Safety is paramount during neurosurgery. While operating, the neurosurgeon uses all the tools at their disposal to ensure there is no damage to any of the nerves from the brain and spine. Most of these cues are visual and the charity has supported microscopes and endoscopes to assist with this. However these cannot see the functioning of the nerves – that is the electrical messages being sent along them. These can be impaired without any visible disruption of the nerve (by stretching or altered blood flow).
The charity has recently, in conjunction with the Trigeminal Neuralgia Support Group, funded the provision of sophisticated Intra-Operative Nerve Monitoring equipment. This equipment monitors the electrical signalling in nerves while an operation proceeds and gives a warning to the surgeon if the signal is altered. The ISIS-IOM system was supplied by Inomed UK and is seen as a ‘Gold Standard’ in the monitoring of nerve systems during neurosurgical procedures, enabling surgeons to operate with confidence close to major neural nerve pathways both in the brain and spine. The ISIS IOM system is capable of simultaneously monitoring up to sixteen nerves (previous equipment was only capable of monitoring two) and will be useful in a diverse range of neurosurgical cases.
An example of an operation where it is used very frequently is microvascular decompression for trigeminal neuralgia and hence this was co funded with the trigeminal neuralgia support group (80% S4W 20% TGN). Trigeminal neuralgia is a sharp pain in the face, widely described as the worst known pain and has been known to drive patients to starvation. It can be cured by an operation to separate a blood vessel pressing on a nerve coming out of the base of the brain. This surgery occurs in a very delicate area near a large number of critical nerves. It has a very high cure rate albeit with a risk of damaging these fragile nerves. With the new intraoperative monitoring equipment surgeons get a warning before an injury reducing the risk of complications from this otherwise life changing operation.