usually involves removing the natural disc between vertebrae and then placing a bone graft between the affected vertebrae to adjoin them. Doctors may also use surgical instruments such as plates, wires, cables, or screws to create the framework for spinal fusion. This surgery can stabilise the spine and reduce related nerve issues. Spinal fusion sometimes requires revisional surgery to fully correct.

LAMINECTOMY. Spinal stenosis, disc herniation, and other issues can cause nerve compression and shrink the spaces between spinal structures. To correct this condition, neurosurgeons can perform laminectomy,  during which they remove a segment of the lamina, the top portion of the bone that encloses the spinal cord. This can alleviate pressure on nerves and tissues.  

INTERLAMINAR IMPLANT. As part of a laminectomy, a neurosurgeon can also place an interlaminar implant, a U-shaped prostheses that decompresses the spine and provides more space for nerves and spinal cord tissue.

FORAMINOTOMY. The foramen is a hollow bone that protects the nerve roots along the spinal column. If this bone becomes damaged or too narrow, it can interfere with nerve function. Neurosurgeons can perform foraminotomy surgery  to adjust soft tissues and bones in the foramen. 

KYPHOPLASTY®. Using this modern surgical strategy, neurosurgeons use x-ray imaging to map the spine, and then use a needle and balloon to enlarge the space between malfunctioning vertebrae. Once there is adequate room for it, they inject special bone cement into the area to support the spine.  

OSTEOTOMY. In cases of severe spinal misalignment or deformity, neurosurgeons may recommend osteotomy. During this procedure, they strategically fracture or break vertebrae or other spinal bones to improve posture and correct structural abnormalities. Ideally, the affected bones will adapt and heal in a way that benefits the spine.

Brain disorders that merit surgery (if other treatment methods are not available or successful): 

  • Parkinson's disease

  • Strokes

  • Benign or Malignant Brain Tumors

  • Dura (damaged protective tissue in the brain)

  • Epilepsy

  • Blood vessel damage

  • Aneurysm (enlarged arteries)

  • Infection

  • Nerve disorders

  • Degeneration as a result of traumatic injury

  • Excessive bleeding or clotting

Most brain surgeries involve one or more of the following techniques:

Craniotomy. During this procedure, a neurosurgeon incises and removes a small segment of the skull in order to access underlying tissue. Once he or she has completed treatment, the surgeon then reconnects the lifted portion of bone with the rest of the skull.

Craniectomy. Using this technique, the neurosurgeon does not replace the area of the skull that he or she removed at the end of the procedure.

Biopsy. This surgery involves making a tiny opening in the skull to remove and test a small portion of tissue. This is a diagnostic procedure.

Shunt surgery. If the brain is not circulating fluids properly, a neurosurgeon may place a shunt, or small surgical device, to improve the flow of liquid within the brain.

Tumour Removal. This surgery involves removing as much of a brain tumour as possible, depending on the size and location of the growth. When neurosurgeons cannot excise the entirety of a tumor, they refer to this procedure as "debulking" or "partial removal."

Ommaya Reservoir Placement. During this procedure, a neurosurgeon installs a tool called an Ommaya Reservoir directly beneath the scalp. This container is connected to a thin tube that extends outside of the skull. After Ommaya Reservoir placement, doctors can use this device to drain unhealthy fluids, test cerebrospinal fluids for disease, or provide chemotherapy for brain cancer.

Neuroendoscopy. Neurosurgeons make small holes in the skull, through which they insert endoscopes to perform a variety of procedures.

Endonasal surgery. Using this minimally invasive technique, neurosurgeons can insert endoscopes into brain tissue through the sinuses, nose, or mouth. This allows them to avoid changing the structure of the skull, reducing the risk for complications and shortening recovery time.

Peripheral Nerve Surgery. The peripheral nerves can become damaged as a result of certain disorders, such as Charcot-Marie-Tooth disease, or as a result of traumatic injury, compression, fractures, tumors, or other conditions. Damage to the peripheral nerves can be debilitating, causing numbness, tingling, or even paralysis on one or both sides of the body. Fortunately, if surgical care is delivered expediently, these nerves can typically heal successfully (if gradually) to restore patients' mobility, nerve function, and overall wellbeing.

Neurosurgeons weigh the benefits of the chosen procedure against the potential risks for complications in the affected nerve. 

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