{"id":885,"date":"2025-04-10T05:03:37","date_gmt":"2025-04-10T05:03:37","guid":{"rendered":"https:\/\/humainhealthcare.com\/?page_id=885"},"modified":"2025-07-03T05:29:26","modified_gmt":"2025-07-03T05:29:26","slug":"neurosurgery-barcelona","status":"publish","type":"page","link":"https:\/\/humainhealthcare.com\/fr\/neurosurgery-barcelona\/","title":{"rendered":"Neurochirurgie"},"content":{"rendered":"[et_pb_section fb_built=&#8221;1&#8243; custom_padding_last_edited=&#8221;off|desktop&#8221; disabled_on=&#8221;on|on|on&#8221; _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; background_color=&#8221;#042C54&#8243; background_enable_image=&#8221;off&#8221; background_blend=&#8221;multiply&#8221; custom_margin=&#8221;||||false|false&#8221; custom_margin_tablet=&#8221;0px||||false|false&#8221; custom_margin_phone=&#8221;0px||||false|false&#8221; custom_margin_last_edited=&#8221;on|tablet&#8221; custom_padding=&#8221;0px||0px||true|false&#8221; custom_padding_tablet=&#8221;0px||0px||false|false&#8221; custom_padding_phone=&#8221;30px||30px||false|false&#8221; disabled=&#8221;on&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row column_structure=&#8221;1_2,1_2&#8243; _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; width=&#8221;100%&#8221; max_width=&#8221;2560px&#8221; custom_padding=&#8221;0px||0px||true|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;1_2&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_divider show_divider=&#8221;off&#8221; disabled_on=&#8221;on|on|off&#8221; _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||164px|||&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_divider][et_pb_text _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;Unna|700||on|||||&#8221; text_text_color=&#8221;#FFFFFF&#8221; text_font_size=&#8221;70px&#8221; text_line_height=&#8221;1.2em&#8221; text_orientation=&#8221;center&#8221; custom_padding_tablet=&#8221;&#8221; custom_padding_phone=&#8221;40px||||false|false&#8221; custom_padding_last_edited=&#8221;on|phone&#8221; text_font_size_tablet=&#8221;55px&#8221; text_font_size_phone=&#8221;40px&#8221; text_font_size_last_edited=&#8221;on|phone&#8221; global_colors_info=&#8221;{}&#8221;]<p>Neurochirurgie<\/p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_2&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_image src=&#8221;https:\/\/humainhealthcare.com\/wp-content\/uploads\/2025\/04\/neurosurgery-barcelona-1-scaled.jpg&#8221; title_text=&#8221;neurosurgery-barcelona&#8221; force_fullwidth=&#8221;on&#8221; _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; height=&#8221;500px&#8221; height_tablet=&#8221;&#8221; height_phone=&#8221;auto&#8221; height_last_edited=&#8221;on|phone&#8221; border_radii=&#8221;on|3px|3px|3px|3px&#8221; box_shadow_style=&#8221;preset1&#8243; box_shadow_color=&#8221;rgba(0,0,0,0.03)&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_image][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; custom_padding_last_edited=&#8221;off|desktop&#8221; _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; background_enable_color=&#8221;off&#8221; background_image=&#8221;https:\/\/humainhealthcare.com\/wp-content\/uploads\/2025\/04\/neurosurgery-barcelona-1-scaled.jpg&#8221; background_size=&#8221;stretch&#8221; custom_margin=&#8221;||||false|false&#8221; custom_margin_tablet=&#8221;0px||||false|false&#8221; custom_margin_phone=&#8221;0px||||false|false&#8221; custom_margin_last_edited=&#8221;on|tablet&#8221; custom_padding_tablet=&#8221;0px||0px||false|false&#8221; custom_padding_phone=&#8221;30px||30px||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;0px||0px||true|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_divider show_divider=&#8221;off&#8221; _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;315px||315px||true|false&#8221; custom_padding_tablet=&#8221;150px||150px||true|false&#8221; custom_padding_phone=&#8221;80px||80px||true|false&#8221; custom_padding_last_edited=&#8221;on|phone&#8221; global_colors_info=&#8221;{}&#8221;][\/et_pb_divider][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; theme_builder_area=&#8221;post_content&#8221; _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; custom_padding=&#8221;||0px||false|false&#8221; hover_enabled=&#8221;0&#8243; sticky_enabled=&#8221;0&#8243;][et_pb_row _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; theme_builder_area=&#8221;post_content&#8221; custom_padding=&#8221;||0px||false|false&#8221; sticky_enabled=&#8221;0&#8243;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221; theme_builder_area=&#8221;post_content&#8221;][et_pb_text _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;Unna||||||||&#8221; text_text_color=&#8221;#042C54&#8243; text_font_size=&#8221;28px&#8221; text_line_height=&#8221;1.6em&#8221; link_text_color=&#8221;#042C54&#8243; ul_line_height=&#8221;1.6em&#8221; header_2_font=&#8221;Unna|700|||on|||#000000|&#8221; header_2_text_color=&#8221;#000000&#8243; header_4_font=&#8221;Unna|700|||||||&#8221; header_4_text_color=&#8221;#000080&#8243; header_4_font_size=&#8221;30px&#8221; header_4_letter_spacing=&#8221;1px&#8221; custom_margin=&#8221;||||false|false&#8221; custom_margin_tablet=&#8221;||||false|false&#8221; custom_margin_phone=&#8221;||||false|false&#8221; custom_margin_last_edited=&#8221;on|phone&#8221; hover_enabled=&#8221;0&#8243; text_font_size_tablet=&#8221;26px&#8221; text_font_size_phone=&#8221;20px&#8221; text_font_size_last_edited=&#8221;on|phone&#8221; header_4_font_size_tablet=&#8221;30px&#8221; header_4_font_size_phone=&#8221;26px&#8221; header_4_font_size_last_edited=&#8221;on|phone&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221; theme_builder_area=&#8221;post_content&#8221; sticky_enabled=&#8221;0&#8243;]<ul>\n<li><a