MC Nairi is a pioneer in the field of brain tumor and spine lesion endoscopic surgery
The methods of brain tumor and spine lesion endoscopic surgery, as well as pain treatment, were introduced in Armenian neurosurgery by the Clinic of Endoscopic Neurosurgery and Spinal Surgery of MC Nairi, which became a pioneer in this field.
The short list of the methods, introduced in the routin practice of the Clinic with very high effectiveness is follow:
Transforaminal endoscopic lumbar disc surgery - from 2007
Due to the introduction of high technologies into neurosurgical practice such kind of operations became possible. Endoscopic operations are considered high-class interventions with high cost. That is why medical institutions in many countries have not yet implemented this method. By the number of operations performed with this method, we are considered to be the leaders in our region. Over the past years, we have performed 1800 similar operations (through transforaminal approach). The advantage of this method is that they are done without incision, that is, soft tissues, back muscles or bone structures of the spine are not damaged. Operations are done with a special endoscope in diameter 8 mm, which is thinner than the diameter of a pen.
Unlike open surgeries with different names (microdiscectomy, microscopic operation, open surgery with endoscopic assistention), during our operations, the endoscope is inserted laterally from midline without damaging the back muscles. During open surgery soft tissues are excised along the middle line of the spine, which subsequently leads to atrophic changes in the muscles of this area. With endoscopic transforaminal method lumbar disc prolapsis or sequester of any size and localization can be removed. At the end of the operation, laser ablation of the intervertebral disc is done, which contributes the recovery process and significantly reduces the possibility of reherniation. The second important advantage is that the hospitalization time is one day. So if you have intervertebral disc hernia it is preferable to do endoscopic operation with transforaminal approach.
Intervertebral disc laser ablation - from 2009
In case of small lumbar disc prolapsis we offer radiofrequency ablation with Cosman RF technology. Under CT-control and under local anestesia a very thin needle is inserted into the intervertebral disc. Due to the permanent CT-control safety is ensured. Then intervertebral disc ablation is done. In addition, after ablation, betamethasone is injected, which removes the release of the nerve root. Ablation leads to the wrinkling of the intervertebral disc, and then to a decrease and shrinkage of disc hernia. The process of wrinkling and resorption takes about 6-12 weeks.
With endoscopic transforaminal method lumbar disc prolapsis or sequester of any size and localization can be removed. At the end of the operation, laser ablation of the intervertebral disc is done, which contributes the recovery process and significantly reduces the possibility of reherniation.
Vertebroplasty in case of spine fractures or tumors - from 2009
The method of percutaneous vertebroplasty (bone cement filling of the affected vertebral body) is the advanced method, which allows to restore the function of the damaged vertebral body, prevent vertebral fracture and disability of patients. The use of percutaneous vertebroplasty for vertebral body fracture allows the patient recover quickly: the periods of hospitalization and postoperative recovery are reduced for several times. The use of percutaneous vertebroplasty in vertebral body tumors (hemangioma, metastasis) helps prevent its possible fracture, and also relieves the patient from the need for radiation therapy. Percutaneous vertebroplasty can be performed under local or epidural anesthesia, which allows the patient to stand up and leave the hospital after a few hours.
Nowadays spinal canal stenosis is also possible to operate by the endoscopic method. Neurosurgical department of "Nairi" medical center was equipped with EasyGo system, which allows to do spinal canal stenosis endoscopic surgery. Patients, who were operated on, go home the next day. It is a great method of surgery for spinal canal stenosis, sequesters, hernias on two levels, disc prolepsis.
Spine reconstructive surgery - from 2010
Spine fixation is indicated in case of spine fractures, tumors, spondylolisthesis, in pathologies that cause serious impairment of the musculoskeletal function of the spine. Our experience allows us to recommend DePuy Spine implants - as very high quality and reliable. A vivid evidence of this is the numerous operations and their long-term results. The advantage of these implants is that they are made of special titanium (Ti-6AI-4V). They are inert to the body and can last a lifetime. Among the medical centers of RA only in the MC Nairi there is a set of special instruments necessary for inputting these high-quality implants. This kind of surgeries is considered to be unique and they are performed only in MC Nairi.
