Visiting a neurosurgeon can be a daunting experience for a patient, whether they are seeking treatment for a history of spinal pain, or for a brain aneurysm that was picked up on a precautionary CT scan.
Neurosurgeon Dr Rodney Allan said the last ten years have brought enormous advances in neurosurgery, with more precise operating techniques leading to better results, faster patient recovery and improved long-term outcomes for the patient.
“Everything is becoming minimally invasive in neurosurgery, and in a much greater way,” said Dr Allan.
“Spinal surgery has changed a lot – it used to be done with big cuts but is now done using a keyhole approach.”
Dr Allan performs does the entire procedure using computer navigation with real-time imaging.
“Every single instrument we put inside the patient, we can see on a scan in 3D for every step of the operation: where it is, at all times, in their body.
“I can see the screws, plates, cages to realign things or take out bone as well as the devices I am using to navigate the bone spurs or lumps of disc material, as opposed to trying to look and work out where it is with my eyes.”
Smaller incisions also mean less exposure to infections for both internal and external wounds, and less time on the operating table (which can mean a need for less anaesthesia).
“It means we can also check screws or artificial discs are in the right place, the perfect place, before the patient wakes up.”
While recovery from the traditional spinal fusion operation would take a week in the hospital, this minimally invasive technique takes only two to three days’ recovery.
Dr Allan also performs the relatively new procedure for brain aneurysms called coiling, which is performed using a catheter through the groin, navigated to the blood vessels in the brain. It means the skull does not need to be cut open.
“A brain aneurysm is kind of like a time bomb in that it can rupture which can lead to disability or even death. Coiling allows us to put little metal springs inside the aneurysm to block it off, and recovery is immediate. Patients go home the next day and back to work two days later.”
“I treat about 200 aneurysms a year, mostly in people between the ages of 30-50. Brain aneurysms can be hereditary, caused by smoking or high blood pressure – but they are mostly just due to bad luck,” said Dr Allan.
Catching a brain aneurysm in time for it to be treated, while partly down to chance, is also a matter of being aware of family history and of the symptoms – headaches, vision changes, confusion and nerve paralysis – and alerting a doctor in order to have the relevant tests done.
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