Cross the threshold into Bay’s two neurosurgical operating suites, and you’ve
stepped into the future. Both suites were designed as integrated surgical
settings to accommodate the BrainLab that allows pre-operative CT or MRI patient
images to be captured in DVD format system. Through this system the surgical
treatment plan is made.
The system continuously provides data back to the surgeon, so he/she knows at
all times where they are in relationship to a tumor, for instance, as well as
vital structures near the operating site.
Surgical images can be viewed from the Zeiss multi-vision microscope. Images
are delivered through ceiling mounted computer monitors that provide real-time,
The entire system can be moved to allow the neurosurgeon the most ideal
trajectory for entering the brain or spinal cord, using minimally invasive
techniques, when possible. At every point, the neurosurgeon, anesthesiologist,
and OR team can see the procedure and anticipate instruments or devices needed
Typical brain surgery procedures can include:
- Craniotomies (opening the skull to expose the
brain for tumor removal or to clip a bleeding aneurysm in the brain and
prevent or minimize stroke impairments).
- Skull-base surgery (to address tumors or blood
vessel abnormalities at the base of the skull. These can include pituitary
tumors, or deep-seated aneurysms.
- Carotid endarterectomy (removing plaque that is
stopping blood flow from the carotid artery to the brain).
- Subdural hematomas (Often the result of a closed
head injury or brain trauma). The blood clot causes an increase in pressure on
The neurosurgical suites are also used for a variety of spine surgeries.
One such procedure is a kyphoplasty. The neurosurgeon repairs spinal
vertebral compression fractures with a balloon. In this procedure, two small
needles are inserted through a puncture in the skin. A small working channel is
passed into the fractured vertebrae. A bone biopsy may be done. Then, two very
strong balloons are inserted and inflated to reduce the fracture, and restore
The balloons are then deflated. The small cavity left in the fractured
vertebra is filled slowly and carefully with medical grade cement. The cement
hardens in minutes, and the spine has greater strength and stability to the
Most back surgeries are done on a Jackson Spinal Table that allows customized
360-degree positioning, a radiolucent frame and support pads, and unrestricted
C-arm integration. It provides optimal spinal surgery positioning for the
patient. Lumbar procedures can include:
- Spinal decompressions (minimally invasive
endoscopic procedure for herniated discs to either remove a portion of the
nucleus in the affected disc, to manipulate a disk back into place, or to
remove bone fragments and spurs).
- Laminectomies (a procedure for spinal stenosis to
relieve pain where bone is impinging on the nerve. A small portion of bone
impinging on the nerve root or disc material from the nerve root is removed to
give the root more space).
- Anterior or posterior spinal fusions (One or more
vertebrae are fused together to treat broken vertebrae, correct deformity,
treat instability or pain, or treat a herniated cervical disc).
- Kyphoplasty (minimally invasive procedure for
spinal fractures caused by osteoporosis or cancer).
- IDET surgeries (a minimally invasive treatment
for chronic low back pain for certain types of degenerative disc disease).
- Removal of spinal tumors
While the neurosurgeon and anesthesiologist lead the intervention, the scrub
personnel and circulating nurses are specially trained on the room’s equipment
-- every instrument, and all hardware needed for each procedure. The entire team
has the stamina to stay engaged in complex brain or spinal surgeries, and the
ability to respond quickly in emergency situations.
Neurosurgical Nursing Coordinator Lori Majeske, CNOR, says: "Our
surgical nursing team knows that seconds count, whether it’s brain or spinal
cord surgery. Sometimes the pre-op team has just minutes to get a patient ready
to enter the OR. Our nursing teams are on call 24 hours a day.
"The OR neurosurgical nursing team makes sure all systems in the room are
ready, that blood is on hand if needed, that assistance is available for
anesthesia and scrub technicians. Every neurosurgical team member has worked
alongside each neurosurgeon, and is intuitive to particular preferences, tools,
and surgical strategies, so the most optimal patient outcome