Comprehensive Neurosurgical Treatments and Procedures

Neurosurgical Treatments and Procedures

At PACE Hospitals, we treat complex brain and spine conditions with advanced diagnostics, expert neurosurgeons, and minimally invasive techniques to ensure safe, precise, and effective care.

Minimally Invasive Procedures

These procedures use small incisions, catheters, or targeted radiation, causing minimal tissue damage and faster recovery.

Endovascular Coiling

Endovascular coiling, or coil embolization or placement, is a minimally invasive procedure that treats brain aneurysms and arteriovenous malformations (AVMs). During this procedure the surgeon inserts a small tube into a blood vessel using a special X-ray (called fluoroscopy), moves the catheter into the aneurysm and inserts tiny platinum coils to fill it to block blood flow, which seals it off and prevent it from bursting or rupture.

Stereotactic Radiosurgery (SRS)

Stereotactic radiosurgery (SRS) is a precise radiation therapy that treats abnormalities in the brain and spine. It uses X-rays to destroy abnormal tissue by damaging the DNA of cells. This prevents the cells from reproducing and growing. This procedure attaches a special frame with pins to the patient's head. A CT, CAT scan, or MRI determines the tumour's location. A large dose of radiation is delivered from multiple directions. SRS can treat brain tumours, epilepsy, trigeminal neuralgia, and arteriovenous malformations (AVMs).

Deep Brain Stimulation Surgery (DBS)

Deep brain stimulation (DBS) is a procedure that implants a small device in the brain to send electrical stimulation to treat neurological conditions that cause disabling symptoms. It is commonly used for movement disorders, psychiatric conditions and epilepsy. This surgery is recommended for people whose symptoms are not controlled by medications or if the side effects of medications interfere with their daily activities.

Occipital Nerve Stimulation (ONS)

This is a surgical procedure that uses a medical device to treat chronic headaches and craniofacial pain. The ONS procedure is the least invasive procedure, which uses electrodes to send electrical impulses to the occipital nerves at the back of the head. This helps regulate pain signals and reduce headache intensity and frequency. It is considered for patients who have not responded to conventional medical therapies and offers an effective and reversible option for pain relief.

Minimally Invasive Spine Surgery (MISS)

Minimally invasive spine surgery uses small incisions, specialized instruments, and advanced imaging to treat spinal conditions. It can be used for procedures like discectomy, decompression, or fusion. This surgery reduces damage to surrounding muscles and tissues, leading to faster recovery, less pain, and lower complications. This procedure is effective in relieving nerve compression and treating neurological disorders.

Endoscopic (Keyhole) Neurosurgery

Performed using a thin endoscope through small openings or natural pathways.

Endoscopic brain tumor removal 

This is a minimally invasive technique used to treat brain tumors, including those in deep or delicate areas such as the base of the skull. Using a thin tube with an endoscope, surgeons access the tumor through small nose openings or tiny incisions. This approach allows precise tumor removal while minimising damage to surrounding brain tissue. This procedure relieves pressure on the brain, reduces neurological symptoms, and promotes speedier recovery with fewer complications.

Endoscopic Third Ventriculostomy (ETV)

ETV is a procedure used to treat hydrocephalus, a condition where excess cerebrospinal fluid (CSF) builds up in the brain. In this surgery, a small opening is created in the floor of the third ventricle using an endoscope. This allows the trapped fluid to bypass the blockage and flow normally, reducing pressure inside the brain. ETV helps relieve symptoms such as headaches, nausea, vision problems, and balance issues, and in many cases, avoids the need for a permanent shunt.

Spine & Peripheral Nerve Surgeries

These may be open or minimally invasive depending on the case.

Nerve Decompression Surgery

This is a surgical procedure aimed at relieving pressure on a nerve, often due to herniated discs, spinal stenosis, or nerve entrapment syndromes like carpal tunnel syndrome. The aim of the surgery is to reduce pain, restore its function, and prevent further nerve damage. Nerve decompression surgery, which involves removing bone spurs, disc material, or tissue compressing the nerve, is often performed after conservative treatments like medications, physical therapy, or injections fail to provide adequate relief, especially for chronic pain and mobility loss.