Endoscopic surgery of some types of brain and pituitary tumors - from 2011
Endoscopic endonasal transsphenoidal surgery is performed through the natural nasal air passage. The advantage of this operation is that it is minimally invasive and is performed without skull trepanation. It is important to mention that in the territory of Armenia only the medical center Nairi is equipped with the StealthStation navigation system, the use of which during the operation makes it possible to accurately determine pituitary tumor localization, its boundaries and the degree of removal, which minimizes the probability of traumatizing adjacent tissues. In addition, our clinic is equipped with an ultrasonic selective aspirator "INTEGRA", which recognizes and removes only brain tumor, without injuring healthy tissues. We also want to mention the following advantage of this surgery: usually the tumor is localized in a small area (about 3 cm) and is adjacent to the carotid arteries, venous plexus, optic nerves. Therefore, it is very important to intervene carefully as to minimize the likelihood damages of these important centers. During the surgery, the tumor is maximally removed, but in cases where its lateral borders are closely adjacent to tissues or blood vessels, partial resection of the tumor is carried out for safety. After the operation, a fat tissue is inserted into the cavity of the removed tumor.
Hospitalization lasts 4-5 days. The patients are allowed to walk the next day. In the postoperative period, depending on the histological structure of the tumor, hormonal or radiation therapy is indicated to individual patients.
Different types of nerve blocks under CT and X-ray control - from 2013
Patients with tumor lesions often suffer from severe pain syndrome, which does not go away even when using narcotic analgesics. For such patients, we offer percutaneous CT-controlled cordotomy for pain relief. The essence of manipulation is in ablation of the sensitive nerve of dorsal-thalamic tract, which passes in the upper cervical part (C1-C2) of the spinal cord. Due to the effect, the deep sensitivity of one part of the body decreases or disappears. So, the pain syndrom which comes from tumor are not transmitted to the brain and the patient gets rid of the pain. An alternative method of treatment is considered to be spinal cord stimulation.
Pain treatments with Cosman RF technology - from 2013
As a rule the reason of low back pain is spondylarthrosis. Spondylarthrosis or facet joint syndrome is a disease caused by inflammation of facet joints, in the result of which spine mobility is reduced and there is a feeling of tension and pain. The main symptom of lumbosacral spine lesion is acute pain in the morning after getting up, but it partially passes after 10-15 minute walk. Patients note that the pain mainly sharpens in the sitting position or after lying in one position for a long time. In such cases, we offer a very effective method of treatment, which is done with Cosman RF technology. So, under X-ray control, special electrodes are applied to the affected facet joints. Manipulation is done in the operation room, under X-ray control and under local anesthesia. The correct position of the electrodes is determined by stimulation, then denervation is done (thermal action), in the result of it the feeling of pain passes. As a rule, denervation of four joints is done simultaneously. The final result is achieved during the coming months, then for final good result therapeutic physical training and some physiotherapeutic procedures are indicated.
Brain tumor surgery with StealthStation navigation system - from 2016
In case of brain tumor surgery is indicated. Especially in those cases when there are clinical manifestations of the disease: speech disturbance, weakness in the limbs and headache, convulsions, visual disturbances. Brain tumors can be malignant or benign. Before the surgery, the histological structure of the tumor can’t be determined. In all cases the aim of the surgery is to save or prolong the patients’ life. What is the advantage of the surgeries performed at “Nairi” Medical Center? Nowadays the effectiveness of surgeries depends not only on the surgeon, but also on the availability of modern equipment and instruments. For example, in Armenia only medical center “Nairi” has StealthStation neuronavigation system, which allows to determine the shortest and safest way to access the tumor and to remove it as much as possible through a small incision without injuring healthy brain substance. In addition, our department is equipped with an ultrasonic destructor INTEGRA, which recognizes, destroys and removes the tumor. All surgeries are performed using a surgical microscope, which maximizes 6-10 times. Exclusive technical equipment and experienced specialists - this is what distinguishes the neurosurgical department of medical center "Nairi", which offers guaranteed professional help to patients with brain tumors.