href=\"#Spine\">Chirurgie de la colonne vert\u00e9brale<\/a><\/li>\n<li><a href=\"#Lumbar\">Hernie discale lombaire<\/a><\/li>\n<li><a href=\"#Cervical\">Hernie discale cervicale<\/a><\/li>\n<li><a href=\"#Advantages\">Avantages de la discectomie ant\u00e9rieure et de la fusion mini-invasive\u00a0:<\/a><\/li>\n<li><a href=\"#Spinal\">St\u00e9nose spinale<\/a><\/li>\n<li><a href=\"#Kyphoplasty\">Cyphoplastie pour fractures vert\u00e9brales<\/a><\/li>\n<li><a href=\"#Resection\">R\u00e9section (corpectomie) et reconstruction vert\u00e9brale des fractures vert\u00e9brales complexes et comminutives<\/a><\/li>\n<li><a href=\"#Minimally\">Correction dynamique mini-invasive de la scoliose (ASC\/VBT)<\/a><\/li>\n<li><a href=\"#Brain\">Tumeur c\u00e9r\u00e9brale<\/a><\/li>\n<li><a href=\"#Vascular\">Neurochirurgie vasculaire<\/a><\/li>\n<li><a href=\"#Pediatric\">Neurochirurgie p\u00e9diatrique (patients de plus de 40\u00a0kg)<\/a><\/li>\n<li><a href=\"#Parotid\">Tumeur parotidienne<\/a><\/li>\n<li><a href=\"#Pituitary\">Tumeur hypophysaire<\/a><\/li>\n<li><a href=\"#Parkinson\">Maladie de Parkinson<\/a><\/li>\n<li><a href=\"#Essential\">Tremblement essentiel<\/a><\/li>\n<li><a href=\"#Epilepsy\">\u00c9pilepsie<\/a><\/li>\n<li><a href=\"#Hydrocephalus\">Hydroc\u00e9phalie<\/a><\/li>\n<li><a href=\"#Trigeminal\">N\u00e9vralgie du trijumeau<\/a><\/li>\n<\/ul>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; custom_padding_last_edited=&#8221;on|phone&#8221; _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; custom_margin_tablet=&#8221;&#8221; custom_margin_phone=&#8221;&#8221; custom_margin_last_edited=&#8221;on|phone&#8221; custom_padding_tablet=&#8221;&#8221; custom_padding_phone=&#8221;0px||0px||false|false&#8221; hover_enabled=&#8221;0&#8243; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221; custom_padding=&#8221;0px||||false|false&#8221; sticky_enabled=&#8221;0&#8243;][et_pb_row _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;&#8211;et_global_body_font||||||||&#8221; text_text_color=&#8221;#000000&#8243; text_font_size=&#8221;16px&#8221; text_line_height=&#8221;1.6em&#8221; header_4_font=&#8221;Unna|700||on|||||&#8221; header_4_text_color=&#8221;#000080&#8243; header_4_font_size=&#8221;42px&#8221; header_4_line_height=&#8221;1.2em&#8221; custom_margin=&#8221;||10px||false|false&#8221; custom_padding_tablet=&#8221;0px||||false|false&#8221; custom_padding_phone=&#8221;0px||||false|false&#8221; custom_padding_last_edited=&#8221;off|desktop&#8221; hover_enabled=&#8221;0&#8243; header_4_font_size_tablet=&#8221;30px&#8221; header_4_font_size_phone=&#8221;30px&#8221; header_4_font_size_last_edited=&#8221;on|phone&#8221; global_colors_info=&#8221;{}&#8221; module_id=&#8221;Spine&#8221; sticky_enabled=&#8221;0&#8243;]<h4>CHIRURGIE DE LA COLONNE VERT\u00c9BRALE<\/h4>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;Unna||||||||&#8221; text_text_color=&#8221;#000000&#8243; text_font_size=&#8221;26px&#8221; text_line_height=&#8221;1.6em&#8221; ul_line_height=&#8221;1.6em&#8221; text_font_size_tablet=&#8221;26px&#8221; text_font_size_phone=&#8221;20px&#8221; text_font_size_last_edited=&#8221;on|phone&#8221; global_colors_info=&#8221;{}&#8221;]<p>Interventions chirurgicales r\u00e9alis\u00e9es selon les normes de s\u00e9curit\u00e9 neurologique les plus strictes gr\u00e2ce \u00e0 la technologie et \u00e0 l'expertise en neuronavigation spinale, O-Arm (TDM) perop\u00e9ratoire et surveillance perop\u00e9ratoire. Interventions mini-invasives : microchirurgie et endoscopie rachidienne.<\/p>[\/et_pb_text][et_pb_text _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;Unna||||||||&#8221; text_text_color=&#8221;#000000&#8243; text_font_size=&#8221;26px&#8221; text_line_height=&#8221;1.6em&#8221; ul_line_height=&#8221;1.6em&#8221; header_2_font=&#8221;Unna|700||on||||#000000|&#8221; header_2_text_color=&#8221;#000080&#8243; header_2_font_size=&#8221;42px&#8221; header_2_line_height=&#8221;1.2em&#8221; header_4_font=&#8221;Unna|700|||||||&#8221; header_4_text_color=&#8221;#042C54&#8243; header_4_font_size=&#8221;29px&#8221; header_4_line_height=&#8221;1.6em&#8221; custom_margin=&#8221;||||false|false&#8221; custom_margin_tablet=&#8221;||||false|false&#8221; custom_margin_phone=&#8221;||||false|false&#8221; custom_margin_last_edited=&#8221;on|phone&#8221; hover_enabled=&#8221;0&#8243; text_font_size_tablet=&#8221;26px&#8221; text_font_size_phone=&#8221;20px&#8221; text_font_size_last_edited=&#8221;on|phone&#8221; header_2_font_size_tablet=&#8221;42px&#8221; header_2_font_size_phone=&#8221;30px&#8221; header_2_font_size_last_edited=&#8221;on|phone&#8221; header_4_font_size_tablet=&#8221;29px&#8221; header_4_font_size_phone=&#8221;24px&#8221; header_4_font_size_last_edited=&#8221;on|phone&#8221; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;]The most notable pathologies treated are:\n<ul>\n\t<li>Pathologies d\u00e9g\u00e9n\u00e9ratives : st\u00e9nose du canal rachidien et st\u00e9nose foraminale<\/li>\n\t<li>Arthrod\u00e8se vert\u00e9brale post\u00e9rieure (TLIF), arthrod\u00e8se lat\u00e9rale (XLIF), arthrod\u00e8se ant\u00e9rieure (ALIF) et arthrod\u00e8se combin\u00e9e<\/li>\n\t<li>Remplacement de disque (proth\u00e8se de disque intervert\u00e9bral)<\/li>\n\t<li>D\u00e9formations vert\u00e9brales et pathologies de l'\u00e9quilibre sagittal<\/li>\n\t<li>Oncologie de la colonne vert\u00e9brale<\/li>\n\t<li>Pathologies squelettiques (tumeurs osseuses, m\u00e9tastases osseuses, etc.)