Health Update: New Technologies In Neurosurgery

On Feb. 3, Saline Memorial Hospital and UAMS joined together to allow residents of Saline County to receive care for spine and neurological problems close to home and give them the assurance that they have access to specialty care if needed.

As the medical director of the program at Saline Memorial as well as chairman of the Department of Neurosurgery, we were glad to help open a neurosurgery clinic in Benton to make services more convenient for local patients and to support the healthcare system in the Benton area.

The clinic is next to Saline Memorial and there we also will be performing a variety of spine surgeries, including anterior cervical decompression, cervical fusions, lumbar decompressions, fusions and disc surgeries. More complex surgeries such as craniotomies and complex spine procedures will be performed at UAMS, as appropriate.

An example of the kind of surgical innovation this new collaboration makes possible for the residents of Saline County is one we’ve pioneered at UAMS. A new neurosurgery technique using a small port is a promising development in brain tumor removal with a minimum of injury to normal surrounding brain tissue.

In late 2013, I was privileged to lead the surgical team that became the first in the state to use a minimally invasive, breakthrough brain tumor removal procedure.

BrainPath

The new BrainPath tube employed in both surgeries makes possible advanced imaging of tracts in the brain and along with a computerized brain navigation system allows physicians to navigate the brain with an unprecedented clarity. Being able to do that means we can target and suction out deep-seated brain tumors, abscesses and hemorrhages with much less disruption of tissue than with traditional techniques.

The procedure is the closest that we can get to a precisely targeted, flawless surgery for deep brain tumors. We are able to get to tumors in a much safer way that will put patients at less risk of brain damage and will preserve critical brain structures and tracts.

Myriad

Along with the BrainPath device, the Myriad — a thin, tubular, three-in-one device (scissors, suction and blunt dissector) designed by NICO, is used to remove hard-to-reach tumors through the narrow corridor. The device can be used on multiple procedures and does not use heat, so there is less risk to surrounding tissue.

The many benefits of the breakthrough procedure, which creates a small, dime-size channel through the brain, include a faster recovery time, minimal internal and external scarring, less trauma to the brain and nerves, and few side effects and complications post-surgery. The procedure trumps traditional open surgery because a limited opening is created to access deep in the brain, so less of the brain is exposed, and the brain tissue is minimally disrupted.

Gamma Knife

Another minimally invasive procedure is Gamma Knife. Gamma Knife uses about 190 beams of low-dose radiation on tumors in the brain and head. On the target tumor, the combined energy of the low-dose beams deliver a high dose of radiation but expose the surrounding tissue to much less radiation than conventional radiation treatment. Those low dose beams are transmitted through a precisely placed helmet device called a halo.

It is an alternative to treating the entire brain with radiation, in certain select circumstances. Some people who have whole brain radiotherapy often have cognitive difficulties as a result. You don’t see that with Gamma Knife radiosurgery. They also experience fewer side effects like hair loss. Gamma Knife treatment for some patients can be an appealing alternative to open surgery.