What is neurosurgery?
Neurosurgery or Neurological surgery is the medical specialty concerned with the diagnosis and treatment of conditions, illnesses and injuries involving the nervous system and its support structures. This includes various conditions involving the brain, the spinal cord, the actual nerves, the skull, the bones of the spine, spinal disks, as well as the blood vessels, ligaments and the protective coverings that offer support to the nervous tissues. Intervention by a Neurosurgeon can be surgical but is most often non-surgical and is determined by the condition or injury as well as the general health of the person. Such problems may be the result of abnormal development from birth (congenital), from aging or “wear and tear” (degenerative), traumatic from a definite injury, infectious, neoplastic from a tumor or it may be related to other medical conditions or disease.
Who are neurosurgeons?
Neurosurgeons are licensed physicians who have completed their college and medical school educations, completed a year of post-medical school training in general surgery and five to six years of additional residency training specifically dedicated to neurosurgery. That training is very intense and comprehensive, exposing each neurosurgeon to the entire spectrum of neurosurgical problems and treatments. Neurological residency training programs are among the most competitive and difficult to enter and are highly regulated to ensure the quality of education and experience they offer to their residents. There are slightly more than 100 programs in the entire United States and most programs allow only one or two residents per year.
What is the history of Neurological Surgery?
Within the family of medical specialization, neurosurgery is relatively young. It has evolved into a true, independent surgical specialty only during the past century, developing from the ranks of general surgery. Our pioneers were courageous general surgeons who ventured into the previously forbidden area of treating disorders of the brain, spinal cord and nerves. Their results were limited by the lack of technology, limitations in surgical equipment and restricted knowledge of the unique tissues and functions that make up the nervous system. The advances that resulted from their monumental efforts have allowed a quantum leap in our knowledge, diagnostic abilities and surgical capabilities over the past fifty years. The technological advances of the surgical microscope, CT scan, MRI Scan and various surgical instruments have allowed us to successfully perform procedures that were not even envisioned by our predecessors. Today, Neurosurgery represents one of the most successful and prestigious specialties which continues to lead the way in research, education and advances in surgical technologies which serve all areas of Medicine.
What types of problems do Neurosurgeons treat?
- Tumors involving the brain, spinal cord, nerves, skull or the spine. These may be a primary growth from the local tissues themselves or a metastatic spread from a cancer in another part of the body.
- Spinal problems resulting in neck or back pain, the pinching of nerves with resultant pain, numbness or weakness in the arms or legs. These conditions can result from ruptured or bulging disks, excessive overgrowth of arthritic bone, slippage of the vertebra, infections or fractures.
- Peripheral nerve injuries or compression resulting in pain, numbness, weakness and wasting of the muscles in the face, arm, hand or leg. Conditions such as Carpal Tunnel syndrome are common when the nerve crossing the wrist is compressed or entrapped.
- Neurovascular disorders such as strokes, brain hemorrhages, aneurysms, vascular malformations, traumatic or non-traumatic blood clots affecting the brain or spinal cord and carotid artery disease.
- Brain disorders such as Parkinson’s disease, epilepsy, hydrocephalus or malformations involving the brain from birth.
- Infections involving the brain and spinal cord, the fluid surrounding these structures or the spinal vertebra and disks.
- Traumatic injuries to the brain, spinal cord, bones of the spine, nerves and skull.
- Use of gamma knife to treat indicated disorders.
What is the difference between a Neurosurgeon and a Neurologist?
A neurologist is a physician with training and expertise in the evaluation and medical management of neurological disorders. Neurosurgeons and neurologists share many of the same patients and often work together for the optimal care of the person. Many conditions are effectively treated by either specialist with some conditions being best managed without surgery and others with operations. When medical intervention fails or is not acceptable, the neurologist will frequently request the assistance of a Neurosurgeon to evaluate the potential for a surgical treatment. Many problems are structural in nature and may therefore respond best to neurosurgical intervention. It is much like the cardiologist who manages heart disease with medical intervention and the cardiac surgeon who offers surgery for those who have failed treatment with medications. Frequently, patients are sent to a neurologist by their primary care physician and, based upon the problem, subsequently referred to the Neurosurgeon for their surgical expertise.
Who can do spinal surgery, a Neurosurgeon or Orthopedic Surgeon?
In today’s medical environment, there is great overlap between specialties. Spinal surgery is one such endeavor. All Neurosurgeons and those select orthopedic surgeons who have special training in spinal surgery are qualified and capable of performing spine related procedures. Historically, Neurosurgeons were among the first to operate on the spine and through their efforts, spinal surgery has evolved. As Neurosurgeons, we feel that our experience handling the delicate tissues of the brain, allow us to operate comfortably on the spine and the nerves that are involved. Our training and experience allows us to utilize various materials, implants and bone grafts to reconstruct or stabilize the boney structures of the spine while relieving compression on the adjacent nerves. Indeed, the vast majority of the operations performed by Neurosurgeons involve the spine and spine related procedures.