<\/li>\n\t<li>Chirurgie des tumeurs de la moelle \u00e9pini\u00e8re (astrocytomes, \u00e9pendymomes, etc.) et des tumeurs intradurales (schwannomes, m\u00e9ningiomes, etc.), cavernomes, etc.<\/li>\n\t<li>Scoliose de l'adolescent. Chirurgies avec guides rachidiens 3D ; chirurgies ant\u00e9rieures<\/li>\n\t<li>Traitement des l\u00e9sions traumatiques de la moelle \u00e9pini\u00e8re par cellules souches<\/li>\n<\/ul>\n&nbsp;\n<h2 id=\"Lumbar\" >HERNIE DISCALE LOMBAIRE<\/h2>\nThe appearance of a herniated lumbar vertebral disc can lead to pain in the lower back, called low back pain or lumbago, as well as discomfort radiating to the lower extremity, called sciatica. Sciatica is the most characteristic symptom of a herniated disc, and the distribution of pain varies depending on the compressed nerve root or nerve.\n\nMost patients improve with conservative treatment. This type of therapy consists of rest, analgesics and anti-inflammatories, injections, etc.\n\nHowever, surgery is necessary in more than 5% of cases, reaching up to 10% of those affected.\n\nTherefore, surgery should be the final option, only recommended if the patient cannot tolerate the pain after 6 to 8 weeks of conservative treatment or if they experience progressive loss of strength or sphincter problems.\n\nIf the herniation is large and compresses all the nerves it encounters, it can cause what is called cauda equina syndrome, which is a surgical emergency.\n\nIn most cases, this pain resolves with conservative treatment without surgery. However, approximately 10% of cases will require surgery.\n\nDiscectomy is the best technique for treating herniated discs.\n\nIf there is no improvement with conservative treatment, after a reasonable period of time (which varies depending on the intensity of the pain and the response to medication), surgical treatment is performed. This consists of removing the herniated disc (discectomy).\n\nIf the patient has had frequent episodes of lower back pain prior to the onset of the herniated disc, a spinal fusion is associated with it.\n\nIn the cervical spine, this spinal fusion is associated with it in most cases.\n\nNON-INVASIVE PERCUTANEOUS TECHNIQUES FOR HERNIATED DISC\n\nThere are other treatments that are performed without opening or with minimal incisions.\n\nThese include percutaneous nucleotomy, laser nucleotomy (laser coagulation of the disc), and chymopapain chemonucleolysis (chemical dissolution of the center of the disc through an injection of this substance).\n\nThese techniques, which can only achieve good results when indicated correctly, are recommended in a small number of cases, when the disc contents have not completely extruded from the wall and the nerve is compressed.\n\n&nbsp;\n<h2 id=\"Cervical\" >HERNIE DISCALE CERVICALE<\/h2>\nUne hernie discale cervicale est une affection dans laquelle le noyau pulpeux du disque intervert\u00e9bral fait hernie dans le canal rachidien, comprimant les structures nerveuses et provoquant des douleurs et d'autres sympt\u00f4mes tels que :\n<ul>\n\t<li>Douleur cervicale persistante qui ne r\u00e9pond pas au traitement conservateur.<\/li>\n\t<li>Compression des racines nerveuses provoquant une faiblesse, un engourdissement ou des picotements dans les bras et les mains.<\/li>\n\t<li>Perte de contr\u00f4le de la vessie ou des intestins due \u00e0 une compression de la moelle \u00e9pini\u00e8re (my\u00e9lopathie).<\/li>\n\t<li>Difficult\u00e9 \u00e0 marcher ou \u00e0 d\u00e9ambuler, faiblesse des jambes.<\/li>\n<\/ul>\n&nbsp;\n<h2 id=\"Advantages\" >AVANTAGES DE LA DISCECTOMIE ANT\u00c9RIEURE ET DE LA FUSION MINIMALEMENT INVASIVE :<\/h2>\nReduced trauma: By accessing the cervical disc through a small incision in the neck, damage to surrounding tissues is minimized, leading to faster recovery and less postoperative pain. Greater precision: Advanced imaging and navigation techniques allow for detailed visualization of the cervical spine, facilitating more precise and safe surgery.\n\nRestored stability: Bone fusion between adjacent vertebrae helps restore stability to the cervical spine and prevent cervical hernia recurrence.\n\nPreserve mobility: We aim to preserve maximum mobility, allowing for a rapid recovery.\n\nMost patients spend only 24 hours in the hospital after surgery and go home without a neck brace, able to resume normal activities with rapid recovery and full mobility.\n\n&nbsp;\n<h2 id=\"Spinal\" >St\u00e9nose spinale<\/h2>\nSpinal stenosis occurs when the spinal canal narrows and puts pressure on the spinal cord and\/or nerve roots.\n\nThe spinal cord is a part of the central nervous system that extends from the base of the brainstem and runs through the spinal canal. Narrowing of the spinal canal, through which the spinal cord and spinal nerves pass, usually occurs in older age and involves one or more areas of the spine.\n\nDepending on the affected area of \u200b\u200bthe spine, spinal stenosis can be classified as:\n\nLumbar spinal stenosis: Located in the lower part of the spinal column, between the L1-L5 vertebrae. It can present in different forms, such as low back pain, radiculopathy, or leg weakness, for example. Symptoms are usually relieved by bending the trunk while standing or sitting. It is a degenerative and, in most cases, slowly progressive condition. Cervical canal stenosis: Narrowing of the canal occurs in the upper part of the spine, between the C1 and C7 vertebrae. Symptoms include neck pain and stiffness, numbness and tingling, loss of strength in the arms and hands, loss of balance, and dizziness.