Neurology is the branch of medicine concerned with the study and treatment of disorders of the nervous system. The nervous system is a complex, sophisticated system that regulates and coordinates body activities. It has two major divisions:
- Central nervous system: the brain and spinal cord
- Peripheral nervous system: all other neural elements, such as eyes, ears, skin, and other "sensory receptors"
A doctor who specializes in neurology is called a neurologist. The neurologist treats disorders that affect the brain, spinal cord, and nerves, such as:
- Cerebrovascular disease, such as stroke
- Demyelinating diseases of the central nervous system, such as multiple sclerosis
- Headache disorders
- Infections of the brain and peripheral nervous system
- Movement disorders, such as Parkinson's disease
- Neurodegenerative disorders, such as Alzheimer's disease, Parkinson's disease, and Amyotrophic Lateral Sclerosis (Lou Gehrig's disease)
- Seizure disorders, such as epilepsy
- Spinal cord disorders
- Speech and language disorders
Neurologists do not perform surgery. If one of their patients requires surgery, they refer them to a neurosurgeon.
A neurologist is a physician specializing in neurology and trained to investigate, or diagnose and treat neurological disorders . Neurologists may also be involved in clinical research, clinical trials, and basic or translational research. While neurology is a nonsurgical specialty, its corresponding surgical specialty is neurosurgery.
What are neurological disorders?
Q: What are neurological disorders and how many people are affected by them?
A: Neurological disorders are diseases of the central and peripheral nervous system. In other words, the brain, spinal cord, cranial nerves, peripheral nerves, nerve roots, autonomic nervous system, neuromuscular junction, and muscles. These disorders include epilepsy, Alzheimer disease and other dementias, cerebrovascular diseases including stroke, migraine and other headache disorders, multiple sclerosis, Parkinson's disease, neuroinfections, brain tumours, traumatic disorders of the nervous system due to head trauma, and neurological disorders as a result of malnutrition.
Many bacterial (i.e. Mycobacterial tuberculosis, Neisseria meningitides), viral (i.e. Human Immunodeficiency Virus (HIV), Enteroviruses, West Nile Virus, Zika), fungal (i.e. Cryptococcus, Aspergillus), and parasitic (i.e. malaria, Chagas) infections can affect the nervous system. Neurological symptoms may occur due to the infection itself, or due to an immune response.
Hundreds of millions of people worldwide are affected by neurological disorders. More than 6 million people die because of stroke each year; over 80% of these deaths take place in low- and middle-income countries. More than 50 million people have epilepsy worldwide. It is estimated that there are globally 47.5 million people with dementia with 7.7 million new cases every year - Alzheimer's disease is the most common cause of dementia and may contribute to 60–70% of cases. The prevalence of migraine is more than 10% worldwide
Types of Neuro and Spine Surgeries
- Brain and Spinal Cord Tumors
- Complex Spine Surgery
- Minimally Invasive Neck and Back Surgery
- Gamma Knife
- Skull-based and Pituitary Tumors
- Stereotactic Radiosurgery
- Pain Management
- Deep Brain Stimulation (DBS)
- Spinal Decompression Rehabilitation Therapy (IDD)
- Trigeminal Neuralgia
- Cerebral Vascular Brain Disorders
- Hydrocephalus/ Arnold Chiari Malformation
- Disc disease
- Percutaneous procedures
- Open and other interventional procedures
- Spinal malformations
- Spinal dysraphism
- Spine reconstruction and fixation
- Surgical pain management
- Spine trauma care
- Percutaneous vertebroplasty
Conditions Treated by Neuro Spine Surgery
Neuro Spine Surgery treat conditions related to the brain, peripheral nerves, spinal cord and extra-cranial cerebrovascular system. There are different procedures involved in Neuro spine surgery that focuses on specific conditions.
