What is Neurosurgery?
Neurosurgery is a branch of medicine that deals with the diagnosis and treatment of conditions affecting the nervous system, which includes the brain, spine, spinal cord, and peripheral nerves. The branch focuses on all types of pathology including infection-related, acquired, congenital, trauma, and degenerative.
One example of a congenital disorder is hydrocephalus, while infection-related conditions include myelomeningocele and meningitis that are quite common among pediatric patients. Traumatic neurological disorders include spine or head trauma that may cause internal bleeding and are quite common among adults, while degenerative disorders include Parkinson's disease and aneurysms, which are typically noted in elderly patients.
Although neurosurgery is basically a surgical specialty, it requires knowledge of neurology, trauma care, critical care, and radiology. A considerable number of patients seen by the neurosurgeon are treated with non-surgical alternatives such as medical, physical, or minimally invasive interventional therapies. Neurosurgeons are closely connected with neurologists in that both need specialized knowledge of the nervous system. While neurosurgeons and neurologists both diagnose and treat neurological conditions, only neurosurgeons can perform surgery.
What is a Neurosurgeon?
A neurosurgeon is a medical doctor who specializes in the diagnosis and surgical treatment of peripheral and central nervous system conditions including trauma, tumors, vascular disorders, infections of the spine or brain, stroke, degenerative diseases, or congenital anomalies. The education and training to become a neurosurgeon is extensive and rigorous and includes the finishing of:
- 4 years of pre-medical education at a university or college
- 4 years of medical school culminating in a D.O. or M.D. degree
- 1 year of internship in General Surgery
- 5 to 7 years in a Neurosurgery residency program
- Some neurosurgeons finish a fellowship following residency to specialize in a specific area
- Continuing education – this involves conferences, annual meetings, research, and scientific journals to stay updated with the advances made in Neurosurgery.
Neurosurgeons provide both surgical and non-surgical management (i.e., evaluation, diagnosis, treatment, prevention, rehabilitation, and critical care) of neurological conditions. Because neurosurgeons have extensive training and knowledge in the field of neurosurgery, emergency room physicians, internists, family physicians, and osteopaths often turn to them for consultations and solutions.
What are the Sub-Specialties of Neurosurgery?
As a result of its extensive nature, neurosurgery is categorized into different sub-specialties, including:
- General Neurosurgery – This involves most conditions that are neurological in nature specifically neurological trauma and neurological emergencies, such as intracranial hemorrhage.
- Neurovascular Surgery – In this sub-specialty, neurosurgeons work closely with interventional colleagues dealing with complex aneurysms and narrowed or abnormal blood vessels.
- Spine Neurosurgery – This involves the treatment of conditions affecting the lumbar, thoracic, and cervical spines; these issues include spinal cord compression by spondylosis or trauma and arthritis in the spinal discs.
- Pediatric Neurosurgery – This amounts to 10 to 15 percent of neurosurgery cases and involves treating children with congenital anomalies such as spinal and facial defects, hydrocephalus, and other rarer conditions.
- Functional Neurosurgery – This involves the management of a wide variety of functional disorders, such as movement disorders, spasticity, and epilepsy.
- Oncological Neurosurgery – This involves the management of tumors in the brain, skull, and the spine that may cause serious complications, such as vision and hearing loss, balance issues, loss of bowel or bladder control, pain and numbness, decreased motor skills, muscle weakness, and even paralysis.
Conditions Treated by Neurosurgery
The conditions treated by Neurosurgery can be broadly described by their underlying cause. These include:
- Congenital anomalies, such as hydrocephalus, spina bifida, aneurysm, and anencephaly
- Benign or cancerous tumors of the spine or brain
- Traumatic injuries of the head, neck, and spine (including brain hemorrhage and skull fractures)
- Central nervous system infections, such as epidural abscess, encephalitis, meningitis, and vertebral osteomyelitis
- Epilepsy and movement disorders, including Huntington’s disease and Parkinson's disease
- Degenerative spinal disorders, such as spinal muscle atrophy (SMA), spinal stenosis, and spinal disc herniation
- Intractable pain related to trauma, cancer, or other causes
- Vascular disorders, such as capillary telangiectasia and arteriovenous malformations (AVM)