BRAIN CONDITIONS

For more than 15 years Barcelona Spine Center has been offering their patients the best and most advanced treatments in neurosurgery. Our center possesses cutting edge technology and has experienced professionals who perform safe operations.

Barcelona Spine Center professionals specialize in brain conditions which are treated at the center:

BRAIN TUMORS: gliomas, meningiomas, metastases, schwannomas, etc.

SPINAL TUMORS: intra and extramedullary.

COMPRESSION NEURALGIA OF CRANIAL NERVES, including widespread and disabling trigeminal neuralgia.

SURGERY OF TUMORS OF THE SKULL BASE: considered the most complex brain surgery. The technological tools in our center and the expertise of our operating teams with these approaches make it possible to undertake these complex types of surgery with very low morbidity (complications) achieving complete tumor resections in deep brain regions.

HYDROCEPHALUS.

CRANIOSPINAL MALFORMATIONS (Arnold-Chiari malformation).

TRAUMATIC: intraparenchymal hematomas, chronic and acute subdural hematomas, skull fractures, etc.

CEREBROVASCULAR: subarachnoid hemorrhage, ventricular hemorrhage, cerebral hematoma, cerebral aneurysms, arteriovenous malformations (AVM), cavernomas…

TECHNIQUES AND TECHNOLOGIES

Barcelona Spine Center, a worldwide benchmark center for spine surgery and neurosurgery, possesses the latest technological tools and surgical teams trained in the use of the latest techniques.

TECHNIQUES

Intraoperative Neurophysiological Monitoring

Intraoperative neurophysiologic monitoring (IONM) is a technique used to assess the functional integrity of the nervous system during surgery in an objective and effective manner. IONM includes techniques such as the blink reflex, electroencephalography or cortical and subcortical mapping.

IONM is a tool to objectively and instantly detect and quantify in real time any functional changes in neural structures with sufficient time to take action, and thus, for example, counteract the effects of ischemia or prevent a mechanical injury that can cause permanent neurological damage

Wide awake brain surgery (awake brain surgery and intraoperative brain mapping)

Performing procedures with the patient awake reduces the risks of intervention through early detection of complications. Awake brain surgery, makes it possible to resect lesions very close to functional and sensitive brain areas, such as areas governing language, motor and sensory function.

cirugia cerebral

TECHNOLOGIES

O-Arm 2
This system, acquired for the first time in Spain by Barcelona Spine Center, makes it possible to navigate with high-precision data, two-dimensional and three-dimensional images during surgery and in real time, increasing patient safety and the performance and efficiency of surgical teams.

During each operation, surgeons obtain multidimensional images and fluoroscopic images that allow them to see the patient’s anatomy in the operating position, monitor the status of surgery and verify surgical changes by means of volumetric 3D images before the patient leaves the OR. With this system, patients benefit from a shorter less invasive surgery, faster recovery and a better end result.

Intraoperative neuronavigation
This complex “cerebral surgical GPS” based on complex camera technology and 3D reconstruction software, can accurately locate and effectively pinpoint brain injury defining and differentiating on the computer screen injured tissue to be resected and the surrounding healthy tissue, minimizing any undesirable complications and potential damage to healthy tissue.

Ultrasonic aspirator
Using ultrasound-based technology, the ultrasonic aspirator breaks up and aspirates tumor tissue. Thus achieving safer and faster tumor resection with less blood loss.

Fluorescence microscope with fluorescein and 5-alanine
The use of this technique allows maximum surgical precision in the case of tumors. Tumors are seen as shining areas with clear boundaries because fluorescein and 5-alanine cross the blood brain barrier and, based on metabolic differences, clearly distinguish tumor tissue from healthy tissue.

Cath lab
In the cath lab diagnosis and endovascular treatment of aneurysms and cerebral arteriovenous malformations are performed. 3D image reconstruction or CT type imaging are carried out. Cath lab techniques make it possible to clearly view coronary stents, thus reducing risk in these procedures.

Endoscopic surgery
Makes it possible to access deeply placed areas even with a reduced field. Endoscopic access allows a 360º view of the field which favors detection and resection of tumor tissue found within the limits of the surgical field.

Cranial stereotactic radiosurgery
Cranial stereotactic radiosurgery (SRS) is a procedure based on ionizing radiation for the treatment of both malignant (metastasis) and benign (vascular malformations) lesions, central nervous system lesions and some functional disorders such as trigeminal neuralgia.

It has been used clinically for over 60 years and involves the administration of high doses in small diameter lesions, about 2-3 cm, in a single treatment session. This procedure requires irradiation systems that allow a rapid decrease in dose at the periphery of the lesion to minimize the dose reaching surrounding normal tissues. Currently, linear accelerators equipped with Cone Beam CT tomographic capacity (CBCT-IGRT) and Intensity-modulated radiotherapy (IMRT) techniques are at the technological forefront of radiosurgery.

At Hospital QuirónSalud Barcelona, our radiation oncology service has more than 18 years’ experience in performing radiosurgery treatments and cranial stereotactic radiotherapy, with more than 1000 cases treated. Both frameless radiosurgery, based on CBCT-IGRT, intensity modulated (IMRT) and also a unique adaptive technology in 6D in real time, are part of the stereotactic procedures performed in our service. Cranial radiosurgery has the following technical limitations:

It requires an exact location of the area to be treated and risk areas to be preserved from radiation through appropriate imaging studies such as CT scans, magnetic resonance arteriography, positron emission tomography, or PET.

Frameless immobilization
Frameless immobilization of the patient during treatment. Classically, an invasive method of immobilization was used during irradiation. Currently, however, this invasive procedure has been replaced by a non-invasive (frameless) technique consisting in the use of a thermo-plastic mask with CT acquisition in the treatment unit itself that ensures correct positioning (error <1 mm) of the patient during irradiation, while increasing patient comfort.

The use of multiple fine beams of ionizing radiation to produce a large dose gradient from the periphery of the lesion to the area of surrounding healthy tissue, minimizes radiation, and therefore toxicity for our patients.

Neuroanesthesia

Furthermore, patients at Barcelona Spine Center have access to:

Neurointensive care units: ICU and coronary care unit

This is a multipurpose medical and high complexity postsurgical unit (neurosurgery, cardiac surgery, thoracic surgery,…). It has 13 individual boxes with natural light. The attending physicians are intensive care specialists and cardiologists. And the nurses are all trained to provide skilled nursing care to critically ill and postoperative patients. It has all the equipment necessary for the monitoring and treatment of critically ill patients: continuous monitoring that makes it possible to continuously determine intracranial pressure (ICP), BIS (bispectral index), capnography, cardiac output, etc. In this unit renal replacement therapy is applied, invasive and non-invasive mechanical ventilation are used, external cardiac counterpulsation therapy (ECP) is applied and temporary pacemakers put in place. There is also an attached cath lab and imaging facilities 24 x 7.

24 hour resonance and CT imaging

Nuclear medicine: advanced tests such as PET-CT

Medical oncology

Multidisciplinary teams: operative collaboration in complex cases with other specialties, vascular surgery and ENT

Neurooncology Committee: monthly session

Neuroendocrionology Committee: monthly session