\n\nThe causes of spinal canal stenosis can be classified into three groups: degenerative, due to alterations in the spinal tissues caused by natural degenerative processes; congenital, present from birth due to alterations in the spinal tissues during embryonic development; and traumatic, due to an injury or trauma that causes alterations in the spinal tissues. There may also be other causes, such as tumors, among others.\n\nOne of the main goals of lumbar or cervical stenosis surgery is to decompress the spinal cord and\/or nerve roots. By giving them more space, nerve swelling will decrease, as will pain. The operation is also expected to increase motor strength in the extremities. Surgeons typically use two surgical techniques for spinal stenosis surgery: decompression, in which the surgeon removes tissue pressing against a nerve structure and creates more space in the spinal canal or the foramen where the nerve exits; and stabilization, to limit movement between the vertebrae, for example, in cases of vertebral listhesis.\n\nTo remove the tissue pressing on the nerve, the surgeon will perform one of these types of surgery:\n\nDecompressive laminectomy. This is the most common procedure and can be a lumbar laminectomy or a cervical laminectomy. It removes the posterior portion of the affected spinal bone, relieving pressure on the nerves by creating more space around them.\n\nHemilaminectomy. This is indicated for patients with symptoms and unilateral stenosis. It resects the lamina on the affected side and preserves the integrity of the interspinous and supraspinous ligaments, minimizing spinal instability.\n\nDiscectomy and fusion. Sometimes, disc degeneration plays a key role in narrowing the intervertebral foramen and causing spinal stenosis. In these cases, it may be necessary to restore the collapsed disc space by removing the degenerated disc and fusing the adjacent vertebrae.\n\nTypically, the patient will be able to walk the day after surgery and will be discharged within 48 hours.\n\n&nbsp;\n<h2 id=\"Kyphoplasty\" >CYPHOPLASTIE POUR FRACTURES VERT\u00c9BRALES<\/h2>\nKyphoplasty is the fastest and safest method for relieving pain in vertebral fractures, restoring vertebral height, and preventing the possibility of fractures due to osteoporosis in adjacent vertebrae.\n\nKyphoplasty is performed using minimally invasive surgery with two incisions, each only 3 millimeters long, parallel to the spine. The patient can walk the same day and does not require a brace or bed rest. It can be performed under local anesthesia.\n\nKyphoplasty is much safer than vertebroplasty because a space is created in the fractured vertebra with an inflatable balloon that restores vertebral height and is filled with plastic cement injected at low pressure.\n\nIn vertebroplasty, the space is not created with a balloon and the cement is injected at high pressure, which carries the risk of invading the spinal canal, blood vessels, and other surrounding tissues, and does not restore vertebral submergence.\n\nKyphoplasty is the most modern and safe method for improving the quality of life of people suffering from vertebral fractures.\n\n&nbsp;\n<h2 id=\"Resection\" >R\u00c9SECTION (CORPECTOMIE) ET RECONSTRUCTION VERT\u00c9BRALE DES FRACTURES VERT\u00c9BRALES COMPLEXES ET COMMINUTES<\/h2>\nIn the most severe fractures, comminuted and burst fractures, a vertebral body fragment may have displaced into the spinal canal, causing compression of the neurological structures (spinal canal stenosis).\n\nIn cases with neurological compromise, partial or total resection of the fractured vertebral body (corpectomy) is required, followed by reconstruction using an expandable somatic cage. Reconstruction is usually completed with an instrumented and cemented percutaneous arthrodesis of the levels adjacent to the fracture. The resection (corpectomy) allows the vertebral fragment located in the spinal canal to be removed and the affected neurological structures to be released. Reconstruction using a somatic cage relieves the patient&#8217;s load on the fracture and relieves the pain it causes.\n\n&nbsp;\n<h2 id=\"Minimally\" >CORRECTION DYNAMIQUE MINIMALEMENT INVASIVE DE LA SCOLIOSE (ASC\/VBT)<\/h2>\nA new technology has recently been developed for the surgical treatment of scoliosis called anterior scoliosis correction (ASC), also known as vertebral body tethering (VBT).\n\nThis technique uses a cord (a biocompatible braided plastic composite) to dynamically join the vertebral bodies of the spine and correct scoliosis. This technique eliminates the need for the rigid metal\/titanium rods used in traditional surgery, preventing the child&#8217;s spine from becoming rigid and unable to bend after surgery.\n\nThis innovative surgical technique maintains spinal flexibility and movement, modulating the harmonious growth of the vertebral bodies, allowing the patient&#8217;s trunk to develop naturally and ultimately reach a normal size for their age and growth. Furthermore, harmonious growth means that the scoliosis curve even continues to improve as the child grows with age.\n\nAnother major advantage of the anterior approach correction technique (ASC\/VBT) is that it is reversible, as it does not induce bone fusion of the patient&#8217;s spine (which would be irreversible). Therefore, if the patient&#8217;s progress is unfavorable, traditional surgical techniques can always be used without any inconvenience to the patient.