Advanced Technology In Neurosurgery

From the Meeting on "Advanced Technology in Neurosurgery", held in Milan on May, 29 - June, 1, 1985

From the Meeting on "Advanced Technology in Neurosurgery", held in Milan on May, 29 - June, 1, 1985

Since the introduction of electrosurgery the techniques of surgery on the nervous system have passed through further improvements (bipolar coagulation, microscope), even if the procedure was not substantially modified. Today, laser represents a new "discipline", as it offers a new way of performing all basic maneuvers (dissection, demolition, hemostasis, vessel sutures). Furthermore, laser offers the possibility of a special maneuver, namely reduction of the volume of a tumoral mass through vaporization. Its application is not restricted to traditional neurosurgery but extends also to stereotactic and vascular neurosurgery. Laser surgery has also influenced the anesthesiologic techniques. At the same time new instrumentation has been introduced: CUSA ultrasonic aspiration, echotomography, and Doppler flowmeter. I have had the chance to utilize these new technologies all at a time and have come to the conclusion that we are facing the dawn of a new methodology which has already shown its validity and lack of inconveniences, and whose object is to increase the precision of neurological surgery. The technological development is still going on, and some improvements are to be foreseen. Laser scalpel is splitting the initial laser surgery into NO TOUCH and TOUCH surgery with laser. As new instrumentarium will be developed, a variable and tunable beam will become available. For example, in a few years Free Electron Laser will further add to the progress in this field.

An advanced technique quickly becoming the "standard" for all neurosurgeons! A comprehensive review of the state-of-the-art technology currently available for neuronavigation. It will provide the reader with the clinical applications of this technology to various aspects of cranial and spinal surgery.

This issue of Neurosurgery Clinics, guest edited by Dr. Nathaniel P. Brooks and Dr. Michael Y. Wang, is devoted to New Technologies in Spine Surgery. Articles in this issue include: Endoscopic Lumbar Discectomy, Endoscopic Cervical Foraminotomy, Endoscopic Lumbar Interbody Fusion, Endoscopic Lumbar Decompression, Lateral Lumbar Interbody Fusion, Retropleural Thoracic Approach, Novel Intervertebral Technologies, Surface Technologies for Fusion, Cell derived/Stem Cell Technologies for Fusion, Disk Replacement, Enhanced Recovery in Spine Surgery/Perioperative pain management, Imaging Technologies, Robotic Instrumentation Placement, Minimally Invasive Deformity Advances, Tissue Engineering/Regenerative Treatments, Minimally Invasive Tumor Ablation, and more.

This Acta Neurochirurica supplement distills the accomplishments of the Joint Convention of the Academia Eurasania Nuerochirurgica and the German Academy of Neurosurgery held in Bamberg, Germany from Sept. 1-3 2005. The main focus is "Medical Technologies for Neurosurgery," including: imaging, image processing, robotics, workflow analysis and ethics. Coverage extends from an overview of medical technologies, to robotic-assisted systems in neurosurgical operating rooms, to intraoperative MRI.

This book is a combination of ideas and experiences from over 100 dedicated and brilliant neurosurgeons around the world. Their common goal is to provide data for a deeper understanding of the multi-faceted aspects of neurosurgery and, by doing so, to better serve patients across the globe. Scientific curiosity, deep dedication, incredible work ethics, entrepreneurship, and creativity are the common traits among all neurosurgeons, and not the exception. By allowing readers to see the field of neurosurgery from the perspectives of surgeons spanning five continents, this book serves to provide multiple, diverse viewpoints and to build a foundation for future collaborations. The book’s 24 chapters are organized into 3 parts. Part I provides the reader with an overview of the role of neurosurgery in worldwide health care, its evolution over the past decades, the current state and future directions of each neurosurgical subspecialty across the five continents. Over the years, the overarching goal for neurosurgeons has been to develop new, more effective and high-end solutions for complex diseases and to provide access to neurosurgical services for all patients. Part II discusses the differences and similarities of neurosurgery education and training across the globe, providing a snapshot of how new tools, technology, and paradigms reduce inequality and increase access to neurosurgical education. Educational accomplishments and challenges still present for the in different regions of the world are reviewed. Part III focuses on economic aspects influencing neurosurgery globally, including how to make efficient decisions in the face of scarcity, yet demand. The authors provide theories, models, and tools helpful to apply when planning to allocate resources, not just financial, but also human and intellectual. A deeper understanding of economics does not necessarily provide the answer to the problem; rather it provides the tools to find an answer, or, ideally, multiple possible solutions. Neurosurgery and Global Health is the first comprehensive guide to the role of neurosurgery in the global health care sphere, providing an in-depth compendium about the understanding of the neurosurgical role within global health, its efforts in the education of tomorrow’s workforce, and the economic aspects driving the field.

Recognized clinical leaders in neurosurgery and neuroradiology review the cutting-edge techniques and technologies now available and describe how minimally invasive techniques have influenced their subspecialties. On the radiology side, the authors explain the latest developments in magnetic resonance spectroscopy, functional imaging, and brain mapping, with emphasis on the application of image navigation directly in the operating room, using both preoperative and intraoperative systems. On the surgical side, some of the world's leading surgeons in pediatric neurosurgery, cerebrovascular surgery, neurosurgical oncology, spinal and peripheral nerve surgery, and trauma surgery detail how they use the powerful new minimally invasive techniques in the own practices. Among the novel approaches discussed are radiofrequency, radiosurgery, thermal therapy, and minimally invasive techniques that allow "molecular neurosurgery" via gene and viral vectors and local delivery systems.