What Is Neurointerventional Surgery?

Neurointerventional Surgeon Training and Procedures

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Doctors with Spine ModelNeurointerventional surgery is a multi-disciplinary Accreditation Council for Graduate Medical Education (ACGME) accredited and American Medical Association (AMA) recognized medical specialty specializing in minimally invasive image-guided procedures to treat disorders of the brain, head/neck, and spine.  Today, only 500 neurointerventional surgeons exist in the United States, making it one of the rarest and most specialized surgical fields.

Neurointerventional surgery is accomplished through a small hole in the skin.  Through this miniature portal, tiny catheters, needles or tubes are placed and guided to their intended targets in the brain, head/neck, or spine.  The field employs sophisticated imaging technologies to precisely guide its devices into highly sensitive neural structures.  Once there, devices that are amongst the most innovative and advanced available to medicine are used to accomplish minimally invasive surgical solutions.  Through innovation, the treatment of certain brain vascular and spinal conditions has lended itself to this minimally invasive approach.

Neurointerventional surgeons provide non-operative and surgical treatment to patients of all ages suffering from neurovascular or painful spinal conditions.  Spinal conditions treated include low back and neck pain due to compression fractures, herniated disc, facet arthritis, and spinal stenosis.

Neurointerventional Surgeon Education and Training
After medical school and a 1 year internship, the doctor will enter a residency program consisting of 4 years of radiology, 6 to 7 years of neurosurgery, or 4 years of neurology.  Radiologists will undergo additional fellowship training in 1 to 2 years of neuroradiology, and neurologists will also undergo fellowship training in 1 to 2 years of vascular neurology or neurocritical care.

After residency and additional fellowship training, neurointerventional candidates will undergo an additional 1 to 2 years of training.  This training will focus on neurointerventional surgical procedures and the management of conditions amenable to such therapy.  No matter the specialty of origin, neurointerventional surgeons have a minimum of 7 years of training beyond medical school.

Depending on their specialty, neurointerventional surgeons will be take their boards in radiology/neuroradiology, neurosurgery, or neurology.  Work is underway to establish a distinct board certification for the new medical specialty of neurointerventional surgery.

What Disorders Do Neurointerventional Surgeons Treat?
Neurointerventional surgeons treat a multitude of conditions affecting the brain and spine that are amenable to image guided minimally invasive therapies.  While most neurovascular cerebral disorders that neurointerventional surgeons treat are rare, there are such a limited number of specialists in this field that these disorders can comprise a significant portion of a neurointerventional surgical practice.

Neurovascular brain disorders amenable to neurointerventional therapies include brain aneurysms, vascular brain tumors, vascular malformations, stroke, and arteriosclerosis ( hardening of the neck and brain arteries). 

There are a number of spinal disorders amenable to minimally invasive neurointerventional surgical treatments.  When neck and back pain is caused by disc herniation, facet arthritis, or spinal stenosis, neurointerventional treatments may provide relief.  Similarly, back pain caused by vertebral compression fractures can be treated by minimally invasive means.  Spinal tumors may be suitable for a number of treatment options. 

Updated on: 01/05/16
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This article was reviewed by Jason M. Highsmith, MD.
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