\n\nThis surgical technique is performed using a minimally invasive approach through the patient&#8217;s ribs (anterior approach to the thorax or mini-thoracotomy) assisted by thoracoscopy. Similar to a spinal endoscope, the thoracoscope provides visualization of the anatomical area being operated on using a high-definition camera. High-quality image visualization allows for highly precise surgery with minimal risk of injury to the patient. ASC\/VBT surgery is performed using a minimally invasive approach, and therefore, patient recovery is very rapid. Patients are discharged from the hospital four days after surgery (barring complications). The surgical incisions are small, allowing for rapid recovery with minimal postoperative pain.\n\nThe best patients for this anterior correction technique (ASC\/VBT) are children and adolescents between 9 and 16 years of age with approximately 2-3 years of growth remaining, with scoliosis angles of less than 65\u00b0, and a spine that is still flexible.\n\n&nbsp;\n<h2 id=\"Brain\" >TUMEUR C\u00c9R\u00c9BRALE<\/h2>\nLa neurochirurgie moderne permet, dans la plupart des cas, l'\u00e9limination des tumeurs sans causer de dommages neurologiques suppl\u00e9mentaires au patient, avec am\u00e9lioration des l\u00e9sions existantes, dans des maladies telles que :\n<ul>\n\t<li>Glioblastome<\/li>\n\t<li>M\u00e9ningiome<\/li>\n\t<li>M\u00e9tastases c\u00e9r\u00e9brales<\/li>\n\t<li>ad\u00e9nome hypophysaire<\/li>\n\t<li>Craniopharyngiome<\/li>\n\t<li>lymphome du SNC<\/li>\n\t<li>Schwannome<\/li>\n\t<li>Syndrome neurologique paran\u00e9oplasique<\/li>\n\t<li>tumeurs de la moelle \u00e9pini\u00e8re<\/li>\n\t<li>tumeur neuronale<\/li>\n<\/ul>\n&nbsp;\n<h2 id=\"Vascular\" >NEUROCHIRURGIE VASCULAIRE<\/h2>\nPour les pathologies les plus importantes : an\u00e9vrismes, MAV, angiomes caverneux, fistules art\u00e9rioveineuses.\n<ul>\n\t<li>Proc\u00e9dures endovasculaires. S\u00e9ances avec des experts vasculaires pour discuter de la strat\u00e9gie th\u00e9rapeutique optimale.<\/li>\n\t<li>Radiochirurgie disponible avec acc\u00e9l\u00e9rateur lin\u00e9aire, gamma knife, cyber knife et protons.<\/li>\n\t<li>Vaste exp\u00e9rience en microchirurgie vasculaire et comit\u00e9s multidisciplinaires de chirurgie vasculaire c\u00e9r\u00e9brovasculaire et rachidienne.<\/li>\n<\/ul>\n\u2022 Advanced treatment of cavernous angiomas: laser (Visualase) and in areas of high functional eloquence: brainstem, basal ganglia, language, and sensory-motor areas; minimization of epileptic seizures after surgery with corticography-guided resection.[\/et_pb_text][et_pb_text _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; text_font=&#8221;Unna||||||||&#8221; text_text_color=&#8221;#000000&#8243; text_font_size=&#8221;26px&#8221; text_line_height=&#8221;1.6em&#8221; ul_line_height=&#8221;1.6em&#8221; header_2_font=&#8221;Unna|700||on||||#000000|&#8221; header_2_text_color=&#8221;#000080&#8243; header_2_font_size=&#8221;42px&#8221; header_2_line_height=&#8221;1.2em&#8221; header_4_font=&#8221;Unna|700|||||||&#8221; header_4_text_color=&#8221;#042C54&#8243; header_4_font_size=&#8221;29px&#8221; header_4_line_height=&#8221;1.6em&#8221; custom_margin=&#8221;||||false|false&#8221; custom_margin_tablet=&#8221;||||false|false&#8221; custom_margin_phone=&#8221;||||false|false&#8221; custom_margin_last_edited=&#8221;on|phone&#8221; hover_enabled=&#8221;0&#8243; text_font_size_tablet=&#8221;26px&#8221; text_font_size_phone=&#8221;20px&#8221; text_font_size_last_edited=&#8221;on|phone&#8221; header_2_font_size_tablet=&#8221;42px&#8221; header_2_font_size_phone=&#8221;30px&#8221; header_2_font_size_last_edited=&#8221;on|phone&#8221; header_4_font_size_tablet=&#8221;29px&#8221; header_4_font_size_phone=&#8221;24px&#8221; header_4_font_size_last_edited=&#8221;on|phone&#8221; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;]<h2 id=\"Pediatric\" >NEUROCHIRURGIE P\u00c9DIATRIQUE. (Patients de plus de 40 kg)<\/h2>\n<ul>\n\t<li>Moelle \u00e9pini\u00e8re attach\u00e9e, lipomes spinaux<\/li>\n\t<li>Troubles du LCR, Chiari (p\u00e9diatrique et adulte), syringomy\u00e9lie, kystes arachno\u00efdiens\u2026<\/li>\n<\/ul>\n&nbsp;\n<h2 id=\"Parotid\" >TUMEUR PAROTIDE<\/h2>\nAfter diagnosis, the tumor is staged to determine its extent and whether it has spread to lymph nodes or other areas. Staging is crucial in determining the appropriate treatment.\n\nTreatment may vary depending on the type of tumor and its nature (benign or malignant). However, the most common approach is surgery to remove the tumor and, in some cases, complementary radiation therapy to eliminate residual cancer cells. Drug treatment is usually considered in more advanced cases or if the tumor is inoperable.\n\nTreatment is customized to each patient&#8217;s needs and based on the recommendations of the medical team after a complete evaluation.\n\nThe main treatment for parotid tumors (benign and malignant) is surgery, as it allows for the removal of the tumor and, in many cases, provides a definitive diagnosis. The type of surgery performed depends on the type of tumor, its size, location, and its nature (benign or malignant).\n\nExtended lumpectomy. It is performed with the assistance of a neurostimulator that locates and alerts when working near the facial nerve. If the tumors are very peripheral, the tumor is removed without dissecting the entire facial nerve.\n\nSuperficial parotidectomy. Removal of a portion of the parotid gland. It is performed when the tumor is located on the superficial part (superficial lobe) of the gland, and the portion above the facial nerve is removed. The goal is to preserve the function of the gland and the facial nerve.