Neurological Surgery is a discipline of medicine and that specialty of surgery that provides the operative and nonoperative management (i.e., critical care, prevention, diagnosis, evaluation, treatment, and rehabilitation) of disorders of the central, peripheral, and autonomic nervous systems, including their supporting structures and vascular supply; the evaluation and treatment of pathological processes which modify the function or activity of the nervous system, including the hypophysis; and the operative and nonoperative management of pain. As such, neurological surgery encompasses treatment of adult and pediatric patients with disorders of the nervous system: disorders of the brain, meninges, and skull, and their blood supply, including the extracranial carotid and vertebral arteries; disorders of the pituitary gland, disorders of the spinal cord, and vertebral column, including those which may require treatment by spinal fusion or instrumentation; and disorders of the cranial and spinal nerves throughout their distribution.
Neurosurgery for mental disorders (NMD, formerly psychosurgery). This is rarely used, but can be performed for cases of severe, intractable depression using strict controls under the Mental Health Act, including fully informed consent and a second opinion. There are several techniques, including the use of diathermy and radioactive iridium implants in operations such as subcaudate tractotomy. Approximately one-third of patients are reported to gain marked benefit, one-third mild benefit and one-third no benefit. Side-effects can include personality changes of a frontal lobe nature and epilepsy. Deep brain stimulation is a recently developed neurosurgical procedure in which functional (and reversible) lesions can be induced. Its use in depression remains experimental only.
neurosurgery is divided into different categories, including general neurosurgery and a host of specialized branches.
General neurosurgery – General neurosurgery is involved with most conditions that are of neurological in nature particularly neurological trauma and neurological emergencies, one example of which is intracranial haemorrhage.
Vascular and endovascular neurosurgery – This involves the diagnosis and treatment of aneurysms, carotid stenosis, strokes, vasospasms, and spinal malformations. Surgical treatments of such conditions are now conducted using minimally invasive techniques such as angioplasty, stenting, and embolization.
Spine neurosurgery – This involves the treatment of disorders affecting the cervical, thoracic, and lumbar spines; these problems include arthritis in the spinal discs, spinal cord compression caused by trauma, or spondylosis. Symptoms of spinal problems include balance deficiency, numbness and tingling in the hands and the feet.
Peripheral nerve surgery – Common peripheral nerve surgeries include carpal tunnel decompression for the treatment of carpal tunnel syndrome as well as peripheral nerve transposition; this branch of neurosurgery is responsible for the treatment of nerve entrapment conditions.
Aside from these specialized branches, neurosurgery also involves the use of different surgical methods for diagnosing and treating neurological conditions. In recent years, there has been a shift from conventional neurosurgical methods to more modern alternatives. While the conventional method requires open surgery where the surgeon opens up the skull to access the brain, newly developed methods now allow specialists to surgically treat neurological conditions through smaller openings. These methods make use of microscopes, endoscopes, and most recently, neuroradiology methods. Open surgery techniques are now usually reserved for traumatic cases or emergencies.
Microsurgery, or microscopic neurosurgery, makes use of microscopic technology to enable surgeons to treat affected areas of the brain through a smaller opening, simply by magnifying the treatment area. Nowadays, even complex procedures such as clipping an aneurysm or complex spine surgeries such as microdiscectomy and laminectomy can be performed through microscopic surgery, making neurosurgical treatment less invasive.
Endoscopic neurosurgery is also widely in use today in the treatment of pituitary tumours, cerebrospinal fluid leakage, hydrocephalus, colloid cysts, and many others.
Risk factors include:
|Procedure||Duration In Hospital||Min Cost
|Spinal Fusion- 1 level||7||450000/6190||750000/10350|
|Spinal Fusion - 2 Level||7||480000/6650||750000/10350|
|Disc Repalcement - 1 Level||3||470000/6450||800000/11000|
|Disc Replacement- 2 Level||3||600000/8250||800000/11000|
|Deep Brain Stimulation||7||1200000/16500||1600000/22000|
|Anterior cervical discectomy and fusion||4-7 days||360000/4950||660000/9500|
|Spinal fusion surgery||4-7 days||360000/4950||760000/10455|
|Cervical spine surgery||4-7 days||400000/5500||750000/10350|
|Lumbar Spine Surgery||4-7 days||400000/5500||750000/10350|
|Spinal Decompression||Depends upon the treatment||360000/4950||1590000/21850|
|Cervical Disc Replacment Surgery||7||750000/10350||1000000/13750|
|Percutaneous Endoscopic lumbar Discectomy||5||360000/4950||560000/7750|
|Posterior Lumbar Interbody Spinal Fusion||5||450000/6500||480000/6690|
|Brain Tumor Treatment||2- 5 days||390000 /5350||550000/7655|
|Brain Cancer Surgery - Craniotomy||Depends upon the treatment||540000/7450||750000/10350|
|Brain Cancer Surgery - Micro Surgery||Depends upon the treatment||750000/10350||1150000/15820|