Surgical Techniques

Endoscopic discectomy is a minimally invasive surgical technique in which the fragment of a herniated disc compressing a nerve root is removed using an endoscope inserted through a small incision. The aim is to preserve muscle and allow faster recovery.

Microdiscectomy is a microsurgical disc removal technique performed through a posterior approach under the operating microscope to relieve a herniated disc fragment pressing on a nerve root. It is most often used in the lumbar spine, and less commonly the cervical spine, to reduce radicular pain.

ACDF is a common spine operation in which a diseased cervical disc is removed through an anterior (front) approach to the neck and the resulting space is filled with a graft/implant to fuse two vertebrae together. The goal is to relieve disc and bony structures compressing a nerve root or the spinal cord.

Endoscopic cervical discectomy is a minimally invasive surgical technique in which a disc fragment compressing a nerve root in the neck is removed using an endoscope inserted through a small incision. In selected cases it aims to preserve motion without fusion and to reduce tissue damage.

Lumbar laminectomy is a decompression operation in which the bony lamina and related tissue compressing the neural structures in the lower spine are removed from the back (posterior approach) to widen the spinal canal. It is most often performed for leg pain and walking limitation due to lumbar spinal stenosis.

Lumbar interbody fusion is a stabilization surgery in which a cage and bone graft are placed into the disc space between two lumbar vertebrae to permanently fuse the level. TLIF and PLIF are two common variants that reach the disc space from the back and are supported with pedicle screws.

Endoscopic transsphenoidal pituitary surgery is a minimally invasive skull base technique in which pituitary gland tumors are removed through the nose (endonasal), via the sphenoid sinus, with endoscopic guidance. The pituitary region is reached through the floor of the sella turcica without opening the skull.

Aneurysm clipping is an open microsurgical procedure in which a small titanium clip is placed across the neck of a brain aneurysm to exclude it from the circulation. It is a durable treatment option that aims to prevent rebleeding while preserving blood flow in the parent artery.

Microvascular decompression is a microsurgical procedure based on separating a blood vessel that is compressing a cranial nerve and placing a soft cushion between them. It is most often used for conditions caused by neurovascular contact, such as trigeminal neuralgia and hemifacial spasm.

Deep brain stimulation is an adjustable neuromodulation method that delivers controlled electrical stimulation through electrodes placed in deep brain nuclei. It is used to control the symptoms of selected movement disorders, primarily Parkinson's disease, essential tremor and dystonia.

Stereotactic radiosurgery (SRS) is an incision-free treatment in which a high dose of radiation is focused on a target in the brain or spine with millimetric accuracy in a single session or a small number of sessions. Gamma Knife and CyberKnife are two typical systems that deliver this approach.

A ventriculoperitoneal shunt is a surgical method in which excess cerebrospinal fluid (CSF) accumulating in the brain ventricles is diverted through a catheter-and-valve system to the abdominal cavity (peritoneum), where it is absorbed. It is used in the treatment of hydrocephalus to lower intracranial pressure.

Endoscopic third ventriculostomy (ETV) is a shunt-free surgical method in which a small opening is created with an endoscope in the floor of the third ventricle to provide an alternative pathway for accumulating cerebrospinal fluid. It is used in selected cases of obstructive hydrocephalus.

Carpal tunnel release surgery is a decompression procedure that frees the median nerve compressed within the carpal tunnel at the wrist by dividing the transverse carpal ligament (flexor retinaculum). It can be performed with an open or endoscopic technique and aims to reduce the pain, numbness, and weakness caused by carpal tunnel syndrome.

Decompressive craniectomy is an emergency surgical procedure in which a portion of the skull is temporarily removed and the dura is opened and enlarged to lower intracranial pressure. By preventing the swelling brain from being compressed within the closed skull, it aims to protect vital structures, and it is used particularly in severe head trauma and malignant (large) ischemic stroke.

Glial tumor resection is the removal of tumors arising from the brain's supporting (glial) cells through a craniotomy, in which a portion of the skull is temporarily opened. The goal is to remove as much tumor as safely possible while preserving brain function, which is why it is often supported by techniques such as awake surgery, neuromonitoring, and fluorescent staining.

Kyphoplasty (balloon kyphoplasty) is a minimally invasive surgical technique for painful vertebral compression fractures in which a balloon is placed percutaneously into the fractured vertebral body and inflated to create a cavity, after which bone cement (usually PMMA) is injected to stabilize the spine. It is most often used for osteoporotic compression fractures.

Percutaneous vertebroplasty is a minimally invasive technique for painful vertebral compression fractures in which bone cement (usually PMMA) is injected directly into the fractured vertebral body through a small skin entry to stabilize the vertebra. It is most often used for osteoporotic compression fractures.

Arteriovenous malformation (AVM) surgery is the microsurgical resection of the abnormal tangle of vessels (nidus) in the brain or spinal cord, where arteries connect directly to veins bypassing the capillary bed. It is often performed as part of a multimodal treatment plan together with methods such as embolization and/or stereotactic radiosurgery.

Carotid endarterectomy is a vascular surgical procedure in which the atherosclerotic plaque built up on the inner surface of the carotid artery in the neck is surgically removed. It is performed to reduce the risk of stroke and transient ischemic attack caused by carotid stenosis.

Chronic subdural hematoma drainage is a surgical procedure in which old blood that has collected over time between the brain and the dura is evacuated through a small hole drilled in the skull (burr hole). It is performed particularly in elderly patients to relieve symptoms caused by compression.

Convexity meningioma surgery is a neurosurgical procedure in which benign tumors arising from the membranes covering the outer surface of the brain (the convexity) are removed via craniotomy. Removing the tumor and the involved membrane as completely as possible aims to reduce the likelihood of recurrence.

Aneurysm coil embolization is an endovascular treatment that excludes a brain aneurysm from the circulation by filling its sac with platinum coils delivered from inside the blood vessel. A catheter is advanced, usually from the groin, to reach the aneurysm sac, where the coils are deployed.

Mechanical thrombectomy is an endovascular treatment that restores blood flow in acute ischemic stroke caused by large-vessel occlusion by removing the clot from inside the cerebral artery with a catheter. A stent retriever and/or an aspiration catheter is used.

Middle meningeal artery (MMA) embolization is an endovascular procedure that occludes the small dural vessels thought to feed a chronic subdural hematoma. It aims to reduce refilling and recurrence of the hematoma and may be performed alone or in addition to surgical drainage.

Cervical disc arthroplasty is a spinal surgery in which a damaged intervertebral disc in the neck is removed and replaced with a motion-preserving artificial disc. The aim is to relieve disc pathology compressing a nerve root or the spinal cord while maintaining motion at the treated level as far as possible, offering an alternative to fusion.

Lumbar disc arthroplasty is a spinal surgery in which a degenerated intervertebral disc in the lower back is removed and replaced with a motion-preserving artificial disc. The aim is to address the source of discogenic low back pain while maintaining motion at the treated level, offering an alternative to lumbar fusion.

Spinal cord stimulation (SCS) is a neuromodulation technique that delivers low-level electrical stimulation to the spinal cord through electrodes placed in the epidural space to manage chronic neuropathic pain. It is not a cure but a method aimed at reducing pain, and it is generally considered in refractory pain conditions such as failed back surgery syndrome (FBSS).