CIREN count with a neurosurgery service linked to the Neurologic Restoration Program that offers its services to five clinics, where specialized neurosurgeries are applied to diseases of the nervous system treated at CIREN with a novel approach called “neurorestorative surgery of the Central Nervous System” are based on surgical methods of minimal access through stereotactic techniques with automated planning and neurophysiologic check ups by semi-registering of the neuronal activity.
This Service offers several options for the treatment of diverse cranial and spinal-type diseases that besides using classical and convenytional approaches, makes use of the goodness of image-guided surgery. It must be mentioned the high development achieved in the design and implementation of program-localization. That allows the performance of functional, tumoral and vascular surgeries with a high degree of precision. The experience and expertise have permitted us to incorporate new options for patients with lesions of a great complexity and difficult to localize, the same as the progressive development of surgical modalities of epilepsy of the temporal lobe.
Although many years have passed with the performance of surgeries of refractory epilepsy, this issue is considered among most novel methods developed at present by this service, as to the importance in the improvement of the patient’s quality of life and the very good results obtained in this line of work. It must be kept in mind that non-treatable chronic epilepsy with antiepileptic medication, implies a poor prognosis with a high mortality rate that increases with age.
The principal lines of work at our service include:
- Functional Surgery of Parkinson’s Disease, essential tremor and dystonias.
- Functional Stereotaxic Surgery of Refractory Epilapsy of the Temporal Lobe.
- Diagnosis and surgical treatment of brain tumors and spinal medulla.
- Vascular neurosurgery
- Surgery of the cranial base.
A new line of work is offered in coordination with the Clinic of Rachimedullar Lesions, as part of the service for THE TREATMENT OF RACHIMEDULLAR PAIN where there are additional tools that allow to solve those problems related with pain, mainly neurologic, through a multidisciplinary team on the use of minimally invasive treatments for the relief and cure of different diseases through the deepening of diagnosis and treatment application of a great number of controls and non-surgical peripheric and neuropathic affectations, as well as degenerative or traumatic disorders of the neurocore with whether or not surgical criteria, for which an integral treatment is proposed.
The experience in neurosurgical and specialized software designs in the application of stereotaxic techniques at the International Center of Neurologic Restoration CIREN, linked to the development reached by specialists at the Immune-Assay Center (IAC) in the construction of highly complex and precise mechanical instruments, has allowed us to design and create the STEREOFLEX Stereotaxic System. It is a system conceived for the performance of procedures with the use of a frame, thus combining simplicity, exactness and versatility in its applications.
Stereoflex permits the aproach to any deep structure inside the human brain a very precise way.The system serves as a guide to reach, in an exact and safe way, predetermined intracranial targets, through a system of own coordinates and the use of imagenologic means. This system is compatible with the Axial Computed Tomography (ACT) and Angiography by Digital Subtraction (ADS) that can be used with great versatility.
The International Center of Neurologic Restoration CIREN, is a Cuban medical scientific Institution with already two decade of experience in investigation and clinical practice, based on the principles of neuroplasticity. It offers health services to patients from more than 85 countries and it is structured in two therapeutic programs, that is, the Neurologic Restoration Program and the Program of General Biologic Restoration (REBIOGER); five highly specialized clinics and an area for basic investigations.
A great experience has been acquired with the use of “Stereoflex”, Stereotaxic Systems in more than 800 surgical interventions in functional surgeries. This development has made possible that at CIREN, the selective Dorso-lateral Subthalamotomy, be performed with a world-round innovation character and exclusive to Iberoamerica for the treatment of Parkinson’s Disease.
Immuno-Assay Center (IAC)
The Immuno-Assay Center (IAC) is a Cuban Institution dedicated to the investigation, development and production of diagnostic means, by using fundamentally immuno-enzymatic methods aimed mainly at hospitals, blood banks, investigation institutes and clinics among other institutions.
This Center created in l987, has developed multiple investigation and developmental projects, which have resulted in a varied group of projects that have already been commercialized in more than a dozen countries.
The accumulated experience in the design of equipment and high precision instruments supported by Informatics Service and Personal Computers and the fact that this Center can count with novel construction technologies, has permitted to carry out the Stereoflex System Project. For the achievement of this project, high-quality materials and computer-controlled machines have been used to guarantee the quality precision and security needs that a new stereotaxic system requires.
Components and Applications of the Stereoflex System:
The System is composed of:
- Stereotactic frame
- Software of Application: STASSIS and NDRS Systems
- Stereotactic surgical instruments
STASSIS: Surgical Planning System for Stereotactic Neurosurgery.
It is a program specially designed to facilitate the planning of surgical procedures in stereotactic neurosurgery.
The system offers:
- Maximum precision
- Multiple imagenologic information
- Graphic surgical planning
- Stereotactic Atlas
- Calculation of brachitherapy
- Tridimensional Imagings (o images)
- Different Stereotactic systems.
NDRS: NeurosurgicalSystem for Deep Brain registering
A computerized system for the digital registering and processing of the deep brain electrical activity is used as a guide for the Stereotactic Functional Neurosurgery. It is used for the effective and safe localization of targets, considering so much the anatomic informationas neurophysiological ones, given by the registers of the neuronal activity with a modern and updated 6.0 Version for Windows certified with an CE Marking.
Learning and Training
Courses and Training are given to specialists, national as well as foreigners, for a better application of the most state of-the-art surgical techniques applied at CIREN.
There are also exchanges between experts in surgical techniques that are in favor of the professional development of specialists.
The treatment s offered at present by CIREN’s Service of Neurosurgery are:
Neurosurgical Treatment for Movement Disorders and Epilepsies:
- VIM Thalamotomy
- Selective Posterovental Pallidotomy
- Selective Dorsolateral Subthalamotomy
- Adjusted temporal Lobectomy
Neurosurgical Treatment of Rachimedullar Lesions
- Derivation of Syringometrics cyst
- Spondolytic myelopathies (anterior and posterior ways)
- Micro-surgical lumbar Drez’lesion
- Micro-surgical dorsal Drez’lesion
- Micro-surgical cervical Drez’lesion
- Cervical discal hernia (microsurgery)
- Lumbar discal hernia (microsurgery)
- Canal stenosis (laminoplastic and laminectomies)
- Cervical spondilosis
Other Neurosurgical Treatment offered:
- Stereotactic Biopsy
- Guided craniotomy (tumors)
- Guided craniotomy (MAV)
- Derivation of peritoneal ventricle
- Tumor of the Hypophysis (transcranial way)
- Tumor of the Hypophysis (Transepto-ephenoidal)
- Intrarachideal tumor with microsurgery
- Syringobulbia derivation of cyst
- Percutaneous micro-compression of Gasser Ganglia with Fogarty’s Ballon (Trigeminal Neuralgy)
- Vascular micro-decompression of the Trigeminal Nerve in posterior fossa.
- Microsurgery of lesions of the pontocerebelose angle
- Biopsy of peripheric nerves
- Decompression of the mediam nerve (retinaculotomy)
- Tumors from the cranial base (operation with different techniques)