Nearly every advancement in medicine continues to be the effect of a physician trying to do things later on better and safer than she or he has done them previously. This idea has possibly been shown no much better than with the concept of modern neurosurgery, that has gone through an impressive evolution since its origins over 150 years back.
Ale today’s neurosurgeons to deal with a number of structural lesions affecting the greatest recesses from the brain and spinal-cord, while minimizing complications associated with manipulating probably the most delicate tissue within your body, is caused by both insightful pioneering surgeons, in addition to dramatic technological advancements which have been put on our discipline. These include a) the operating microscope – which supplies unparalleled visualization for that surgeon, b) endovascular techniques – which permit treating aneurysms along with other vascular lesions to become performed via a catheter, staying away from more invasive “open” nuclear physics and c) endoscopic surgery – which enables management of neurosurgical illnesses through more non-invasive corridors, hastening a person’s recovery.
The newest modern advancement in the area of neurosurgery continues to be those of applying a very concentrated “lethal” dose of radiation very precisely for an section of diseased tissue while minimizing the quantity of radiation that surrounding tissues receive just millimeters away – technology known as Stereotactic Radiotherapy, or SRT (also generally referred to as Stereotactic Radiosurgery). The delivering of radiation to tissues with less accurate methods has existed for many years.
When treating a lung or breast tumor, there’s relatively little clinical consequence to radiating a couple of extra inches of ordinary tissue round the tumor. Laser hair removal paradigm is unacceptable, however, when treating pathologies from the nervous system where such techniques can lead to significant “collateral damage” of nearby functional nerve tissue, producing new unintended nerve deficits. This have to precisely and reliably offer so much high doses of radiation to some well-defined but frequently irregularly formed tumor with millimeter precision to prevent injuries to surrounding functional nerve tissue drove the innovations in modern imaging and computing strategies to get the technological interfaces essential to precisely concentrate on the radiation energy.
The adoption of SRT techniques by all the sub-specialties of contemporary neurosurgery has led to significant modifications in treatment recommendations to patients with illnesses that, previously, were treated more invasively with “open” nuclear physics techniques. While effective, they generally carry longer publish-operative recoveries and bear additional risks connected with traditional surgery (infection, stroke, unintended harm to tissues all around the lesion). Fraxel treatments has permitted neurosurgeons to deal with some illnesses from the brain and spinal-cord that, previously decade, were considered too harmful to deal with.
SRT is really non-invasive in being able to deliver therapeutic energy for an precisely defined target with no cut and has been utilized in the last 2 decades to deal with a multitude of pathological neurosurgical conditions. Included in this are benign and malignant brain tumors, vascular lesions for example arteriovenous malformations, neurodegenerative conditions (e.g. Parkinson’s disease) as well as certain discomfort syndromes for example trigeminal neuralgia. During the last half a century, a significant quantity of understanding continues to be received about targeting techniques, radiation energy dosing and effectiveness with certain lesions to permit SRT that need considering like a valid option to open surgery for several illnesses. With a few bigger solid and vascular tumors, SRT was used being an adjunctive therapy to “open” surgery and endovascular techniques. In addition, the potency of SRT to supply growth charge of certain benign tumors (e.g. acoustic neuromas and meningiomas) is responsible for the neurosurgical community to re-think the very best strategy to a few of these lesions.
In conclusion, the introduction of SRT has benefited neurosurgeons, radiation oncologists as well as their patients by growing the choices open to treat a number of benign and malignant pathologies from the nervous system. While malignant brain illnesses have a rather careful prognosis, it’s the hope of neurosurgeons and radiation oncologists everywhere the wider utilization of SRT technology allows the advance of national 5-year survival averages close to 23%.
Dr. Gordon Tang has been in the field of neurosurgery for over 20 years. He is associated with a number of hospitals including Alta Bates Summit Medical Center – Alta Bates Campus and Eden Medical Center.