Neuro-spinal specialists can perform many types of surgeries to alleviate uncomfortable symptoms, correct misalignment, and repair spinal structures. Spine surgery may correct unhealthy abnormalities in the spinal cord, nerves, ligaments, vertebrae, and the discs between them. It can be performed in the cervical, thoracic, lumbar, and sacral portions of the spine and surrounding tissues. Some of the conditions include –
- Brain and Spine Tumors
- Degenerative disc disease
- Lumbar spinal stenosis
- Cervical spinal disc disease
- Neck pain
- Herniated pain
- Lumbar spinal stenosis
- Lower back pain
- Surgical pain management
- Spine trauma care
Surgical Procedures of Neuro Spine Surgery
- ALIF: Anterior Lumbar Interbody Fusion
- Anterior Cervical Discectomy & Fusion
- Artificial Cervical Disc Replacement, Prestige®
- Cervical Posterior Foraminotomy
- Dekompressor Discectomy
- Endoscopic Carpal Tunnel Release
- Interspinous Process Decompression - X-STOP®
- Intradiscal Electrothermal Therapy (IDET)
- Laminectomy (Cervical) with Fusion
- Lumbar Radiofrequency Neurotomy
- Micro Endoscopic Discectomy
- Minimally-Invasive Lumbar Microdecompression
- Minimally-Invasive TLIF (Transforaminal Lumbar Interbody Fusion)
- PLIF: Posterior Lumbar Interbody Fusion
- Spinal Cord Stimulation (Paddle Lead)
- Spinal Cord Stimulator Implant
- Total Disc Replacement
- XLIF® Lateral Lumbar Interbody Fusion
Laser Spine Surgery
Laser spine surgery is an alternative to traditional spine surgery where doctors use thin blades and manual instruments to open the skin and modify the tissue and bone beneath it. This is a minimally invasive endoscopic procedure that does not require any cutting or disturbing of the muscles and bones. The procedure is performed on an outpatient basis and only requires a very small incision. The recovery is also quick in this procedure unlike conventional spine surgery. An endoscope is used for directing a laser beam at the affected area. The laser is passed through the small incision made which is in the back of the back or neck. The other device used in laser spine surgery is the scalpel. Both the direction and placement of the laser depend upon the actual site of the spinal issue. This is known as the best proven procedure for spine related problems.
Cervical Spine Surgery
Cervical spine surgery is performed for eliminating tingling, weakness, pain and numbness caused in the spine. The surgery also prevents the abnormal motion in the spine and also restores nerve function. The surgery is performed for a number of cervical spine problems. The conditions of instability, degenerative disorders or trauma can produce excess pressure on the nerves and on the spinal cord that is coming from the spine.
Total Disc Replacement
The degeneration of the spinal structures may result in neck or back pain that decreases the quality of life. Total disc replacement surgery, also referred to as artificial disc, is a new innovation in spine surgery. The surgical procedure is done for removing pain and also preserves the natural motion. The surgery is recommended when all other therapies have failed. An incision is made by the surgeon at the front of the neck. Before removing the disc material it is important to determine the correct levels. For this Fluoroscopy is used and the artificial disc is then removed.
Lumbar Spinal Stenosis Surgery
This surgery is performed for relieving the pressure on the nerve roots or the spinal cord. The surgery removes the damaged parts of the spine. The enlargement of the spinal canal is done through this surgery that eases pressure on the nerve. Weakness in the legs, numbness and pain are reduced by performing this surgery. Decompressive laminectomy is the major type of lumbar spinal stenosis surgery. This procedure eases the pressure on the spinal nerve roots. The procedure takes out a part of the bone or fibrous tissue for creating space for the nerves. The procedure of spinal fusion can be performed simultaneously in order to stabilize the spine. The procedure of spinal fusion can improve the function of the spine and also reduces pain.
Anterior Cervical Decompression and Arthroplasty
The surgical procedure aims at eliminating pressure from the nerve roots or spinal cord. The reconstruction of the spine is done to permit for motion at the treated segment.
Carpel Tunnel Syndrome
This syndrome results in tingling, pain and different problems of the hand due to pressure caused on the median nerve in the wrist. Carpel tunnel is the little space in the wrist from where many tendons and median nerve runs from the forearm of the hand. The function of the median nerve is to control the feeling and movement of thumb and first three fingers except little finger. The causes of this syndrome include
- Bone spurs and wrist injuries
- Smoking can also decrease blood flow to the median nerve.
