Minimally Invasive Brain & Spine Surgery

The Minimally Invasive Approach

By definition, minimally invasive procedures are less traumatic to the body than conventional, open surgical treatments for the same condition. With the help of special devices and techniques, doctors can, in many cases, perform delicate procedures through a small incision. This approach minimizes the disruption of bodily tissues, thereby reducing post-procedural pain and recovery time, and lessening the risk of complications.

UBNS is a vanguard of minimally invasive neurosurgery. Our experienced team of neurosurgeons has gained worldwide recognition for excellence in the minimally invasive treatment of cerebrovascular diseases. Although not everyone is a candidate for minimally invasive techniques (described below), the technology is evolving so that more patients can be treated effectively in this manner. Our expertise helps us determine and deliver the best therapy for our patients.

Minimally Invasive Endovascular Procedures

The term endovascular refers to any medical treatment that accesses the body's extensive network of blood vessels to treat serious abnormalities throughout the body. Using endovascular technology, UBNS physicians can enter almost any major artery or vein (usually in the upper leg or arm) with a small needle puncture. From the point of entry, tiny hollow tubes called catheters, which contain medicine or small surgical instruments, can be navigated to the area of abnormality, where repairs can be made. Commonly, we use this vascular "highway" to access and treat vascular abnormalities of the brain and spine, including aneurysms, vascular malformations (AVMs), atherosclerotic disease & stenosis, and vascular tumors.

Minimally Invasive Endoscopic Procedures

An endoscope is a device employed by UBNS neurosurgeons to operate through a limited opening to allow them to see anatomical structures better than ever before. The typical endoscope used in neurosurgery features a tiny lens at the end of a small catheter and camera for visualization, a light source for illumination, and one or more channels through which instruments can be directed for surgical manipulation. Most of the current applications of endoscopy in neurosurgery are directed at hydrocephalus (often eliminating the need for shunting), but endoscopic treatments can also be applied to other forms of intracranial pathology, including pituitary and intraventricular tumors and lesions. This method of surgery is particular appealing to patients, as incisions are small and cosmetic, and tissue disruption is drastically minimized (as compared to conventional, open surgical procedures). As a result, post-operative pain and recovery time are significantly reduced. To learn more about endoscopic procedures at UBNS, please visit the Endoscopic Surgery section of our website.

Minimally Invasive Spine Procedures

Vertebroplasty:
A relatively new procedure, vertebroplasty stabilizes osteoporotic compression fractures to provide immediate pain relief. The procedure provides an instant internal vertebral body fusion as bone cement (methyl methacrylate polymer) is injected into a weakened vertebral body under fluoroscopic guidance. The treatment is performed with local anesthesia and some mild sedation. Vertebroplasty is also used for pain relief and stabilization of vertebral metastatic lesions and hemangiomas.

Similar to vertebroplasty is balloon kyphoplasty. In this procedure, tiny balloons are inserted into fractured vertebrae and inflated. The space created by the balloons is then filled with cement to support the bones and prevent further collapse.

Disc Surgery:
UBNS physicians are treating routine lumbar disc ruptures using tubes smaller than 1-inch through the METRx^TM Microendoscopic (METRx^TM MED) system. In addition to allowing smaller, more cosmetic skin incisions, this technique avoids muscle cauterization and dissection techniques which can often be painful and prolong the recovery period. Instead, the muscle is spread (similar to the technique used in laparoscopic surgery) in such a way that when the procedure is over, the muscle can return to its normal preoperative state with minimal trauma. Patients often leave the hospital on the same day the procedure is performed.

Foraminotomy:
Compressed or pinched nerves in the low back and neck can result in pain, numbness, and/or weakness in the arms and legs. The nerve is most often pinched in the bony canal as it exits the spinal cord to the body through an opening called a foramen. Instead of performing a traditional lengthy midline incision down the back, our surgeons are now able to place a small tube over the bony canal that is squeezing the nerve root. Once the tube is placed (under x-ray guidance and using wires with special dilators), a small amount of bone can be removed, freeing the affected nerve from the tight spinal canal. Many patients awake from surgery pain free and are often able to go home the next day.

Pedicle Screws and Interbody Fusion:
Minimally invasive technologies have evolved to a point where it is now possible to insert fusion devices through a 26-mm tube, eliminating the need for large open incisions. With the aid of x-ray imaging, the screws required to stabilize the spine and keep the interbody device in place can also be inserted through small incisions and guided over wires into the proper location. For patients with pain on one side, discogenic back pain, or unilateral vertebral bone fractures, these minimally invasive approaches have produced good patient outcomes.

To learn more about any of the minimally invasive procedures described above, or to schedule an appointment with one of our specialists, please call our main office at (716) 887-5200.

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