Neurosurgery is bathed in a mystique that, while perhaps beneficial to the typical neurosurgeon’s ego, does little to advance a critical field or enhance potential patients’ understanding of its present status, limitations and capabilities. With that in mind, this list of five recent neurosurgery advances that may legitimately improve patient outcomes (or, in some cases, have already done so) is useful reading for anyone who wishes to learn more about the discipline.
- Gamma Knife Surgery
Gamma Knife surgery is a form of radiosurgery that utilizes focused beams of radiation to target a small abnormality within the brain. The technique is typically used to treat brain tumors and arterio-venous abnormalities for which open surgical intervention is not optimal or practical. The key innovation of Gamma Knife is its ability to target very specific areas without harming neighboring tissues. This powerful result is achieved with about 200 small beams of radiation that, taken by themselves, have almost no effect on the tissue that they pass through. The point at which they meet, however, receives a meaningful dose of radiation that can shrink tumors and/or treat potentially harmful abnormalities.
- Cyberknife Surgery
Cyberknife is a robotic surgery system that, similar to Gamma Knife surgery, utilizes the basic principles of targeted radiosurgery to achieve clinically meaningful results with fewer complications and improved patient outcomes. The Cyberknife uses a linear particle accelerator that can be directed at any area of the body and targets focused anomalies without harming intervening tissues. The robotic component provides critical stability and control, further minimizing the risk of complications.
- Physician-in-Training Assists
Historically, experienced clinicians have worried about the presence of inexperienced physicians-in-training in the operating room. While physicians-in-training provide critical assist functions and play important support roles during complex surgery, their presence is often viewed as a distraction or, worse, active impediment to favorable outcomes. New research puts this theory to rest: An exhaustive study by Johns Hopkins found no uptick in rates of complications or death when physicians-in-training are present in the operating room.
- Optical Coherence Tomography
Optical coherence tomography (OCT) is a groundbreaking imaging technology that dramatically improves clinicians’ ability to identify neurological structures and diagnose specific disorders with a high level of confidence. It is the latest in a series of technological breakthroughs, complementing functional MRI, CT and PET imaging techniques. Though outcomes vary depending on numerous factors, including clinician competency, OCT is substantially less time-consuming than MRI work.
OCT is particularly promising for cancer diagnosis, where it is critical to distinguish healthy from cancerous tissue with high degrees of specificity. Its ability to produce color-coded maps leads directly to superior surgical outcomes, as surgeons using OCT are better able to achieve clear margins without unnecessarily removing healthy tissue.
- Stereotactic Neurosurgery
Stereotactic surgery applies a simple concept to a formidably complex activity: minimally invasive neurosurgery. Using a three-dimensional coordinate system that accurately maps the neurological environment, stereotactic neurosurgeons can pinpoint tiny targets within the brain and central nervous system at a stunning level of accuracy. Stereotactic techniques can be used to identify areas for virtually any time of surgical intervention, including Gamma Knife radiosurgery, biopsy and ablation.