Advanced imaging, navigational guidance, radiotherapy combine to provide superior outcomes
In advanced neurosurgical care, few concepts are as important as access — access to the most comprehensive array of therapeutic options, access to the most experienced and technically adept clinicians, and increasingly, access to the most advanced intraoperative imaging and navigational guidance. Select centers, like the Cooper Neurological Institute (CNI), offer patients not only the latest in advanced technology, but also the full spectrum of multi-disciplinary treatment approaches.
“Without question, the Cooper Neurological Institute offers patients the best-equipped neurosurgical operating rooms in the region,” says H. Warren Goldman, MD, PhD, Chief of the Department of Neurosurgery and Director of the Cooper Neurological Institute.
Operational since 2009, the two custom-built neurosurgical operating rooms are specifically tailored to perform complex cranial and spinal procedures.
The state-of-the-art technology includes:
- Intraoperative large-bore CT, or iCT.
- Surgical Navigation Integration (multi-modal image-guidance).
- Video Display Distribution, or “Patient-Aware” System.
“We were one of the first centers in the nation to install iCT, and are still the only neurosurgical program in the region to have this technology,” says Dr. Goldman. “Intraoperative CT allows for pre-, intra-, and post-operative high-resolution scanning sequences to be acquired in approximately six seconds.”
CNI intraoperative advances extend to surgical navigation for both cranial and spinal surgery. Cooper utilizes a multimodal image guidance system that is anatomical and functional. Image integration is so precise that it identifies where healthy tissue ends and the tumor begins; or can pinpoint where to place a pedicle screw in the spine to maximize patient mobility.
Surgical Advances in Spine Care
In addition to intraoperative CT, Cooper University Hospital is one of several major medical centers in the Delaware Valley, to utilize O-arm® imaging technology for spine surgery. A multi-dimensional surgical imaging platform, the system provides precise image acquisition and real-time views, not available with traditional fluoroscopic imaging. “We are able to get quicker, more accurate placement of hardware during a procedure, and to check post-operative placement while the patient is on the table,” says Steven S. Yocom, DO, Co-Director of the CNI Spine Program. “This technology significantly decreases radiation exposure to patients and OR personnel, and decreases the need for revision surgeries, and improves outcomes.”
“Surgery is not our only treatment option, nor is it the end of the care continuum for the Cooper Neurological Institute patient,” says Dr. Yocom. “We have dedicated clinicians that offer therapies targeting pain management and maximizing functional capacity? including epidural spinal injections, osteopathic manipulation, acupuncture, and physical therapy.”
David H. Clements, MD, Co-Director of the CNI Spine Program, also credits the multidisciplinary support provided by Cooper neuroradiology in his operative work with scoliosis and spinal deformities. “Our surgical program is supported by world-class neuroradiologists who are able to accurately diagnosis complex spinal pathology,” says Dr. Clements.
The CNI spine program, renowned for exceptional patient outcomes, received the Blue Distinction® designation in 2010 from Horizon Blue Cross Blue Shield of New Jersey. Blue Distinction is a quality designation awarded to select medical facilities that meet rigorous, evidence-based objective criteria. CNI demonstrated exceptional outcomes in multiple categories of quality assessment, far exceeding the Blue Distinction acceptable threshold for incidence of dural tears in complex primary posterior lumbar fusions.
Advances in technology provide benefits for both the patient and the surgeon; however, additional equipment and personnel can create visualization issues for the operative teams. At Cooper, the neurosurgical rooms are equipped with a state-of-the-art video or “patient-aware” system for immediate display of patient data delivered via touchscreen.
The technology is integrated with multiple systems: hospital PACS, vital sign monitors, endoscopes, guidance systems, microscopes, room camera, and the surgical field camera. Images are displayed on seven, boom-mounted, flat screen monitors in the rooms. “At a glance, this technology offers an unparalleled level of information for the surgical team,” says Dr. Goldman.
Multi-disciplinary Approach to Brain Tumors
The Cooper Neurological Institute provides accurate diagnosis and cutting-edge treatment for a wide array of disorders and disease. One of the most comprehensive of these programs is the rigorous Brain Tumor Program. CNI offers a multi-disciplinary, collaborative, patient-centered philosophy that provides a single point of contact for patients along the continuum of their brain tumor care. In addition to the full spectrum of diagnostic modalities, CNI offers a full range of therapeutic options, including:
- Image-guided tumor removal
- Stereotactic frame-based and frameless biopsy
- Conventional radiotherapy
- Intensity modulated radiation therapy (IMRT)
- Gamma Knife™ radiosurgery
- CyberKnife, multi-session stereotactic robotic radiotherapy
“Many options regarding radiation treatments are available at Cooper University Hospital for brain and spinal tumors as well as benign diseases,” says Lesley A. Hughes, MD, Cooper radiation oncologist. “We have a full complement of radiation technologies available to individualize each patient’s care.”
The Gamma Knife™ Perfexion® is a precision device that allows radiation to be delivered with pinpoint accuracy for intracranial diseases, both malignant and benign, with a noninvasive surgical technique that is both patient friendly and efficient in treatment delivery.
Cyberknife technology is a frameless radiosurgical device that enables safe and effective delivery of focused radiation to the brain and spine using advanced robotic technology.
“We can treat the patient in only a few fractions, over a reduced timeline, and provide a strong program of conformal radiation treatment options,” says Dr. Hughes.
“The therapeutic options available at Cooper – Gamma Knife and CyberKnife radiotherapy, tumor removal and chemotherapy – are diversified and leading edge in the Delaware Valley,” says Dr. Goldman. “Our multi-disciplinary approach is essential to the success of our program.”
The combination of therapies that arises from a multidisciplinary approach provides an individualized approach, says Nati Lerman, MD, medical oncologist for the Cooper Brain Tumor Program. “The combination of chemotherapy and targeted radiotherapy has significantly extended the life expectancy of many glioma patients, says Dr. Lerman. “We have a weekly Brain Tumor meeting where there is input from all disciplines: neurosurgery, pathology, radiation oncology, neurology, oncology, pain management, and physical medicine. This approach allows us to tailor an individual plan of care for each patient.”
Round-the-Clock Emergent Access
The Cooper Neurological Institute provides seamless access to care. Urgent neurosurgical patients are transferred round-the-clock through the Cooper Transfer System (COTS) by calling 1.866.723.2687.
To contact the physicians of the Cooper Neurological Institute for consultation or to make an appointment, call: 1.888.6.COOPERCNI (1.888.626.6737).