Definition and Overview
Neurosurgery is the branch of medical science that deals with the prevention, diagnosis and treatment of disorders and diseases affecting the brain, spinal cord and peripheral nerves of the central nervous system. Neurosurgery is also considered an effective rehabilitative procedure for people suffering from degenerative neurological conditions. It is often the final option when conventional methods have less than stellar results.
Any type of surgery, including those performed using minimally invasive techniques, carries certain risks and complications. So it’s extremely vital that neurosurgery follow-ups be strictly followed. This follow-up is a crucial part of post-operative care, which primary goal is to monitor the patient’s recovery and assess the success of the surgical procedure. It is usually scheduled 1 to 2 weeks after surgery to give the patient ample time to rest and recover outside of the hospital. Though a patient is given instructions to follow for his recovery, it is through a follow-up check that any complications (if there are any) can be remedied and treated immediately, preventing them from becoming more serious or life-threatening.
Who Should Undergo and Expected Results
Neurosurgery is for patients, from children to adults, who are experiencing brain, spinal cord and peripheral nerves issues. Those who have undergone surgical procedures for the following conditions are usually called back for a neurosurgery follow-up:
Brain tumors, brain injury and cerebral aneurysm – These are typical brain disorders which main treatment is neurosurgery. Brain tumors, especially malignant ones, have to be removed particularly if they impinge on the function of the brain. When a traumatic blow to the head happens, as with accidents, the brain may be injured resulting in swelling and bleeding (intracranial hemorrhage). In such event, a neurosurgeon will cut a hole in the skull to release the blood. An aneurysm, on the other hand, is a swelling in the arterial wall. It leaks blood when it ruptures. When an aneurysm is in the brain, it can cause a stroke or death. Neurosurgeons try to prevent this by clipping or sealing the aneurysm to prevent if from leaking further.
Cervical spine and lumbar spine surgery – The former is usually meant for people with cervical disc disease or cervical stenosis while the latter is for those with a herniated disk, lumbar compression fracture or lumbar stenosis. These wear-and-tear diseases affect the spinal cord as they put pressure on the nerves when the discs of the spine become misaligned, worn out and flattened. Neurosurgery removes the affected part of the disk to release the pressure on the nerve.
In certain cases, neurosurgery follow-up is required months or years after the operation, particularly if the patient is taking medication as a part of the post-operative treatment. The intake of medication is regularly monitored and thus, can be adjusted or stopped immediately depending on the patient’s recovery progress.
Also, some patients who have undergone neurosurgery require rehabilitative treatment to monitor and manage side effects. In the case of brain surgery, these may include problems in patient’s motions, vision, speech and other functional controls. The patient needs to undergo rehabilitation therapy as well as neurosurgery follow-up to monitor his progress.
How Does the Procedure Work
Post-operative neurosurgery follow-up is inevitable. It is typically scheduled 1-2 weeks after surgery where the patient meets the doctor at his office to check his recovery, monitor his vitals and discuss additional rehabilitation therapy if needed. This is where the doctor will perform a physical examination to check the sutures, prescribe or adjust the medication, monitor for signs of infection and give instructions regarding exercise and returning to the daily routine.
A neurosurgery follow-up may be initiated ahead of schedule when the patient experiences the following symptoms after surgery:
- Leakage of fluid from the incision
- High fever (higher than 101.5)
- Continuous pain despite taking pain medication
There may be other symptoms that the doctor will advise the patient or the family members to be wary of like hallucinations, seizures, speech problems, tingling feeling in the arms or legs and nausea and vomiting.
Other rehabilitative treatments also require a neurosurgery follow-up to track and monitor the patient’s progress. It can be scheduled quarterly or semi-annually depending on the patient’s treatment schedule. Physical examinations and diagnostic tests may be performed during these follow-up sessions to test muscular ability and control.
Possible Complications and Risks
Complications may arise when danger signs that the doctor has warned about have been ignored or neglected. The earlier the symptoms are treated, the better it is for the success of the surgery and the well-being of the patient. But if they’ve gone ignored, the problems will become serious and much more difficult to treat.
- Gasco J, Mohanty A, Hanbali F, Patterson JT. Neurosurgery. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier Saunders; 2012:chap 68.