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Brain and Spinal Tumor Surgery

Brain and Spinal Tumor Surgery

Brain & Spinal Tumor Surgery

Surgery is the first and most common treatment for most people with brain and spinal tumors. Surgical removal and continued monitoring may be the only treatment for some tumors like brain and spinal tumors. The goals of the surgery could include the following:

  • Complete removal (resection) of the brain tumor
  • Partial removal of tumors near sensitive areas of the brain relieves symptoms and facilitates or increases other treatments’ effectiveness. Less pressure within the skull can mean reduced symptoms and improved ability to function (for example, to think, speak or see better).
  • A biopsy — a surgical procedure to remove a small sample of a brain tumor for examination under a microscope — is usually performed during surgery to remove the tumor. A biopsy can be performed as a separate procedure if the tumor can’t be removed without damaging critical parts of the brain or if the patient is otherwise not a candidate for surgery. A biopsy lets doctors confirm the diagnosis (including tumor type, malignancy, and grade) and recommend the most appropriate treatment. Doctors who cannot perform a biopsy will diagnose the brain tumor and plan the treatment based on other test results. It may take a week or longer after the biopsy to find out the name and type of your brain tumor.

The challenge of the brain and spinal tumor surgery is removing as much of the tumor as possible without severely damaging normal brain tissue, which demands skill and experience, as well as advanced technology and a well-orchestrated team.

Dr. Abdul Baker is the best option in this scenario because of his immense experience as a neurosurgeon in Texas.

Brain and Spinal Tumor Surgery

Preparing for Brain Tumor Surgery

To identify the exact location of the brain and spinal tumor and plan the brain surgery procedure, the neurosurgeon will order imaging tests as needed, which may include:

Your neurosurgeon may use fiducial markers — small stickers that look like white doughnuts — to target certain areas for surgical resection or treatment. They are painlessly affixed to your scalp before your operation by a member of your radiology team.

A CT or MRI scan with the fiducials in place creates a 3D map of your head. During surgery, the fiducials provide a series of reference points for your surgeon and integrate navigation during surgery with the 3D map.

This imaging-assisted technique helps your surgeon safely find the way around your brain and precisely locate tumors, targets for deep brain stimulation, and other lesions in three dimensions as they work, almost like a GPS.

The neurosurgeon will use the map to plan the procedure to avoid areas of the brain associated with key functions.

You may be scheduled to have your fiducials attached a day or two before your surgery. It’s important not to disturb or remove them. Ask your surgeon when they plan to attach them since you cannot shower or wash your hair once they are in place. They will be removed once your operation is complete.

In addition to pre-operative testing and imaging, your doctor will instruct you on which medications to take and not to take before your procedure. Brain and spinal tumor surgeries are complicated; you need proper pre and post-operative care.

Your doctor will also discuss whether you need to stop eating at a certain time before your surgery.

Types of Brain Tumor Surgery

Craniotomy

craniotomy is the most common type of surgery to remove a brain tumor. This procedure involves making an incision in the scalp and removing a piece of bone from the skull to give the neurosurgeon access to the tumor. Carefully planned surgical procedures can help the neurosurgeon address challenging skull base tumors.

MRI-Guided Laser Ablation

MRI-guided laser ablation is a minimally invasive neurosurgical technique for a number of diseases, including brain tumors. The treatment uses lasers to target and destroy the tumor.

The procedure can help surgeons address the most serious brain tumors, including glioblastoma multiforme and brain tumors that are located close to sensitive structures in the brain, making them hard to access through traditional open surgery.

MRI-guided laser ablation can offer reduced pain after surgery and shorter recovery time compared with craniotomy.

Endoscopic Brain Tumor Surgery (Neuroendoscopy)

Neuroendoscopy is a minimally invasive surgical procedure in which the neurosurgeon removes the tumor through small holes (about the size of a dime) in the skull or through the mouth or nose. A surgery done through the nose is called an endonasal endoscopic surgery.

This approach allows the surgeon to access areas of the brain that cannot be reached with traditional surgery and remove the tumor without cutting or harming other parts of the skull.

Tubular Retractor System for Neurosurgery

The tubular retractor system is the latest minimally invasive procedure that can help your neurosurgeon manage several serious conditions, including brain tumors.

A retractor is any instrument that moves or holds tissue so a surgeon can reach a particular area. The tubular retractor is valuable because it moves aside the folds and delicate tissues of the brain with less risk of damage than other surgical methods — it displaces the tissue instead of cutting through it.

The tubular retractor system can be especially useful in situations when a tumor is located deep in the brain. It also offers a less invasive option than traditional open surgery (craniotomy), just like minimally invasive spine surgery.

Brain and Spinal Tumor Surgery by dr baker

How the Tubular Retractor System Works?

  • The surgeon makes a small incision in the skin and a small opening in the skull.
  • Computerized navigation helps the surgeon move the tubular retractor gently through the brain’s white matter and gain access to the tumor.
  • The surgeon works through the tubular retractor to extract the tumor. A fiber optic camera can be used to help visualize the area.
  • Once the problem is corrected, the surgical team withdraws the instruments, removes the tubular retractor, and closes the small incision.

Because the tubular retractor system involves a smaller incision and less disruption to the brain tissue, it may involve less risk, less discomfort, and a shorter recovery period than what is associated with traditional surgery.

Your Johns Hopkins neurosurgeon will work with you to choose the most appropriate surgical procedure for your individual situation.

Intraoperative Imaging

Specialized MRI and CT machines in the operating room provide real-time mapping of brain anatomy during surgery, helping doctors better navigate delicate structures surrounding the tumor.

