Functional Surgery in Neurosurgery Applications

What is Functional Surgery?

Functional surgery is the general name given to specialized surgical techniques in which special devices are used in parallel with technological developments to correct the loss of function in the patients' bodies, reduce pain, and help control.

Functional surgery in neurosurgery can be successfully applied in the following diseases:

• Hydrocephalus
• Parkinson's disease
• Tremor in hands
• Involuntary movements (Dystonia)
• Stiffness in arms and legs
• Contraction in the arms and legs (Spasticity)
• Epilepsy
• Pain treatment,
• Loss of sphincter control

Functional surgery is an advanced and still developing treatment method such as:

• Neuroendoscopic surgical methods
• Stereotactic surgical methods
• Guide systems used during surgical procedures such as neuromonitoring and neuronavigation
• Deep brain stimulation
• Neurophysiological systems such as Spinal Cord stimulation and nerve stimulation

Functional surgery can significantly improve patients' quality of life and improve their health and general well-being by correcting functional defects or helping to maintain control. However, like any surgical procedure, it has risks and side effects. Therefore, it is important to consult your doctor before any surgical procedure.

What are the Types of Functional Surgery?

There are many types of functional surgery that can be applied in different areas. Some types of functional surgery include:

Stereotactic Surgery

It is a minimally invasive and highly accurate method to reach lesions in the brain. With the 3-dimensional coordinate system, the lesion is reached as a point shot; Procedures such as biopsy, stimulation and radiosurgery can be performed.

Neuroendoscopic Surgery

They are optical systems that help surgical application with minimal tissue elimination by reaching the surgical area with the help of neuroendoscope. Neuroendoscopic surgery has a wide range of uses such as;

• Pituitary Surgery
• Endoscopic discectomy 
• Endoscopic Hydrocephalus surgery
• Intraventricular mass surgeries
• Skull base surgery

Since it is a minimally invasive method, the patient's hospital stay is short. The return of the patient to his daily life after the surgery can be in the early period.

Deep Brain Stimulation

In diseases such as Parkinson's disease, Tremor in the hands, Involuntary movements (Dystonia); It includes the placement of stimulation probes in the disease-related regions of the brain using stereotactic surgery methods and programming the stimulation according to the response of the patient with the external control unit.

Vagal Nerve Stimulation

It is aimed to reduce the frequency and use of examinations by stimulating the vagal nerve with electrical stimulus when there is difficulty in responding to drugs in epilepsy patients.

Spinal Cord Stimulation

Omurilik yaralanmalarında veya cerrahi tedaviye rağmen ağrı devam ediyorsa sinir hücrelerinin yanıt vermesine yardımcı olmak veya ağrı kontrol mekanizmasını düzenleyerek hastaların ağrılarını azaltmak için omurilik stimülasyonu kullanılır.

Sacral Stimulation

It can be applied in bladder control disorders or in the treatment of erectile dysfunction.

Shunt Surgery

In patients with hydrocephalus; It is the method used in cases where there is no transition to other spaces due to malabsorption or blockage in the brain. They are systems that will allow the fluid in the brain to drain into the abdomen or heart in order to treat the increase in cerebral fluid in the head and the resulting increase in pressure in the head.

Baclofen Pump Implantation

The Baclofen Pump is used in cases that cause spasticity such as spinal cord injury or inability to move the arms and legs due to spasticity in patients with cerebral palsy. With this procedure, a pump is placed under the skin in the abdomen and a catheter is placed in the spinal cord in order to reduce the systemic side effects of Baclofen Pump and to ensure regular dose control in the nervous system. After the process is completed, external control can be made with the help of a device and the pump can be filled with medication when necessary.

Functional Neurosurgery in Conclusion

Functional neurosurgery can carry high risks, as it is a delicate procedure for the brain tissue or nervous system. However, the risks can be minimized with the right patient selection, the use of the right surgical methods and a good follow-up. Functional neurosurgery can be an important option for suitable candidates and can significantly improve patients' quality of life.

Different types of functional surgery offer customized treatments for patients' different health problems. Like any surgical procedure, these procedures carry risks, so it is important to consult your doctor before any surgical procedure.