Stereotactic and Functional Neurosurgery

Stereotactic and Functional Neurosurgery is the advanced subspecialties in neurosurgery. Due to technology growth in robotics, imaging, computer-assisted surgery, and neurophysiology are being applied to medical-related problems, offering opportunities for the latest approaches to radiotherapeutic and surgical management of diseases of the spinal cord, brain, and spine.

Stereotactic Surgery

It is a minimally invasive surgical intervention that uses a three-dimensional coordinate system to locate targets inside the body and to perform actions including lesion, injection, stimulation, ablation, implantation, and radiosurgery. Stereotactic surgery is used to treat abnormalities in the brain and spine region. The diagnosis of stereotactic surgery includes computed tomography, magnetic resonance imaging, and radiographic mammography. 

Procedure: This surgery works on the basis of three main components:

A stereotactic planning system such as coordinates calculator, image matching tools, atlas, and more

A stereotactic device

A stereotactic placement procedure

Nowadays stereotactic planning systems are computer-based and used for positioning the stereotactic device. 

Treatment: It uses ionizing radiation to inactivate defined targets in the head or spine without the need to make an incision. This treatment demands steep gradients to decrease injury to adjacent normal tissue while maintaining treatment efficiency in the target. The treatment is performed carefully by a team of neurosurgeons, medical physicists, radiation therapists, and radiation oncologists. It is a safe, efficient, and less invasive treatment alternative. This method is used to treat disorders such as trigeminal neuralgia, schwannomas, meningiomas, and pituitary adenomas. 

Functional Neurosurgery 

Functional neurosurgery is a subspeciality of neurosurgery. It is used to treat abnormalities such as dystonia, pain, epilepsy, Parkinson’s disease, tremor, and other neuropsychiatric disorders. Due to the advanced development in functional neurosurgery, then it results in better outcomes, a lower rate of complications, and improved stereotactic approach, and more.  Recent technological advances in imaging, devices, and imaging are prompting developments in functional neurosurgery applied to a growing number ofpsychiatric and neurological diseases.

Procedure: The treatment performed for functional Neurosurgery involves 

Implants for invasive monitoring

EEG 

Lobectomies

Seizure focus resection 

Corpus callosotomy 

Stereotactic laser ablation Responsive neurostimulator (RNS) implants

Treatment: The treatment will vary based on the disorder and its location in the brain or spine region.

Controlling beginning epileptic seizures is taking appropriate medications. Some of the presurgical evaluations used here are video-EEG monitoring, physical examination, and advanced imaging. The affected area can be treated by vagal stimulation, hemispherectomy, lobectomy, and more. 

Chronic pain and tic can be relieved by taking medication, if it is severe then it can be solved by moving the blood vessel in a clinical procedure called microvascular decompression. 

Deep Brain Stimulation is used to treat patients with  Movement Disorders. It involves implanting an electrode in the brain to interrupt and stimulate nerve activity. 

The surgical treatment of psychiatric disease 

Surgical Treatment of Psychiatric Disease is cingulotomy, subcaudal tractotomy, vagal nerve stimulation for depression, deep brain stimulation for OCD, and depression. 

Conclusion

Stereotactic and functional neurosurgery involves techniques such as biopsy, craniectomy, radiosurgery, and biologicals in the treatment of functional and movement disorders in the brain and spine region.