- Illnesses such as diabetes, rheumatoid arthritis and hypothyroidism.
Gamma Knife therapy is considered as the best proven and precise treatment for brain disorders. This therapy does not involve any kind of surgery and the therapy involves 201 precise beams of radiation directly on the tumor. The beams are more powerful when they work together on a single point. This therapy destroys the cancer cells and also stops them from multiplying. The tumor disappears after some time.
The building up of the fluid in the ventricles (cavities) deep inside the brain is termed as Hydrocephalus. The size of the ventricles may increase due to excess fluid that places pressure on the brain. This condition can happen at any point in life but is more commonly seen in older adults and infants. The shunt is known as the most common treatment for hydrocephalus where a drainage system is inserted. Ventriculostomy is the other treatment for hydrocephalus condition.
Robots have proven themselves as a perfect instrument as they provide measurement reliability and movement controllability that can face the challenges of Neurorehabilitation. They can take the form of a joystick or a robotic arm that can effectively enclose the limb just like an exoskletal frame. The sensors in the robots can record joint torques, position and velocity which are collectively known as movement data. The limb can be easily moved as these robots possess actuators.
The discs between vertebrae can become herniated, meaning that part of their center protrudes through their tough exterior, or is otherwise damaged. This can occur anywhere along the spine, causing pain and weakness. Herniated discs can also lead to other spinal disorders. During discectomy, a neurosurgeon excises a portion or the entirety of the damaged disc to alleviate these symptoms. Discectomy can be a standalone procedure, or it may be performed in conjunction with spinal fusion, laminectomy, or other surgeries.
Patients with scoliosis, kyphosis, fractures, herniated discs, or other spinal disorders may benefit from spinal fusion surgery. This technique usually involves removing the natural disc between vertebrae and then placing a bone graft between the affected vertebrae to adjoin them. Doctors may also use surgical instruments such as plates, wires, cables, or screws to create the framework for spinal fusion. After this surgery, the bones gradually integrate for six to nine months, completing the process. This surgery can stabilize the spine and reduce related nerve issues. Spinal fusion sometimes requires revisional surgery to fully correct.
Spinal stenosis, disc herniation, and other issues can cause nerve compression and shrink the spaces between spinal structures. To correct this condition, neurosurgeons can perform laminectomy, during which they remove a segment of the lamina, the top portion of the bone that encloses the spinal cord. This can alleviate pressure on nerves and tissues.
As part of a laminectomy, a neurosurgeon can also place an interlaminar implant, a U-shaped prostheses that decompresses the spine and provides more space for nerves and spinal cord tissue.
The foramen is a hollow bone that protects the nerve roots along the spinal column. If this bone becomes damaged or too narrow, it can interfere with nerve function. In this instance, neurosurgeons can perform foraminotomy surgery, a procedure to adjust soft tissues and bones in the foramen. If neurosurgeons significantly alter the foramen or remove a large portion of it, they may term this surgery a foraminectomy instead.
Using this modern surgical strategy, neurosurgeons use x-ray imaging to map the spine, and then use a needle and balloon to enlarge the space between malfunctioning vertebrae. Once there is adequate room for it, they inject special bone cement into the area to support the spine.
In cases of severe spinal misalignment or deformity, neurosurgeons may recommend osteotomy. During this procedure, they strategically fracture or break vertebrae or other spinal bones to improve posture and correct structural abnormalities. Ideally, the affected bones will adapt and heal in a way that benefits the spine.
Cost of Neuro and Spine Surgery
Neuro and spine surgery in India is easily available at low costs. There are a number of hospitals and a panel of experienced doctors who offer the best services for patients from across the world. All the advanced surgeries, technologies and medical treatments are available in India.
Spinal Decompression Therapy
Carpal Tunnel Syndrome
Vagus Nerve Stimulation
Headache & Facial Pain
ALS & Neuromuscular Disorders