What are the most commonly performed neurosurgery procedures?

 


Neurosurgery or neurological surgery is a branch of medicine concerned with the prevention and treatment of disorders of the nervous system including disorders of the brain, spinal cord, peripheral nerves, etc Neurosurgeons performing these surgeries are highly trained and experienced. In most cases, people have little or no knowledge of a large number of medical procedures. Often, when we talk about complex neurosurgeries, we believe they are centered on the brain. Although this is partially true, there is much more involved than just neurosurgical procedures. They can be performed on adult and pediatric patients alike. The procedure is dependent on the disorder, disease, or type of injury and may involve either surgical or non-surgical methods. The advent of non-invasive and invasive brain surgery has simplified the procedure greatly.

There are several types of neurosurgical procedures:

  • Anterior Cervical Discectomy
  • Craniotomy
  • Chiari Decompression
  • Laminectomy
  • Lumbar Puncture
  • Epilepsy Surgery
  • Spinal Fusion
  • Microdiscectomy
  • Ventriculostomy

 

Anterior Cervical Discectomy

A cervical discectomy and fusion (ACDF) remove a herniated or degenerative disc in the neck. During surgery, a throat incision is made to remove the disc. The disc is fused together by inserting a graft through the bones above and below. If physical therapy or medications fail to relieve your neck or arm pain caused by pinched nerves, ACDF surgery may be an option.

 

Craniotomy

A craniotomy involves the surgical removal of part of the skull to expose the brain. To remove the bone flap, special surgical instruments are used. Temporarily removing the bone flap is done before the brain surgery, then it is replaced after the surgery. There are certain craniotomy procedures that can be guided by computers (such as magnetic resonance imaging or computerized tomography scans to reach the precise location within the brain. Usually, this technique involves placing a frame onto the skull or using superficially placed landmarks on the scalp to add a frameless system. Using either of these imaging procedures along with craniotomy is known as a stereotactic craniotomy.

Chiari Decompression

Brain tissue can extend into the spinal canal in the case of Chiari malformation. When part of your skull is abnormally small or misshapen, it presses on your brain and pushes it downwards. Although Chiari malformations are uncommon, imaging tests have helped increase their frequency of diagnosis. There are three types of Chiari malformations, depending on the anatomy of the brain tissue that is displaced into the spinal canal and whether developmental abnormalities of the brain or spine are present. It occurs when the skull and brain are growing. Due to this, certain signs and symptoms may not become apparent until later in life. There are two types of pediatric Chiari malformation: type II and type III (congenital).

Laminectomy

By removing the lamina - the part of the vertebra that covers the spinal canal - a laminectomy creates space in the spine. A laminectomy or decompression surgery provides relief from spinal pressure by enlarging your spinal canal. Pressure in the spinal canal is usually caused by bony growths, which can occur in someone who has arthritis in their spine. Some people develop these overgrowths as a result of the aging process, but sometimes they're referred to as bone spurs.

Lumbar Puncture

The lumbar region of the back is treated with a lumbar puncture (spinal tap). A needle is placed between two lumbar bones (vertebrae) to extract a sample of cerebrospinal fluid during a lumbar puncture. The fluid that surrounds your brain and spinal cord protect them from injury. The lumbar puncture may be used to diagnose serious infections, such as meningitis; disorders of the central nervous system, such as Guillain-Barre syndrome and multiple sclerosis; or cancers of the brain or spinal cord. When anesthetics or chemotherapy drugs are injected into cerebrospinal fluid, lumbar punctures may be performed.

 

Epilepsy Surgery

Epilepsy surgery involves removing an area of the brain that causes seizures. When seizures occur in a single region in the brain, epilepsy surgery is most successful. Epilepsy surgery is not the first line of treatment, but when at least two anti-seizure medications fail to control seizures, it is considered. A series of pre-surgical tests are required to assess whether you are a candidate for epilepsy surgery and how the procedure will be carried out.

Spinal Fusion

During spinal fusion, you permanently join two or more vertebrae in your spine, eliminating motion between them. During spinal fusion, techniques designed to mimic the normal healing process are used. A spinal fusion involves the attachment of bone or bonelike material between the vertebrae of your spine. Mechanics may use screws, rods, and plates to hold vertebrae together so they can heal into one solid part. A spinal fusion connects two or more vertebrae permanently to reduce pain, increase stability or correct a deformity in the spine. Spinal fusion may be recommended by your doctor for the following conditions:

Deformities of the spine

Spinal weakness or instability

Herniated disk

Microdiscectomy

One of the most common minimally invasive spine surgery procedures is microdiscectomy, also known as microdecompression. The main purpose of a microdiscectomy is to relieve your back pain by relieving pressure on your nerves.

 

Ventriculostomy

An external ventricular drain (EVD) is used in ventricular catherization with an intraventricular catheter (IVC).  As part of the surgery, an external collecting device is connected to the ventricles of the brain through a catheter.  The ventricles are four spaces inside the brain that contain cerebrospinal fluid (CSF), which is essential for supporting and nourishing the brain. Under normal conditions, fluid travels through the ventricles and surrounding the spinal cord. Because of the restricted area inside the cranial cavity, this natural circulation can get stopped, resulting in hydrocephalus (excess CSF) and brain compression. To remove excess CSF, a catheter will be inserted into one ventricle and lead to a collection device located outside the cranium.Ventriculostomy may be performed when there is bleeding into the ventricles, which can also restrict the circulation of cerebrospinal fluid, or when the pressure inside the skull (intracranial pressure) is increased following traumatic brain damage.

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