Neurosurgery

Neurosurgery covers the diagnosis and surgical treatment of diseases, injuries and abnormalities in the nervous system, such as cranial, brain and spinal cord injuries, tumours and other abnormalities, bleeding, vascular malformations and diseases of the spine, as well as functional disorders such as pain, spasticity, epilepsy and movement disorders.

At our hospitals, the spectrum of neurosurgery mainly covers conditions affecting the spine, such as herniated discs, vertebral fractures, spinal deformities and tumours of the spinal cord.

Symptoms and diagnosis

Depending on their illness, patients may experience a range of different symptoms. You may suffer from back or neck pain, or pain or weakness in the arms and legs. Certain diseases of the brain can cause headaches or problems with speech, writing or walking.

All possible treatment options will be explored as part of an initial examination with the neurosurgery specialist. Depending on the symptoms and suspected illness, it is essential that various additional radiological examinations are carried out, such as a conventional X-ray or MRI scan.

Treatments

With the exception of people with significant neurological impairments, all patients can benefit from medication (painkillers and anti-inflammatory drugs), physical therapy (physiotherapy, spinal manipulations, acupuncture, massages) or pain therapy by infiltration (injections of medication directly into the affected vertebral areas). If these conservative treatments do not remedy the pain, a surgical procedure may be advisable, which will be discussed in detail with the patient.

There are various risks associated with surgery, depending on the type and site of the operation. Thanks to the innovative technology available in our clinics, patients with spinal conditions are offered minimally invasive surgical procedures to reduce postoperative pain, shorten their stay in hospital and enable them to return to everyday life quickly.

For certain conditions such as herniated discs (lumbar and cervical spine) and decompression surgery on the lumbar spine, treatment is provided at the day clinic, with the option of spending the night in the clinic after the operation. Surgery for other conditions may require the patient to stay for three to seven days at the clinic.

Rehabilitation

In the postoperative phase, a multidisciplinary team (surgeon, physiotherapist, nursing staff) will assist the patient throughout their recovery period.

The success of neurosurgical treatment is dependent on the ability to offer scientifically sound treatments, tailored to the needs of each patient.

Thanks to new minimally invasive surgical techniques and early postoperative mobilisation, our patients are often able to go home the evening of the operation or the following day.

Depending on the type of surgery performed, normal everyday life can usually be resumed within three to six weeks after the operation.

For certain patients, especially after ‘salvage surgery’ on the spine, it may be beneficial to spend 7 to 14 days in a rehabilitation clinic. as this can facilitate a faster and more complete recovery.

FAQs

When should you see a neurosurgeon?

In the event of persistent or very painful symptoms that are affecting your day-to-day life, such as back or neck pain, pain or weakness in the arms and legs, or neurological issues (problems with speech, writing or walking), a consultation with a specialist is recommended. If these symptoms emerge suddenly, are particularly pronounced or are causing you significant worry, you should contact a specialist or a hospital immediately.

For certain patients who have already undergone surgery for a spinal condition, a second opinion or follow-up consultation with a neurosurgery specialist may be required in order to plan a ‘salvage operation’. This is an operation to realign the spinal column and to correct any general imbalance that often results from previous surgery.

What is the difference between spinal surgery and neurosurgery?

The two fields overlap. For a long time, neurosurgery focused more on relieving pressure on the nerves, while spine surgery, a key area of orthopaedics, focused on procedures known as ‘spinal instrumentation’, for example in the case of fractures. In the past, operations would often involve two surgeons, each contributing their own personal expertise. The decompression surgery to relieve pressure on the nerves in the case of spinal stenosis was performed by a neurosurgeon, for example. The spinal surgeon would then perform a fusion operation in the segment being operated on, to address any instability or curvature.

Nowadays, the question no longer arises as to which specialist is the most suitable. In both disciplines, doctors specialise in the entire treatment spectrum for spinal diseases. Treatment options range from outpatient infiltrations and sclerosis of nerves, to minimally invasive inpatient procedures, disc prostheses and fusion surgery.

How long do you have to stay in hospital after an operation like this?

This depends on the type of surgery you have and your state of health. Certain procedures can be performed on an outpatient basis (in the day clinic). There is also the option of staying overnight in hospital. For more intensive surgery, you may have to stay in hospital for three to seven days.

Should you undergo a course of rehabilitation after a neurosurgical procedure?

This depends entirely on the type of surgery performed. During your stay in the clinic, your surgeon will recommend either an inpatient or outpatient rehabilitation programme. The entire nursing team will offer you rehabilitation measures that are tailored to your needs.

When should you ideally start rehabilitation?

Rehabilitation after a neurosurgical procedure begins on the day of the operation (for patients whose surgery was minimally invasive) or on the following day. A special physiotherapy team will look after you throughout your hospital stay and, in consultation with the surgeon, will offer you a rehabilitation plan tailored to your needs.

What activities are allowed after the operation and how quickly can I get back to my everyday life?

Depending on the type of surgery you have had, you may be able to resume your normal routine three to six weeks after the operation. However, the restrictions specified by the surgeon must be observed during the first six weeks. For example, you must avoid twisting and bending your back too forcefully, and you must not lift, push or pull items weighing more than 2.5 kg.

You must inform your employer that you will be unfit for work for around six to twelve weeks. However, patients are frequently able to resume work before the end of this period. It is advisable to exercise caution and common sense. For example, do not force anything if you are in pain.

When will I be able to drive again?

You can drive again once you feel ready to stop taking any opioid painkillers (based on morphine) and your surgeon has given permission. In general, this is two to three weeks after lumbar decompression and discectomy, and four to six weeks after lumbar fusion surgery.

Start with short distances and get out of the car every 30 to 45 minutes to take a short walk and change your position.

Caution: Certain painkillers slow your reflexes.

Videos

<p>Spinal Care Through Innovation | Neurosurgery, Clinique de Genolier</p>

Spinal Care Through Innovation | Neurosurgery, Clinique de Genolier

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