Neurosurgery

It is the field of medicine where surgical treatments of brain, spine, spinal cord and nerve diseases are performed.
Neurological Sciences Center has education, knowledge and experience above world standards; It consists of surgeons, neurologists, anesthesiologists and intensive care specialists, radiologists, psychiatrists, psychologists, physical therapy and rehabilitation specialists, physiotherapists, nurses and technicians. The diagnosis and treatment of the patients have been prepared using all the possibilities of technology and are carried out in specialized services and intensive care units. For a superior service, the department continues its studies on neuro-oncology, neurosurgery, epilepsy, spine surgery, pediatric neurosurgery, stereotactic and functional neurosurgery, peripheral nerve surgery and neuro-spinal trauma.

Surgical treatment is performed by applying microsurgical methods to tumors originates from the brain, spinal cord or nerve membranes, pituitary gland tumors and skull base tumors.

It includes surgery and other treatments for subarachnoid hemorrhage, aneurysms, cerebral and spinal arteriovenous malformations, and some cases of stroke. “Bypass” operations are also performed in cerebral vascular occlusions.

Specialized neurology and neurosurgery team successfully perform epilepsy surgeries. Monitoring is performed in epilepsy.

Spine and Spinal Cord Surgery Center is specialized in spinal cord and nerve surgery. In this center, lumbar hernia and neck hernia surgeries, spinal canal narrowing and calcifications, spinal and spinal cord tumors, congenital spinal cord and spinal disorders, scoliosis surgical treatments are performed. In addition, intrathecal drug pump applications are used for spasticity and pain treatments. Fractures of the spine caused by osteoporosis or tumor metastasis can be treated with spine strengthening surgeries such as kyphoplasty or vertebroplasty. In addition, injection applications can be performed in the treatment of spinal pain that does not require surgery.

Carpal tunnel syndrome, ulnar entrapment neuropathies, peroneal neuropathies, nerve compression such as meralgia paresthetica, nerve and plexus cuts and injuries are treated with microsurgery.

There are diseases of the spine due to different causes and treatment approaches specific to each disease and patient. Brain and Nerve Surgery Specialist Prof. Ahmet Hilmi Kaya stated that spinal wear occurs faster in those with genetic predisposition, and pointed out that the surgery of the spine, which has vital structures in an extremely restricted area, is also important and special.

Yeditepe University Koşuyolu Hospital Brain and Nerve Surgery Specialist Prof. Ahmet Hilmi Kaya stated that when these tumors are malignant, they disrupt the muscle, bone and membrane structure of the spine. In addition, it can cause paralysis or paralysis-like conditions by putting pressure on the surrounding, for example, nerves. “The spine, which is a very blood-circulated structure, creates a suitable environment for a tumor that occurs elsewhere in the body to metastasize.”

Prof Dr. Ahmet Hilmi Kaya gave the following information about the surgical approach in spinal tumors: “In order to determine the treatment method for spinal tumors, many evaluations are made such as the location, type of the tumor and what will be taken in the surgery. In benign tumors that originate from themselves, it is important to completely remove the tumor with surgical treatment in order to provide complete cure. In cases of malignant tumors of their own origin or tumors caused by metastasis from other regions, surgical and oncological treatments should be performed together to eliminate the pressure on the spinal cord when necessary. In cases where a part of the spine needs to be removed with the tumor, a new mechanical structure is created with screws and special materials instead of the removed part by engineering the spine. “

Prof. Ahmet Hilmi Kaya stated that like every system in the body, diseases of the spine can also be seen due to degeneration.

“Since the spine is the main column of the body, it is defined as the fastest aging tissue. The fact that the gel-like disc tissue located in the spine between the vertebrae does not have a vein in itself and can only be fed from cartilage tissue prepares the ground for early wear and hence hernias, ”he said.

Pointing out that spinal wear occurs faster in those with genetic predisposition, Prof. Ahmet Hilmi Kaya said, “Again, degeneration at the bone ends, spurring , formation of calcification in the facet joints and connective tissue that hold the spine, gradually narrow the spine and compress the spinal cord. If this narrowing is in the neck, it affects walking and balance, pain and muscle weakness begin. In waist, it causes a condition called “narrow channel”, “he said. Prof. Kaya said, “This condition always causes the person who walks comfortably for a long time to take a rest break and the distance he travels to decrease gradually. Surgical treatment of stenosis is like rewinding the age. “It can be performed successfully with a minimally invasive method, without damaging the structure of the spine and without harming the nerves.”

Prof Dr. Kaya said that in case of hernia formation, should should know if there is nerve compression, how is the structure of the disc, if it is a hernia that will not comfort the patient in the long term, does it threaten the nervous system, has it already caused nervous system symptoms, and what is the degree of pain?, and added: “The treatment method is decided by evaluating the patient’s history, examination findings and imaging results together. Since not every hernia requires surgical treatment, it is of great importance to distinguish normal from abnormal. “ Patients most frequently consult a physician for low back pain due to degenerative diseases. Abnormal hernia is seen in very few of the people in this group and surgical treatment is applied to a certain percentage of them. Even resting and drug therapy alone is effective in suitable patients. Blocks can be made around the nerve with some pain relieving and edema-relieving drugs. Underlining that we work together with the physical therapy and rehabilitation department in patients who do not require surgery, but if there are findings such as urinary incontinence and significant weakness in the leg, then surgical treatment is definitely applied, Dr. adding that trying different treatment methods in such a condition may result in irreversible problems.

Today, spine surgery is performed by minimally invasive method, endoscopic or microsurgery. Stating that these methods affect the structure of the spine less than classical open surgery and reduce the risks by revealing the tissue more clearly, Yeditepe University Hospital Brain and Nerve Surgery Specialist Prof. Ahmet Hilmi Kaya continued as follows: Dr. – “It provides access to the surgery area through tunnels called keyhole. Thus, the postoperative period is also more comfortable for the patient. We choose to apply surgical treatment when a degenerative problem occurs in an elderly patient who has a very good general condition, who regularly leaves his home and take walks, but now not able to do, due to disease. Because it is very important for the patient to return to an active life and maintain his health with movement. We prefer non-surgical methods to relieve complaints such as pain if a patient of the same age who does not live outside the home and who has general health problems cannot return to active life due to other reasons even if we perform surgical treatment. In other words, the priority in the decision of surgery is not the age of the patient, but his/her capacity. “

Where Are Spine and Spinal Cord Tumors Seen?

Spinal tumors generally occur in 3 different regions.

1. In the spine bones,
2. In meninges,
3. Inside the spinal cord.

Metastases usually occur in the spine. There are also primary tumors arising from the bone. Tumors in the spinal cord and its membrane are usually tumors originating from the nerve tissue.

The most common complaint is pain localized to the spine. Pain usually worsens at night. Complaints other than pain vary depending on the location of the tumor. For example, a tumor located in the neck area can cause loss of strength in arms and legs as well as pain. In the advanced period, the loss of strength progresses and paralysis may occur in the arms and legs, urinary incontinence and loss of sensation may be seen. If the location of the tumor is lower, that is, in the back or waist area, only the legs can be affected. Bladder and bowel functions are also among the affected areas.

The most common tumors in the spinal bones are metastases, that is, tumors that occur elsewhere in the body and spread to the spine. The most common ones we see in this group are the metastases of diseases such as lung cancer, breast cancer and multiple myeloma.

First of all, it is necessary to understand what kind of tumor is encountered by taking biopsy in spine tumors. In some cases, treatment can be started if the source of metastasis is known. Tumors associated with metastasis require a teamwork and are carried out with patients’ oncological treatments.