For better or worse, neurosurgery is practically synonymous with the scientific cutting edge. “It’s not brain surgery,” is a common response to the complaint that a particular task is difficult or excruciating, for instance. Even among other medical specialists, all of whom are respected as pinnacles of achievement by members of the general public, neurosurgeons are afforded special deference and social prominence.
But that doesn’t mean that neurosurgeons can’t learn, and that the science of neurosurgery can’t advance. In fact, neurosurgery is constantly advancing, and the pace of innovation has actually sped up in recent years. Here’s a look at five of the most consequential recent advances in neurosurgery. What might they mean for you and yours?
- Gamma Knife Radiosurgery
Gamma Knife radiosurgery is a type of stereotactic brain surgery (neurosurgery) harnesses the power of minutely targeted gamma ray beams to deliver powerful doses of radiation to specific areas of the brain. The beams are delivered via a helmet that’s surgically attached to the skull and calibrated to target abnormalities, such as small tumors and lesions. Gamma Knife isn’t indicated for larger tumors or lesions due to its precise nature.
Although Gamma Knife has been in use for some time, it’s gaining popularity thanks to its minimally invasive nature — it doesn’t require a surgical breach of the skull — and relatively low risk of side effects or complications. It’s often possible to complete a Gamma Knife procedure in a single day, possibly with the patient kept overnight for observation. That’s significantly better than more invasive neurosurgeries, which can require days of inpatient recovery.
- Endonasal Surgery
Endoscopic neurosurgeries use the nasal passages as entry points for brain or cervical spine procedures. They’re minimally invasive procedures that don’t require an incision through the skull. Instead, they use tiny instruments affixed to the end of a flexible probe. Endoscopic surgeries are ideal for biopsies and tumor excision procedures in regions near the base of the skull or top of the spine. They’re not indicated for tumors or abnormalities found elsewhere in the brain, though this may change as technology advances.
- Minimally Invasive Spinal Surgery
Like endoscopic neurosurgeries, minimally invasive spinal surgeries use very small incisions and instruments guided via flexible probe. They’re indicated for procedures at any point on the spinal column, though other forms of minimally invasive surgery may be indicated for areas near the base of the skull.
Like other minimally invasive procedures, minimally invasive spinal surgeries offer the promise of faster recovery times and fewer complications. However, they do present some serious risks, including the low but real chance that the procedure can’t be completed as planned due to unforeseen complications or the limitations of the minimally invasive approach. These are likely to be mitigated as technology advances.
- Minimally Invasive Intracranial Surgery
Minimally invasive intracranial surgery applies the same basic principles as minimally invasive spinal surgeries — small incisions, guided instruments, less tissue damage — to cranial neurosurgery. They’re indicated for small tumors and other abnormalities that can be easily accessed through strategically placed entry points in the skull. Their risks, side effects and limitations are similar to minimally invasive spinal surgery. That said, they’re typically preferable to open cranial surgeries, which present a host of serious risks.
- Deep Brain Stimulation
Deep Brain Stimulation (DBS) is a nonsurgical treatment that shows tremendous promise for the treatment of certain Parkinson’s Disease symptoms, including tremors, rigidity and stiffness, poor motility and problems with walking. It can also be used to treat essential tremor and dystonia. DBS works via a “brain pacemaker” — an implanted device that delivers regular, low-voltage currents to the thalamus and other movement-related regions of the brain. The goal is to interrupt abnormal signals that affect movement and control, reducing symptoms — though not reversing the progression of the disease.
What Does Neurosurgery’s Future Hold?
If your job doesn’t require an expert-level understanding of the human brain, some or all of these advances are likely to come as news to you. Likewise, you’re probably not keeping up with the latest journal articles and research papers on neurosurgical minutiae. Rest assured that the field continues to advance at a brisk, accelerating clip — and that you’ll eventually learn of the most consequential advances. Who knows? You or a loved one might just turn out to benefit from a novel process or treatment.