\n\nTotal parotidectomy. Removal of the entire parotid gland. When the tumor is malignant, large, or in a position that makes partial removal inappropriate, the affected parotid gland is removed. The goal is to preserve the facial nerve to minimize changes in facial function, but this may vary depending on the extent of the tumor.\n\nRadical parotidectomy. Radical removal. This procedure is performed in cases of advanced malignant tumors that have spread to nearby structures, such as nerves or lymph nodes. It involves the removal of the parotid gland (with the facial nerve within it), regional lymph nodes, and other affected structures.\n\nReconstructive techniques. In some cases, especially after a total or radical parotidectomy, reconstructive surgery may be performed (immediately or delayed) to restore facial function and appearance. This may involve tissue transfer, such as a nerve or muscle graft (reconstructive microsurgery), to restore facial nerve function, or static techniques that achieve facial symmetry, cosmeticize facial features, and reduce functional impact.\n\nIt is important to note that the choice of the specific surgical procedure depends on the medical team&#8217;s evaluation of the tumor and careful planning to minimize side effects and complications. Parotid surgery should be performed by a surgeon experienced in maxillofacial or head and neck surgery with reconstructive expertise, as preservation of the facial nerves and facial function is crucial.\n\nAfter surgery, radiation therapy or facial rehabilitation therapy may be required to achieve a full recovery and minimize cosmetic and functional consequences.\n\n&nbsp;\n<h2 id=\"Pituitary\" >TUMEUR DE L'HYPOPHYSAIRE<\/h2>\nThe first line of treatment for pituitary gland tumors is usually surgery. This is indicated in cases of macroadenoma (a tumor larger than 1 cm), when it compresses the optic tract, or when hormonal testing reveals excessive production (as is the case with GH and ACTH production in acromegaly and Cushing&#8217;s disease, respectively). However, prolactinoma, a prolactin-secreting tumor and the most common functioning pituitary gland tumor, is a secretory tumor that is usually treated medically without the need for surgery except in special cases.\n\nPituitary gland surgery consists of removing the tumor while leaving healthy glandular tissue intact. Pituitary gland surgery has improved significantly in recent years thanks to the transsphenoidal approach, which involves removing the tumor through an incision at the level of the nose, entering through the sphenoid sinus (cavity located behind the nose).\n\nTraditionally, surgery was performed through a craniotomy (transcranial approach), in which the skull was opened to enter and remove the tumor. Currently, this technique is only performed in exceptional cases where the transsphenoidal approach is not possible.\n\nTo view the surgical area through the transsphenoidal approach, a surgical microscope or a fiberoptic endoscope is used, allowing for a minimally invasive approach to the pituitary gland.\n\nThe benefits of this technique compared to the traditional technique directly impact the patient, with a significant reduction in local complications, a shorter surgical time, increased patient comfort (absence of postoperative nasal packing and decreased postoperative pain), and a reduction in the average hospital stay, which can be as little as 24\u201348 hours.\n\nIn many cases, the entire tumor can be removed, preserving healthy tissue. However, in other cases, the tumor is very large and can invade neighboring structures, leaving tumor remnants or removing part of the healthy tissue. This can lead to deficiencies of certain pituitary hormones. In this case, medical treatment is necessary to correct these deficiencies.\n\nIn general, intensive care is not required after surgery. Headache, nasal congestion, a mild loss of taste and smell, which disappears in the following days, and fatigue, which usually improves within a few days, are common.\n\nIn the case of pituitary tumors, radiation therapy is used when the tumor persists, grows, or recurs after surgery, when surgery cannot be performed due to contraindications or a low probability of success.\n\n&nbsp;\n<h2 id=\"Parkinson\" >MALADIE DE PARKINSON<\/h2>\nParkinson&#8217;s disease surgery is indicated when drug treatment fails to control the patient&#8217;s symptoms throughout the day.\n\nIt is performed with deep brain stimulation (DBS). To achieve this, high-frequency stimulation is applied to a small part of the brain called the subthalamic nucleus by placing electrodes. Electrical impulses inhibit the overactive part of the brain that causes the disease.\n\nParkinson&#8217;s disease currently has no cure, but the benefits obtained through surgery are clear: it achieves a setback equivalent to years of progression. Specifically, there are improvements in movement, as well as a reduction in rigidity and tremors in patients.\n\nIt also allows for medication reduction, which avoids the psychiatric side effects of medications.\n\nSurgery is performed on patients who do not tolerate drug treatment well or find it ineffective, as well as on those for whom the disease is particularly disabling.\n\nSurgical success depends on the selection of the candidate, proper placement of the electrode in the brain, and proper stimulation and medication.