Neurosurgery is the surgical specialty that diagnoses, treats and manages conditions affecting the brain, spine, spinal cord and nerves. 

A neurosurgeon is a specialist doctor trained in both surgery and non-surgical care for problems involving the central nervous system and peripheral nervous system.

Although many people think neurosurgery means “brain surgery,” it also includes spine surgery, nerve surgery, skull base surgery, treatment for brain tumours, stroke-related blood vessel problems, spinal disc disease, trauma, pain and movement disorders. 

A patient may be referred to a neurosurgeon with symptoms such as severe back pain, neck pain, sciatica, arm or leg weakness, numbness, headaches, seizures, dizziness, balance problems or memory changes. Referral may also follow diagnosis of a known or suspected condition, such as a brain or spinal tumour, aneurysm, hydrocephalus, nerve compression, or a head or spinal injury. 

Your assessment may include a neurological examination, MRI scan, CT scan, X-ray, nerve conduction study, blood tests or discussion with other specialists such as neurologists, oncologists, radiologists, rehabilitation doctors and physiotherapists. 

Treatment does not always mean surgery. Many patients are treated with monitoring, medicines, physiotherapy, injections, rehabilitation, lifestyle changes or pain management before surgery is considered. 

When surgery is recommended, the aim is usually to protect the brain, spine or nerves; remove pressure; treat bleeding or abnormal blood vessels; remove a tumour; stabilise the spine; reduce pain; improve movement; or prevent worsening symptoms. 

Common Neurosurgery procedures

Common neurosurgery procedures include:

•  craniotomy
• brain tumour surgery
• spinal decompression
• discectomy
• laminectomy
• spinal fusion
• aneurysm clipping
• endovascular treatment
• shunt surgery
• deep brain stimulation
• epilepsy surgery
• peripheral nerve decompression. 

Some operations are minimally invasive or keyhole procedures, while complex brain, spine or skull base surgery may require a longer hospital stay. Your neurosurgical team will explain the expected benefits, risks, recovery time and follow-up plan in language you can understand. 

General neurosurgery and neuro-oncology: General neurosurgery covers common brain, spine and nerve conditions, including head injury, spinal pain, nerve compression, hydrocephalus, brain bleeding, and benign or cancerous brain and spinal tumours. Care may include scans, monitoring, medicines, biopsy, craniotomy, tumour removal or image-guided surgery, often alongside oncologists, radiologists, and rehabilitation teams. 

Spine neurosurgery: Spine neurosurgery treats problems involving the neck, back, spinal cord, spinal nerves and vertebrae. Common conditions include herniated disc, sciatica, spinal stenosis, spinal cord compression, spine fractures, spinal tumours and degenerative disc disease. Procedures may include discectomy, laminectomy, decompression, minimally invasive spine surgery and spinal fusion. 

Cerebrovascular and endovascular neurosurgery: Cerebrovascular neurosurgery treats blood vessel problems in the brain and spinal cord, including aneurysm, arteriovenous malformation, cavernoma, and narrowed vessels. Treatment may include monitoring, microsurgery, aneurysm clipping, bypass surgery, embolisation, coiling or stenting. 

Skull base neurosurgery: Skull base neurosurgery treats tumours and other conditions deep at the base of the brain, near important nerves and blood vessels. Conditions include acoustic neuroma, meningioma, pituitary tumour, chordoma and cerebrospinal fluid leak. Surgery may use microsurgery, endoscopy, keyhole approaches and close teamwork with ENT surgeons. 

Functional neurosurgery: Functional neurosurgery treats conditions caused by abnormal brain or nerve signals, such as Parkinson’s disease, essential tremor, dystonia, severe pain, spasticity and epilepsy that continues despite anti-seizure medicines. Following careful specialist assessment, treatment may include deep brain stimulation, epilepsy surgery, lesioning procedures, or nerve stimulators. 

Peripheral nerve surgery: Peripheral nerve surgery treats nerves outside the brain and spinal cord. Patients may have carpal tunnel syndrome, ulnar nerve compression, nerve injury, nerve tumours, brachial plexus injury, foot drop or pain from trapped nerves. Treatment may include nerve release, nerve repair, nerve grafting, or tumour removal.