Neurosurgeons can also use intraoperative imaging to immediately check whether any lingering tumor tissue remains visible on scans.

What are the treatment options for someone with an inoperable brain tumor?

Brain tumors could be considered inoperable because:

  • They don’t have clear borders and are hard to distinguish from healthy tissues.
  • They are too close to areas of the brain that control vision, language, body movements, or other important margins.
  • Surgery would result in a significant loss of function.

Some tumors are labeled “inoperable” but can be removed by neurosurgeons with specialized expertise. If you’ve been told your tumor is inoperable, consider seeking a second opinion at a large, multidisciplinary brain tumor center.

These teams typically offer advanced surgical techniques that allow greater access to hard-to-reach sections of the brain.

Despite advancements in treatment, a tumor’s biology, location, or behavior may make it truly inoperable. In such cases, your doctor may recommend other treatments, such as radiation, chemotherapy, immunotherapy, or clinical trials. Spinal tumor surgery can also be inoperable, but your doctor will suggest suitable treatment options.

Awake Surgery for Brain Tumors

What is “awake” brain tumor surgery?

Awake brain tumor surgery, also known as intraoperative brain mapping, is a procedure performed while the patient is awake but sedated. This allows the neurosurgeon to stimulate a part of the brain during the surgery to identify important functional areas to avoid.

This procedure can be used to remove tumors that are often considered inoperable due to size and/or location or those that have spread throughout the brain and don’t have clear borders, such as some types of glioma. Awake brain surgery can shrink these tumors.

This type of surgery is not for everyone, and it has some limitations, including:

  • The patient’s general health (e.g., awake brain surgery is not performed in patients with some types of sleep apnea and those who are obese)
  • Whether the patient will be able to remain calm during the procedure and respond to the neurosurgeon

If you visit Dr. Baker, he diagnoses the patient’s symptoms thoroughly and then suggests whether a patient needs “awake brain surgery” or not.

How Does Awake Brain Tumor Surgery Work?

The neurosurgeon and neuroanesthesiologist will work together to determine the most appropriate type of anesthesia for each patient. The patient may be:

  • Awake throughout the procedure: The patient will receive a nerve or scalp block — an injection of medication to block pain — and local anesthesia — medicine to numb a small part of the body — on the scalp.
  • Sedated at the beginning and end of the procedure and awake in the middle: The patient will receive a scalp block and a little anesthesia for sedation at the beginning. The neuroanesthesiologist stops the sedation when the neurosurgeon is ready to remove the brain tumor. After that, the neuroanesthesiologist sedates the patient again.
  • Put to sleep at the beginning and end of the procedure and awake in the middle: The patient will receive a nerve block and general anesthesia — medicine that makes the patient unconscious. The neuroanesthesiologist will wake the patient when the neurosurgeon is ready to remove the brain tumor and put the patient to sleep again.

During surgery, the neurosurgeon will stimulate the area around the tumor with small electrodes. To precisely locate the functional areas of the brain that must be avoided, the neurosurgeon or another doctor will ask the patient to perform tasks such as talking, counting, and looking at pictures.

The neurosurgeon will use computer images of the brain taken before and during the procedure and the patient’s responses to create a map of the functional areas of the brain.

The neurosurgeon then removes as much of the tumor as possible while avoiding the functional areas of the brain.

Throughout the procedure, the neuroanesthesiologist will ensure the patient does not feel any pain, monitor vital signs (heart rate, breathing, and blood pressure), and talk to the patient to help the patient remain calm.

Care and Recovery After Brain Tumor Surgery

After your brain tumor surgery, you will likely spend the night in a neuro-critical care unit (NCCU) for observation. You may be connected to IVs, a heart monitor, a catheter, and an oxygen mask. You will also have a dressing (bandage) on your head for a day or two.

When you leave the NCCU, you will continue recovery at a neurosurgery nursing unit. You should be able to be out of bed eating and taking short walks the day after surgery. Once you eat and drink normally, the IVs will be removed from your arm.

You should not experience a lot of pain after surgery. Most people take acetaminophen for minor discomfort, but stronger pain relievers may be appropriate, as your doctor recommends. The same post-operative concerns prevail for spinal tumor surgery.

How Long is a Hospital Stay After a Brain Tumor Surgery?

A typical hospital stay after brain tumor surgery is two to five days. An MRI or CT scan will be performed the day after surgery to benchmark the success of the treatment.

The exact length of stay depends on many factors, such as the type of surgery performed and whether any complications require further treatment.

Going Home After Brain Tumor Surgery

Before being released from the hospital, you will receive detailed instructions about caring for yourself at home and what to expect during recovery.

After you are released from the hospital, you can continue your recovery at home with home-based or outpatient physical, occupational, and speech therapy, as needed.

You will need to return for a follow-up visit with your surgeon in one week to assess your health and remove any staples or stitches. In some cases, they will need to stay in for longer.

It will take time to return to your usual level of energy. Healing requires extra rest. The amount of time required to recover after brain surgery is different for each person, and it depends on the following:

  • The procedure used to remove the brain tumor
  • The location of the tumor within the brain
  • Areas of the brain affected by the surgery
  • Your age and overall health

For Brain and Spinal Tumor Surgery, Dr. Abdul Baker is the Best Choice!

Contacting the right doctor and the right medical center predicts the success of any surgical procedure. Dr. Abdul Baker, a highly experienced neurosurgeon in Sherman and Plano, Texas, has performed hundreds of brain and spinal tumor surgeries. You can contact and visit him for a successful surgery.