August 19, 2009 > Latest Innovations Give Hope to More People with Neurological Illnesses and Injuries
Latest Innovations Give Hope to More People with Neurological Illnesses and Injuries
One of the most exciting areas of innovation in medicine today is in the field of neurosurgery. This specialty treats patients who suffer from disorders of the brain, spinal cord or other areas of the nervous system that could be helped by surgery or other less invasive approaches. Some of the more common conditions include brain tumors, stroke, spinal cord injury and Parkinson's disease.
Today, technological innovations have vastly improved the speed and accuracy of diagnosing neurological ailments. When treatment needed, the trend is now toward minimally invasive surgery and other therapies that are less painful for patients, require shorter and fewer hospital stays, and resulting in better, faster recoveries. Scientific advances are also making great strides in drug treatment and other therapies.
At Washington Hospital in Fremont, the Taylor McAdam Bell Neuroscience Institute world-class physicians, technologists, nurses and other professional staff use powerful, leading-edge, minimally-invasive technologies to treat adults and children with a wide range of neurological diseases and disorders.
"Due to exciting developments in both diagnostics and intervention, we can now help many patients with conditions that were previously considered untreatable," says neurosurgeon Dr. Sandeep Kunwar, M.D., co-medical director of the Institute's Gamma Knife Program.
Increasingly powerful technology are making it possible for doctors to assess brain and spinal problems with greater precision and accuracy, improving their ability to diagnose abnormalities. For example, scans performed with state-of-the-art magnetic resonance imaging (MRI) technology now give diagnosticians twice the information they used to glean from previous generations of the technology.
"At Washington, we also use PET (positron emission tomography) imaging to look at functional disorders of the brain," states Dr. Kunwar. "This is especially useful in patients with complicated problems. Now, we can more closely examine the different regions of the brain that control certain functions performed by the body."
"Before PET, it was difficult to identify exactly what was happening in the brain, what was abnormal about the tissue and whether it would be safe to do surgery," he adds. "Now, we know a lot more, and it allows us to make better decisions about treatment."
Some diagnostic imaging technologies are now used in the operating room immediately before and during surgery. Called neuro-navigation, these procedures act much like a GPS system, giving surgeons a functional map with the best possible, real-time information about the condition.
To treat some brain disorders, doctors can now map where speech and motor functions are located. This provides more specific information to help surgeons remove many tumors, or larger parts of tumors, that used to be considered inoperable. The mapping procedures can be performed with patient asleep or awake, making it possible to diagnose problems that affect speech, for example.
Also, advanced technologies, such as the state-of-the-art Gamma Knife PERFEXION(tm) at Washington Hospital, can treat brain tumors very aggressively with better control than surgeons have ever had. With the Gamma Knife, many benign tumors can be cured non-invasively, meaning that no incisions are required. Instead, highly focused doses of radiation are applied to destroy all of part of the tumor. The procedure is nearly painless and most patients return home the same day.
For some people suffering from Parkinson's disease, physicians are now performing a procedure called Deep Brain Stimulation, as an alternative to medication that is no longer effective against tremors and other symptoms of the disease. Much like with a cardiac pacemaker, a wire is placed into a deep part of the brain, and electrical impulses stimulate brain issue that affects the patient's motor functions.
"This procedure can improve symptoms and has the potential to give patients with Parkinson's disease up to seven or eight additional years of function," says Dr. Kunwar.
In treating spinal conditions, surgeons can now perform complex procedures without having to cut or move muscles to reach the surgical site. This means less an easier, less painful recovery and less resulting scar tissue. Minimally invasive procedures like the XLIF(r) to treat degenerative disc disease and the XSTOP(r) to treat spinal stenosis are proving highly effective in relieving pain. Moreover, patients are usually able to resume normal activities more quickly. Both of these surgeries, as well as other advanced minimally invasive neurosurgical procedures, are being performed at Washington Hospital.
In another surgical advancement now done at Washington, surgeons can remove tumors that arise from the base of the skull during a procedure called Keyhole Craniotomy. Performed through a very small incision, the procedure removes the tumor with minimal effect on brain tissue. Because the incision is so small, patients recover more quickly, while risks and complications are fewer.
The future is near
Today, much of the scientific research done over the last 30 years is now being investigated on humans in clinical trials. Treatments that are showing great promise for the near future include improvements in drug therapy, growth factor therapies and gene therapy. Doctors are also performing clinical trials on immunotherapies that have great potential to help people with Parkinson's and Alzheimer's disease.
"Another hot topic being researched is the role of stem cells and the possibility of reactivating them to treat damaged parts of the brain and spinal cord," Dr. Kunwar adds.
Clinical trials in humans are also being performed on new, targeted drugs to treat brain tumors.
"In the next ten years, we anticipate there will be many changes in the way we respond to diseases that before were thought of as untreatable, including conditions like spinal cord injury," Dr. Kunwar states. "The future of neurosurgery has so much potential to improve and extend lives for many people."
For more information about the Taylor McAdam Bell Neuroscience Institute at Washington Hospital, visit www.whhs.com.