Discectomy (Slipped Disc Surgery)

This is performed to remove the portion of a herniated (slipped) disc that is pressing on nearby nerves or the spinal cord. This pressure can cause symptoms such as severe back pain, leg pain (also called sciatica), numbness, or weakness. By removing the offending disc material, the surgery relieves nerve compression, restores normal nerve function, and significantly reduces pain and neurological symptoms.

Laminectomy

Laminectomy involves removing a part of the vertebral bone called the lamina to create more space within the spinal canal. It is commonly used to treat spinal stenosis, where the narrowing of the canal compresses nerves. This procedure decompresses the spinal cord and nerve roots, improving symptoms like pain, tingling, weakness, and difficulty walking.

Spinal Fusion

Spinal fusion is a procedure where two or more vertebrae are permanently joined together using bone grafts and implants (such as rods and screws). It is used in conditions like spinal instability, fractures, deformities, or degenerative disc disease. By stabilising the spine, this surgery prevents abnormal movement that can damage nerves, thereby reducing pain and protecting neurological function.

Carpal Tunnel Release

Carpal tunnel release is performed to treat Carpal Tunnel Syndrome, a condition where the median nerve is compressed as it passes through the wrist. This compression leads to symptoms like numbness, tingling, weakness, and pain in the hand and fingers. During surgery, the tight ligament (transverse carpal ligament) is cut to relieve pressure on the nerve. This improves nerve function, restores hand strength, and reduces or eliminates neurological symptoms.

Peripheral Nerve Repair / Grafting 

This is used to treat nerve injuries caused by trauma, cuts, tumors, or long-standing compression. When a nerve is damaged or severed, signals between the brain, spinal cord, and muscles are disrupted, leading to weakness, loss of sensation, or paralysis. In this procedure, surgeons either directly reconnect the nerve ends or use a nerve graft to bridge the gap. This helps restore nerve continuity, allowing nerve fibers to regenerate and gradually recover function, sensation, and movement.

Rhizotomy

Rhizotomy is a procedure that involves cutting or removing specific nerve roots in the spinal cord to treat chronic pain or muscle spasticity. During a rhizotomy, a surgeon uses a surgical tool, chemical, or electrical current to destroy nerve fibres that send pain signals to the brain. It can provide immediate pain relief that can last for several years. However, the pain can return if the nerve heals and regrows. Other risks of the procedure include excess bleeding, local infection, nausea or vomiting, and sensory changes like numbness or sensitivity.

CSF Diversion Procedures

These manage cerebrospinal fluid (CSF) flow and pressure.

Ventriculoperitoneal (VP) Shunt

A ventriculoperitoneal (VP) shunt is a surgical procedure and device that treats hydrocephalus, a condition where there is too much cerebrospinal fluid (CSF) accumulation in the brain and spinal cord. During the procedure, a surgeon places a thin plastic tube or catheter into a ventricle of the brain and another catheter under the skin behind the ear. The procedure takes about 1.5 hours and is performed in an operating room under general anaesthesia. This prevents pressure from building up in the brain.

General Surgical Procedures (Supportive)

Used across multiple specialties including neurosurgery.

Surgical Drainage

Surgical drainage is a procedure that involves inserting a tube into a wound, body cavity, or organs to remove blood, pus, or other fluids. There are different drains, including closed drains (connected to a collection device) and open drains (which allow fluid to drain freely into a dressing or container). Surgical drainage is commonly used in procedures involving abscesses, infections, or after surgeries like abdominal or orthopaedic operations.

Surgical Excision

Surgical excision is a medical procedure that removes tissue from the body using a sharp knife, laser, or other cutting tool for diagnostic or therapeutic purposes. It is commonly used to remove abnormal growths or tumours, such as skin lesions, moles, cysts, and skin cancers. This procedure is carried out under local anaesthesia, and it can be done in various parts of the body, such as the skin, organs and bones, depending on the condition the incision is then closed with stitches.

