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neurosurgery

Neurosurgery

Neurosurgery (or neurological surgery), constitutes a medical discipline and surgical specialty that provides care for adult and pediatric patients in the treatment of pain or pathological processes that may modify the function or activity of the central nervous system (e.g. brain, hypophysis, and spinal cord), the peripheral nervous system (e.g. cranial, spinal, and peripheral nerves), the autonomic nervous system, the supporting structures of these systems (e.g. meninges, skull & skull base, and vertebral column), and their vascular supply (e.g. intracranial, extracranial, and spinal vasculature).

Treatment encompasses both non-operative management (e.g. prevention, diagnosis – including image interpretation – and treatments such as, but not limited to neurocritical intensive care and rehabilitation) and operative management with its associated image use and interpretation (e.g. endovascular surgery, functional and restorative surgery, stereotactic radiosurgery, and spinal fusion – including its instrumentation.

Today, neurosurgery is part of the portfolio of all university hospitals. It is a highly specialized service that, because of high costs, is often centralized.

Neurosurgery is one of the fastest developing medical specialities, and results are continuously improving through the introduction of new treatment methods. Recent major advancements in neurosurgery include the application of microsurgery, the advancements in Imaging techniques and the high quality and increased amount of a intensive care unit.

To improve the cost transparency of the local health care system, treatment cost was recently referenced to disease related groups (DRG). To define a valid case mix index (CMI), patient status at admission must be well documented. Concurrently, treatment quality must be closely monitored to provide transparency between health care providers with respect to the clinical outcome and the complications during the treatment process 1) 2) 3).

Subspecialties

Brain Tumor Surgery

Cerebrovascular Surgery

Epilepsy Surgery

Neurotraumatology

Pediatric neurosurgery

Peripheral nerve surgery

Skull Base Surgery

Spinal Neurosurgery

Functional Neurosurgery

Stereotactic Neurosurgery


The most important changes have occured in the fields of neurooncology, vascular neurosurgery and spinal surgery. Inter-specialty collaboration is establishing itself as a model of care. These data may guide resource allocation for a population increasing both in number and in age 4)

History

Books

see Books

Journal

Neurosurgery Journal

see Neurosurgery Journal

Impact Factor: 3.780

Future

Globally, the lack of access to basic surgical care causes 3 times as much deaths as HIV/AIDS, tuberculosis, and malaria combined. The magnitude of this unmet need has been described recently, and the numbers are startling. Major shifts in global health agenda have highlighted access to essential and emergency surgery as a high priority. A broad examination of the current global neurosurgical efforts to improve access has revealed some strengths, particularly in the realm of training; however, the demand grossly outstrips the supply; most people in low-income countries do not have access to basic surgical care, either due to lack of availability or affordability. Projects that help create a robust and resilient health system within low- and middle-income countries require urgent implementation. In this context, concurrent scale-up of human resources, investments in capacity building, local data collection, and analysis for accurate assessment are essential. In addition, through process of collaboration and consensus building within the neurosurgical community, a unified voice of neurosurgery is necessary to effectively advocate for all those who need neurosurgical care wherever, whenever 5).

1)
Clark JC, Spetzler RF. Creating a Brave New World for Neurosurgery. World Neurosurgery. 2011; 75 (5):608–9. doi: 10.1016/j.wneu.2010.12.032
2)
Scho¨b O, Kocher T, Langer I. Fu¨nf Fragen an die Medizinische Qualita¨tssicherung: Die Selbststeuerung erhalten. Bulletin des me´decins suisses. 2014; 95(39):1446–8.
3)
OECD/WHO. OECD Reviews of Health Systems: Switzerland 2011.
4)
Kamat AS, Parker A. The evolution of neurosurgery: how has our practice changed? Br J Neurosurg. 2013 Dec;27(6):747-51. doi: 10.3109/02688697.2013.786805. Epub 2013 Apr 24. PubMed PMID: 23611638.
5)
Park KB, Johnson WD, Dempsey RJ. Global Neurosurgery: The Unmet Need. World Neurosurg. 2016 Apr;88:32-5. doi: 10.1016/j.wneu.2015.12.048. Epub 2015 Dec 28. PubMed PMID: 26732963.
neurosurgery.txt · Last modified: 2018/09/01 08:24 by administrador