\n\nThe first step is a brain MRI, the images of which are subsequently used by neuronavigation software. The MRI is used to calculate the coordinates of the area where the stimulating electrodes will be inserted.\n\nA small incision is made in the scalp, and then a hole approximately 1 cm long is opened in the skull (stereotaxy). Thanks to the guidance provided by an electrophysiological recording of neuronal activity, the exact location for the electrical stimulator is located.\n\nThe procedure is performed under local anesthesia, and the patient is conscious during the procedure, allowing them to collaborate with the surgical team to assess the effect of the stimulation before the final implantation of the electrode.\n\nThe second part of the treatment takes place a few days later under general anesthesia and involves placing the connecting cables and the pacemaker or battery that supplies the electrical stimulation under the skin. Typically, the pacemaker is inserted under the collarbone.\n\n&nbsp;\n<h2 id=\"Essential\" >TREMBLEMENT ESSENTIEL<\/h2>\n<h4>QU'EST-CE QUE LE HIFU ?<\/h4>\nHigh-intensity focused ultrasound (HIFU) is used to treat patients with essential tremor and the tremor, rigidity, and clumsiness that occur in Parkinson&#8217;s disease.\n\nIn the vast majority of cases, the tremor improves immediately, an effect that the patient benefits from in a single session.\n\nAs it is a noninvasive procedure, no prior hospitalization is required, and the patient is discharged within 24 hours after the session. As with any treatment, side effects may occur, which, in most cases, usually resolve within a few weeks.\n\nA month later, the patient will return for a follow-up visit, and at that point, the follow-up care required by specialists will be determined.\n\nThis technique is used to treat essential tremor and Parkinson&#8217;s tremor and is also used to treat other Parkinson&#8217;s symptoms such as rigidity and slowness.\n\nThe patient should be evaluated in consultation by a neurologist to determine whether or not they are a candidate for this procedure.\n\nThe procedure is applied unilaterally, so the benefit is achieved on the most affected side of the body.\n\nGenerally speaking, potential candidates include:\n<ul>\n\t<li>Patients dont les tremblements et autres sympt\u00f4mes r\u00e9pondent partiellement au traitement.<\/li>\n\t<li>Patients qui, en raison de leur \u00e9tat de sant\u00e9, de leur \u00e2ge, etc., ne sont pas candidats \u00e0 la chirurgie.<\/li>\n<\/ul>\nHIFU is performed like a magnifying glass in which the sun&#8217;s rays converge to concentrate the heat on a single point. This is how high-intensity focused ultrasound (HIFU) equipment works. This technology captures the heat from thousands of ultrasounds beams and concentrates them on a target: the group of neurons involved in the tremor.\n\nThis is a noninvasive procedure that does not require an operating room; rather, it is performed in the MRI examination room. The patient is awake and only has a stereotactic frame placed on the head and a silicone membrane containing water to cool the skin and prevent damage.\n\nOnce the surgical target is located on the MRI, the neurosurgeon begins applying ultrasound, which will be increased in intensity depending on the patient&#8217;s improvement until the maximum possible effect is achieved.\n\nDepending on the patient&#8217;s progress, an MRI will be performed after a few months.\n\n&nbsp;\n<h2 id=\"Epilepsy\" >\u00c9PILEPSIE<\/h2>\nEpilepsy surgery requires a multidisciplinary team. The selection of the surgical candidate, as well as the preoperative evaluation with video-EEG monitoring, functional MRI, and even invasive monitoring, are key aspects in predicting the success of the surgery, as they identify the epileptogenic lesion area.\n\nThe most frequently used surgery is hippocampectomy (removal of the temporal pole below the first temporal gyrus) and subpial excision of the hippocampus, entorhinal cortex, and amygdala. These procedures can be approximately 3 cm in length.\n\nSurgical outcomes are validated by scales and by the reduction of antiepileptic medication.\n\nAmong the types of epilepsy, temporal lobe epilepsy is the most common, and it is the only curable type.\n\nDrug treatment controls 80% of patients with temporal lobe seizures, but the rest do not respond to various antiepileptic treatments for which drugs are prescribed.\n\nThe remaining patients (20%) who do not respond to drugs are candidates for surgery. Of these, 75% can improve with surgery.\n\nSurgery involves removing a portion of brain tissue, with or without a visible lesion, related to the cause of the epileptic seizures. These are focal seizures. They most often respond very well to surgical treatment.\n\n&nbsp;\n<h2 id=\"Hydrocephalus\" >HYDROC\u00c9PHALE<\/h2>\nVentriculoperitoneal shunt (VPS) is a surgical procedure performed to drain excess fluid accumulation within the cranial cavity (hydrocephalus).\n\nThis accumulation of cerebrospinal fluid (CSF) causes dilation of the brain&#8217;s cavities (ventricles), thereby exerting increased pressure on brain tissue. This, if not treated immediately, could cause irreparable damage to brain function.