The following article hopes to inform you about the 7 most common neurosurgical procedures that are conducted today. These procedures range from extremely old to relatively new in origin, and a good deal of them are considered to be life-saving surgeries. So sit back, relax, and enjoy learning about the most common neurosurgical procedures.
- Spinal Fusion
Spinal fusion is a relatively common surgical procedure that has a similar concept to welding. Essentially, spinal fusion welds two small bones in the spine called vertebrae together to form one solid bone. This procedure is used to alleviate painful movement of the spine and any stability problems. The surgical procedure is not without risks, however — most doctors will only recommend this procedure when they are able to specifically pinpoint the source of your pain through x-rays, MRIs, or CAT scans.
Spinal fusion is used to treat the following problems:
- Degenerative Disk Disease • Scoliosis • Herniated disc
- Spondylolisthesis • Fractured Vertebrae • Tumor
- Spinal Stenosis • Infection
A craniotomy is a surgical removal of a part of the skull covering the brain, appropriately named the “bone flap” to relieve pressure on the brain. Depending on the reason why one would need this procedure, the bone flap will either be replaced soon after the surgery or later on. This procedure is used for a plethora of reasons including diagnosing/removing a brain tumor, repairing an aneurysm, removing blood clots from a blood vessel, draining a brain abscess; repairing skull fractures or tears in the dura mater (the membrane covering the brain); relieving intracranial pressure (ICP) in the brain after a traumatic brain injury or stroke; and even as a treatment for epilepsy or movement disorders such as Parkinson’s disease or Dysania.
- Decompressive Craniectomy
A depressive craniectomy is an emergency surgery that removes a larger portion of the skull to allow a rapidly swelling brain enough room to expand. This procedure is done when a patient is suffering from a life-threatening head injury, such as a traumatic brain injury or stroke. A study conducted in 2016 that analyzed the survival rate of patients who underwent a decompressive craniectomy versus those who only underwent medical therapy found that 26.9% of patients who had the procedure died within a 6 month period versus the 48.9% of patients who did not have the surgery. Furthermore, 42.8% of patients who had the surgery had a favorable outcome, which is substantially higher than the 34.6% of nonsurgical patients who had a favorable outcome. These results yielded that a patient with a traumatic brain injury will have a better chance of survival if they undergo this radical procedure.
Cranioplasty is the second part of a decompressive craniectomy procedure and is usually performed well after the craniectomy when a patient is stable enough to undergo this procedure. This surgery consists of a surgical repair of the bone defect in the skull that was created from a previous surgery or injury. During this operation, the doctor will lift up a piece of the scalp to insert either the original bone or a custom contoured graft that fits the shape of the skull that was previously removed. If the original bone is not available, a graft made of either a titanium plate or mesh, synthetic bone substitute, or acrylic will be used.
- Anterior Temporal Lobectomy
An anterior temporal lobectomy is a last-resort surgery to treat severe epilepsy by removing a section of the front (anterior) portion of the temporal lobe. This surgery is only used to treat intractable epilepsy in adolescents and/or adults. A recent study of this surgery proved to have favorable outcomes for those suffering from debilitating seizures: 58% of randomized patients who underwent surgical intervention were free of disabling seizures and only 10-15% of patients had unimproved 1 year after the procedure. These results are comparable to only 8% of patients become free of disabling seizures in the medical therapy (nonsurgical intervention) group. Finally, 65-80% of patients who underwent surgery were considered to be seizure free after 1-2 years.
Considered to be one of the oldest medical procedures still used today, a ventriculostomy consists of a device inserted into the brain that drains excess cerebrospinal fluid (CSF) in the head. This device can also be used to measure intracranial pressure levels in the brain. Excess CSF and blood can pool in the brain after an injury, surgery, or an aneurysm, and can cause life-threatening slowing of blood flow through the brain, that can lead to brain damage.
Trepanation is the oldest medical procedure known to the human race and is estimated to be about 5,000 years old. In fact, about 5-10% of all skulls discovered from the Neolithic period (12,000 -4,000 years ago) were found to be trepanned (approx. 1500 skulls). Trepanation consisted of drilling a small hole into the skull for treatment of various ailments, pain, and even as a ritualistic spirit removal procedure. This procedure is still conducted today, but its name was changed to “craniotomy”.
And there you have it — 7 of the most common (and coolest) neurosurgical procedures that are conducted today,