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Brain metastases treatment with MRI-guided laser ablation (program ID: 500774)

Helios Hospital Hildesheim

location_on Hildesheim, Germany
9.5/10 from 23 Votes
Specialized hospital
Rafael de la Riva

Head Physician
Dr. med.

Rafael de la Riva

Specialized in: spinal surgery

Department of Spinal Surgery

The program includes:

  • Initial presentation in the clinic
  • clinical history taking
  • review of medical records
  • physical examination
  • laboratory tests:
    • complete blood count
    • general urine analysis
    • biochemical analysis of blood
    • inflammation indicators (CRP, ESR)
    • indicators of blood coagulation
  • neurological examination
  • CT/MRI scan
  • neuropsychological tests (if indicated):
    • ENMG (electroneuromyography)
    • EEG (electroencephalography)
    • SEPs (somatosensory evoked potentials)
    • VEPs (visually evoked potentials)
    • BAEP tests (brainstem auditory evoked potentials)
  • preoperative care
  • MRI-guided laser ablation of brain metastases
  • postoperative MRI control
  • symptomatic treatment
  • control examinations
  • the cost of essential medicines and materials
  • nursing services
  • full hospital accommodation
  • developing of further guidance by specialists
    in oncology and radiotherapy

How program is carried out

During the first visit, the physician will conduct a clinical examination and neurological examination, and go through the results of the available diagnostic tests. After that, you will undergo the necessary additional examination, such as the laboratory blood and urine tests, MRI scan with obtaining 3D images and creating volumetric images of the whole brain. Based on the results of an additional examination, the physician will clarify the localization of brain metastases. After that, the preparation according to the preoperative standard will begin.

Laser ablation of metastases begins with the formation of access to the brain. When using a catheter with a laser fiber, a hole with a diameter of 3.2 mm is sufficient for this. The miniature size and flexibility of the catheter help preserve healthy brain tissue.

When the catheter reaches metastasis, energy is delivered through the laser fiber. Under the influence of high temperature, metastases are destroyed. The procedure is guided by real-time MRI. Surgeons also assess the temperature of healthy brain tissue using thermographic images to avoid overheating.

After the completion of the operation, you will be transferred to the ward, under the round-the-clock supervision of doctors and nurses. In several days, the attending physician will evaluate the results of the postoperative MRI scans, schedule the date of discharge from the hospital and give you detailed recommendations for further follow-up and treatment.

Required documents:

  • Medical records
  • MRI/CT scan (not older than 3 months)
  • Biopsy results (if available)
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About the department

The Department of Spinal Surgery at the Helios Hospital Hildesheim offers modern surgery for the treatment of the full range of spinal diseases and injuries. The department's competence also includes pain therapy for chronic back pain. The patients with spinal injuries receive high-quality emergency care. The Chief Physician of the department is Dr. med. Rafael de la Riva.

The department annually admits more than 1,500 inpatients and about 6,000 outpatients. The department's specialists use in their work sparing minimally invasive surgical techniques that allow achieving an excellent treatment outcome and at the same time significantly reduce the period of postoperative recovery. The operating rooms have advanced equipment and modern neuromonitoring systems that ensure high safety of the surgical treatment. The department's surgeons have unique clinical experience, thanks to which they achieve recovery of patients even in specially complex spinal pathologies and injuries.

One of the priority focuses of the department's clinical activities is on the operations for the treatment of spinal disc herniation. The surgeons of the medical facility usually use microsurgical and endoscopic techniques. Microsurgical removal of a herniated disc is aimed at eliminating compression of the contents of the spinal canal by a hernia. The essence of the operation is to remove the hernial protrusion using a minimally invasive approach, without damaging healthy muscle and bone structures. The use of microsurgical techniques practically eliminates the risk of damage to nerve endings, and also contributes to a rapid recovery after surgery. In addition, such interventions cause minimal postoperative pain syndrome.

The department quite often performs intervertebral disc replacement. The main indications for such operations include degenerative spinal diseases, chronic back pain, spinal disc herniation with compression of the spinal nerve roots, and other pathological changes. The intervertebral disc replacement surgery consists of two stages – removal of the affected intervertebral disc and the implantation of an artificial one. Prior to the operation, the patient undergoes laboratory and instrumental diagnostics, based on the results of which the doctors determine the optimal type of replacement surgery (partial or total) and the most suitable type of prosthesis. The surgical procedure is performed under general anesthesia, through small skin incisions 3-4 cm long. During the operation, the doctor uses special micro-instruments and a surgical microscope. The duration of the procedure is from 30 minutes to one and a half hours. The patient gets to his feet the very next day after the operation, after which rehabilitation begins.

The department also successfully performs spinal stabilization surgery, decompression interventions for spinal stenosis, operations for the treatment of osteoporotic vertebral fractures, operations for spondylolisthesis and many other interventions. The use of the advanced surgical techniques and computer-assisted navigation systems guarantees the patient the highest safety during interventions, while the professional skills of the surgeons working in the medical facility provide the achievement of the best results, relieving the patient of pain syndrome and giving him a chance for a decent quality of life.

The department's range of medical services includes:

  • Microsurgical interventions on the intervertebral discs
  • Intervertebral disc replacement
  • Decompression interventions for spinal stenosis
  • Stabilizing spinal interventions
  • Vertebral replacement surgeries for fractures or tumors
  • Vertebral augmentation using bone cement for osteoporotic fractures
  • Surgery for spondylolisthesis
  • Peripheral nerve compression syndromes
  • Peripheral nerve compression syndromes (carpal tunnel syndrome, cubital tunnel syndrome)
  • Surgery to remove spinal fluid cysts
  • Pain therapy for chronic back pain (for example, sciatica, phantom pain, pain caused by tumors, head and face pains)
  • Emergency care for spinal injuries
  • Other therapeutic options

Photo of the doctor: (c) Helios Kliniken GmbH


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