\n\nHydrocephalus is primarily the result of an imbalance between the levels of fluid produced (CSF) surrounding the brain and the levels of fluid absorbed. This is triggered by conditions that cause obstruction at fluid absorption sites, excess production, or bleeding. This imbalance can occur at any age, but it is most common in newborns and adults over 60-65 years of age. Its origin can be congenital or acquired:\n\nCongenital: present at birth as a result of:\n<ul>\n\t<li>Probl\u00e8mes g\u00e9n\u00e9tiques<\/li>\n\t<li>Anomalies cong\u00e9nitales de la colonne vert\u00e9brale (spina bifida)<\/li>\n\t<li>Infections pendant la grossesse<\/li>\n\t<li>Pathologies qui surviennent lors de l'accouchement<\/li>\n<\/ul>\nAcquis : se d\u00e9veloppe \u00e0 la suite de :\n<ul>\n\t<li>Tumeurs (tumeurs c\u00e9r\u00e9brales)<\/li>\n\t<li>Infections (m\u00e9ningite)<\/li>\n\t<li>H\u00e9morragie c\u00e9r\u00e9brale (saignement)<\/li>\n\t<li>Chirurgie post-cr\u00e2nienne<\/li>\n\t<li>Origine inconnue<\/li>\n\t<li>Accidents<\/li>\n\t<li>Traumatisme cr\u00e2nien<\/li>\n<\/ul>\nL'objectif du shunt ventriculop\u00e9riton\u00e9al (VPS) est d'\u00e9vacuer l'exc\u00e8s de liquide accumul\u00e9 \u00e0 l'int\u00e9rieur du cr\u00e2ne vers la r\u00e9gion abdominale (p\u00e9ritoine) en implantant un cath\u00e9ter (tube + valve). sera utilis\u00e9 dans la r\u00e9gulation et le drainage dudit liquide.\n\n&nbsp;\n<h2 id=\"Trigeminal\" >N\u00c9VRALGIE DU TRIJUMEAU<\/h2>\nTrigeminal neuralgia is a special type of facial pain, highly intense and requiring specialized treatment. In some cases, neurosurgery is necessary to overcome the bothersome symptoms caused by irritation of the cranial nerve, the trigeminal nerve.\n\nWhen normal causes of trigeminal pain (facial pain, especially dental conditions such as cavities, abscesses, infections of the mouth or facial bones, complicated wounds, and others) have been ruled out, the pain is generally due to minor deformities or malpositions of certain small blood vessels (arteries or veins) that may touch this nerve as it passes through the base of the skull. These blood vessels are normal; in other words, they are not generally a malformation or unnecessary vessels; they are simply slightly different positions that trigger the symptoms. With the normal pulsation of the arteries, the nerve interprets the stimulus as intense pain and then generates the symptoms of facial pain. Other times, less frequently, tumors or infections will be found that cause pain through direct contact with the nerve, but these cases are not grouped within the primary trigeminal neuralgia we are referring to here.\n\nIt always involves stabbing pain on one side of the face that can radiate toward the ear canal. It is usually triggered by a normal stimulus to the face (for example, cold or heat, speaking, eating, touching certain areas, smiling, sneezing or coughing, etc.). The intensity of the pain varies and can range from tolerable, moderate pain to the most intense pain that humans can suffer. When the pain is very severe, one faces the classic picture of trigeminal neuralgia, as the patient is limited and unable to perform certain basic activities normally (eating, speaking, etc.) due to the great fear of experiencing the pain again.\n\nAnyone can suffer from trigeminal neuralgia. Generally, but not always, it occurs after the age of 50. When there are no normal factors that cause the pain (such as dental problems), there is no predisposition to this pain due to other personal or family medical conditions. It is important to emphasize that dental disease should always be ruled out before making this diagnosis, as the pains are similar and are often confused.\n\nThere are several therapeutic options for trigeminal neuralgia.\n\nOpen surgery is indicated when a normal vessel in the brain is compressing the nerve. Therefore, the surgery aims to separate this vessel and insert a material that prevents the vessel&#8217;s pulse from transmitting to the nerve. This is done through a small opening behind the ear bone on the painful side of the face (retromastoid craniotomy).\n\nThis procedure is primarily indicated for young patients.\n\nAnother alternative is to burn (thermocoagulation) the part of the nerve trunk corresponding to the painful area of \u200b\u200bthe face (Gasserian ganglion) with radiofrequency (an ablative technique). This procedure effectively renders the face numb. This procedure can work for years, although pain may recur.\n\nThis procedure is indicated for older patients or those with conditions that preclude the first option. It is performed under deep sedation.\n\nAnd the last alternative is to modify the nerve&#8217;s function with radiosurgery. It is indicated when there is no vessel compressing the trigeminal nerve or in patients with significant pathologies or advanced age.\n\nThis procedure does not produce immediate results; it can take weeks or months for the pain to improve. Relapse may also occur with the pain returning, at which point the treatment can be repeated.[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; custom_padding_last_edited=&#8221;on|phone&#8221; _builder_version=&#8221;4.27.4&#8243; _module_preset=&#8221;default&#8221; background_color=&#8221;#f9f9f9&#8243; custom_padding=&#8221;||||false|false&#8221; custom_padding_tablet=&#8221;||||false|false&#8221; custom_padding_phone=&#8221;0px||||false|false&#8221; locked=&#8221;off&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row custom_padding_last_edited=&#8221;on|phone&#8221; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; custom_padding_tablet=&#8221;&#8221; custom_padding_phone=&#8221;||0px||false|false&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.27.0&#8243; _module_preset=&#8221;default&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_text _builder_version=&#8221;4.27.4&#8243; 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