Surgical Debridement

Surgical debridement is a medical procedure that removes dead, damaged and infected tissue from a wound using a scalpel or other surgical instrument. During this procedure, the surgeon cleans and disinfects the skin around the wound, examines the wound to check for foreign objects, and removes the infected or damaged tissue. The goal of debridement is to improve the healing potential of the remaining healthy tissue.

Open Neurosurgery

These involve opening the skull or spine for direct access.

Craniotomy

A craniotomy is a surgery where a small part of the skull is temporarily removed to reach the brain to remove a brain tumour or a sample of brain tissue. A surgeon uses specialized tools to remove a section of bone from the skull, called a bone flap. The bone flap is then temporarily removed and replaced after the surgery. It is performed to treat various brain conditions, including brain tumours, blood clots, bleeding in the brain, seizures, brain aneurysms, and vascular malformations.

Posterior Fossa Craniotomy

Posterior Fossa Craniotomy is a specific type of craniotomy that involves removing and replacing a bone flap to treat lesions in the posterior fossa (a small space at the base of the skull, near the brainstem and cerebellum). This procedure is often used to treat conditions like brainstem tumours, cerebellar tumours, or Chiari malformation.

Craniectomy

A craniectomy is a major brain surgery which involves removing a part of the skull to reduce Intracranial pressure (ICP) in the brain due to swelling, inflammation, or extra fluid. This pressure can be life-threatening and cause brain damage. It's often performed after a traumatic brain injury (TBI) or to treat conditions that cause brain swelling or bleeding.

Clot Evacuation

Clot evacuation is a procedure to remove a blood clot in the brain. A surgeon typically performs clot evacuation through a craniotomy. The procedure aims to relieve pressure on the brain caused by the build-up of blood, which can lead to brain damage; removing this clot helps restore normal function of the brain and reduces the risk of further complications like brain herniation.

Surgical Clipping (Aneurysm Clipping)

Surgical clipping, or microsurgical clipping, is a procedure used to treat brain aneurysms by placing a metal clip at the neck of the aneurysm to block blood flow and prevent rupture. The recovery time typically takes 4 to 6 weeks, though it may be longer if the aneurysm has ruptured. This method carries a low risk of bleeding in the brain or disrupting blood flow to surrounding areas.

Lesionectomy

A lesionectomy is a surgical procedure performed to remove a brain lesion, or abnormality, that causes seizures. A neurosurgeon makes a temporary opening in the skull, called a craniotomy, and removes the lesion with surgical tools. Less invasive methods are also available, such as using thin probes guided by MRI to enter the brain. It may cause language deficit, memory, and cognitive decline.

Anterior Temporal Lobectomy

Anterior temporal lobectomy is a surgical procedure where a portion of the front part of the temporal lobe of the brain is removed. It is commonly performed to treat drug-resistant epilepsy. The procedure aims to control seizures by removing parts of the brain such as the amygdala, hippocampus, and anterior temporal gyri.

Microvascular Decompression (MVD)

Microvascular decompression (MVD) is a procedure that treats trigeminal neuralgia, a condition that leads to severe facial pain. The procedure involves making a small cut behind the ear and then drilling a small hole in the skull to reach the nerve. The surgeon then moves the blood vessels away from the nerve and inserts a pad between the nerve and the arteries, helping to reduce the pain or other symptoms. MVD has a long-term success rate of about 80%. Most patients experience immediate pain relief, and 75–80% experience complete pain relief after 1–2 years.

Burr Hole Drainage
Burr hole drainage is a surgical procedure that treats conditions caused by excess fluid around the brain, such as subdural hematomas and hydrocephalus. During the procedure, a surgeon drills one or more small holes in the skull and also inserts a flexible rubber tube to drain the fluid and leaves it in place for a few days to relieve pressure on the brain.

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