Neurosurgeons are members of a rapidly evolving field. As one of the youngest surgical fields -- neurosurgery only dates to the early 1900s -- it's characterized by change and rapid spread of new ideas and techniques. All of these have led to the development of neurosurgery sub-specialties. Overall, neurosurgeons work to prevent, diagnos, treat and rehabilitate nervous system conditions in patients of all ages.
After she finishes training as a general neurosurgeon, a neurosurgeon may spend another one or more years training in a sub-specialty. These include pediatric neurosurgery, spine, trauma and pain surgery, interventional neuroradiology, cerebrovascular surgery, neuro-oncology, functional neurosurgery and stereotactic neurosurgery. Advances in technology helped to spur development of these sub-specialties.
Pediatric, Functional, Sterotactic
Pediatric neurosurgeons focus on children and neurological disorders that affect children's small and growing bodies -- head injuries, brain and spinal tumors, seizure disorders and, in particular, hydrocephalus, or water on the brain. Advances in programmable shunt devices greatly decrease fluid pressure on the brain. Functional neurosurgery focuses on movement disorders, such as multiple sclerosis and Parkinson's disease. This sub-specialty has seen a dramatic surge in technology, including advances in computer navigational technology that allow extremely precise placement of recording electrodes, which can control or eliminate movement disorders. Stereotactic neurosurgery involves procedures for the brain using a stereotactic ring, which is attached to the patient's head under local anesthesia. Used commonly for treating tumors, the ring provides a reference for calculating target coordinates through imaging techniques and medication distribution to extremely small areas of the brain.
Blood Vessels and Spine
Cerebrovascular neurosurgeons treat disorders involving blood flow to and within the brain and spine, and perform operations to relieve narrowed blood vessels or to remove aneurysms or other abnormalities. They perform some operations while temporarily stopping the patient's heart. Neurosurgeons who specialize in the spine treat conditions such as herniated discs, spine and spinal cord tumors, spinal fractures and deformities of the spine, such as scoliosis. Many more patients today are successfully treated with spinal surgery due to rapid technological advances since 2000.
Seizures and Pain
Neurosurgeons sub-specializing in seizures treat patients with seizure disorders that cannot be managed with heavy medication. They perform operations to insert electrodes on the brain's surface that locate and map the area of abnormal electrical activity. The surgeons then they go into the brain to remove that area. Pain specialists treat patients with uncontrolled pain that cannot be controlled with medications. These patients have conditions that include cancer, nerve and nervous system injuries, failed back surgeries and limb amputations. The surgeons may, for example, insert a medication pump, a spinal cord stimulator or surgically cut nerve pain-signaling pathways.
Neuro-Oncology and Interventional Neuroradiology
Neuro-oncologists treat cancerous tumors of the brain and spine, while preserving as much normal tissue as possible through use of stereotactic rings and medical imaging techniques. Interventional neuroradiologists treat conditions such as tumors, strokes and fractured spine vertebra by using microcatheters inserted in the groin area and, employing imaging technology, deliver medicines through blood vessels leading into the brain. In another technique, they inject cement into a fractured vertebra, eliminating the need for invasive surgery.
Education and Salary
Becoming a neurosurgeon is a time-intensive endeavor. After obtaining a bachelor's degree, the future neurosurgeon must complete medical school, then complete a one-year internship in general surgery. That's followed by a hospital residency in neurosurgery lasting from five to seven years. Neurosurgeons typically become certified through the American Board of Neurological Surgery to show they have the skills and knowledge to provide quality care. Neurosurgeons are also licensed in the state where they work. Becker's Hospital Review reports that, in 2011, neurosurgeons overall earned median annual salaries of approximately $600,000, with top neurosurgeons earning more than $1 million.
- Women in Neurosurgery: So You Want To Be A Neurosurgeon?
- American College of Surgeons: Neurological Surgery
- Neurosurgery PA: Frequently Asked Questions
- University of Virginia Medical Center: Functional and Stereotactic Neurosurgery
- UCLA Neurosurgery: Stereotactic Radiosurgery Program
- Penn State Hershey Neurosurgery: Vascular Neurosurgery
- University of Michigan Health System A. Alfred Taubman Health Care Center: Pain Neurosurgery Program
- Jackson Memorial Hospital: Neuro-oncology
- Cedars-Sinai: Interventional Neuroradiology
- U.S. Bureau of Labor Statistics Occupational Outlook Handbook: Physicians and Surgeons -- How to Become a Physician or Surgeon
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