Neurosurgery – Brain and Spinal Surgery
Neurosurgery at Sheba Medical Center is provided within the Division of Surgery and offers premier care for patients in all neurosurgical subspecialties. We perform cerebrovascular surgery, radiosurgery, stereotactic and functional surgery, spinal surgery, and pediatric neurosurgery, as well as manage head and spinal cord trauma.
Our Neurosurgery Unit contains many state-of-the-art clinics, all staffed by a select team of brain and spine specialists and equipped with the latest technologies. We are dedicated to advancing neurosurgery through clinical research and the development of new, advanced techniques.
Conditions Treated by Neurosurgery at Sheba
Our medical team of world-class, specially trained neurosurgeons has extensive experience and expertise in the surgical treatment of many brain and spinal conditions. Many of these conditions can cause pain and/or threaten spinal function. Our goal is to alleviate pain and restore full function to every patient. Sheba’s neurosurgeons are highly qualified in the complex surgical methods necessary for operating on and around the nervous system. To promote faster healing and recovery, Sheba’s neurosurgeons strive to use minimally invasive procedures whenever possible, such as neuroendoscopy.
We offer neurosurgery for the following conditions:
Hydrocephalus refers to the buildup of fluid in the ventricles within the brain; this excess fluid puts pressure on the brain. Normally, cerebrospinal fluid flows through the ventricles, moistening the brain and spinal column. However, too much of this fluid can damage the brain and impair function. Hydrocephalus occurs most commonly in infants and adults over 60.
The surgical insertion of a shunt, a drainage system, is the most common treatment for hydrocephalus. The shunt is a long, flexible tube with a one-way valve that prevents fluid from the brain from flowing in the wrong direction. Generally, one end of the tube is placed in one of the ventricles of the brain and then channeled under the skin to another part of the body, such as the abdomen, where the fluid can be easily absorbed. The shunt system usually remains in place for the rest of the person’s life, and regular monitoring is necessary. Possible complications include mechanical malfunctions, infections, and blockage that interferes with the proper drainage of cerebrospinal fluid.
Pituitary Tumors (Adenomas)
A pituitary tumor is an abnormal growth in the pituitary gland, which can cause an overproduction or underproduction of important hormones. The majority of pituitary tumors are benign growths, called adenomas, which stay local and don’t spread to other parts of the body.
Surgical removal of a pituitary tumor is typically necessary if it is causing the overproduction of specific hormones or pressing on the optic nerves. Sheba surgeons will perform endoscopic transnasal transsphenoidal surgery to remove the tumor through the nose and sinuses, thereby avoiding an external incision. When the nostrils are too small or distorted, this surgery may be done through an incision under the upper lip. Our neurosurgeon will use specialized microsurgery devices and a microscope to magnify the field of surgery, identify, and precisely remove the adenoma safely from nearby healthy tissue.
Transsphenoidal surgery does not affect any other part of the brain. However, it can be very difficult to remove a large tumor using this approach, especially if it has penetrated brain tissue or any surrounding nerves.
A herniated disk occurs when there is a problem with one of the disks (rubbery pads) that rests between the individual vertebrae of the spine. Although aging and disk degeneration are the typical causes of disk herniation, most of the time the precise culprit of disk herniation cannot be identified.
Each spinal disk consists of a tough, rubbery exterior that surrounds a central jellylike nucleus. When a herniated disk (also called a slipped disk or ruptured disk), occurs, it means that some of the inner nucleus has pushed out through a tear in the disk exterior. This can happen in any region of the spine, and sometimes it irritates a nerve – causing numbness, weakness, or pain in a leg or arm. When that happens, surgery may be required to relieve the problem.
Depending on the patient’s specific condition, surgery for a herniated disk can be:
Laminectomy – our neurosurgeon will remove the lamina (the back part of a vertebra that covers the spinal canal) to create space. This relieves pressure from the spinal cord or nerves.
Discectomy – in this procedure, the damaged part of a herniated disk is removed in order to relieve pressure from a spinal nerve and treat pain that radiates down the legs or arms; it is not generally done to relieve neck or back pain.
Spinal stenosis refers to a narrowing of the spaces in the spine, and it occurs most commonly in the lower back and neck. As a result, pressure may be placed on the nerves that go through the spine. Spinal stenosis is usually caused by normal wear and tear related to osteoarthritis. Sometimes it leads to pain, tingling, muscle weakness, and numbness, while other times it is asymptomatic. In severe cases, surgery may be recommended to restore the collapsing disk space in the spinal canal, making more room for the spinal cord or nerve roots.
To decompress the spinal cord and/or spinal nerve and enable the nerves to heal, Sheba neurosurgeons may perform a discectomy and fusion. This surgical procedure involves removing the degenerated disk and fusing the adjacent vertebrae. Alternatively, minimally invasive options done with a laparoscopic, abdominal approach may be suitable.
Craniotomy (Head surgery)
A craniotomy is the surgical removal of part of the skull bone to provide access to the brain. Using specialized tools, a bone flap is made and temporarily removed – to be replaced after the brain surgery is finished. Sheba neurosurgeons perform computer-guided craniotomy using imaging to help reach the exact location that needs treatment in the brain.
Craniotomies may be performed to remove large or complicated brain tumors, as well as for clipping an aneurysm to preventing a rupture. This procedure may also be necessary in cases of intracerebral hemorrhage in order to drain the bleeding.
Why Choose Sheba for Neurosurgery in Israel?
The Department of Neurosurgery at Sheba is one of the largest neurological centers in the world. We perform approximately 1,200 surgical procedures every year. Our staff comprises world-renowned experts who trained at leading medical facilities, and they are skilled in applying the latest technologies and frontline surgical techniques. Whenever possible, we strive to perform treatment with minimally invasive procedures to promote easier, faster recuperation. In addition to our premier skill, we also practice medicine with a compassionate, personal touch – custom-designing treatment programs to meet the needs of each individual patient, before, during, and after surgery.
Sheba is committed to holistic healthcare that considers your quality of life as you undergo neurosurgery for your medical condition. Supportive services, including social workers, nutritionists, and rehabilitation professionals, conveniently offer therapies on our all-inclusive campus. To help facilitate a smooth experience, we assign every patient a personal medical coordinator from the International Medical Tourism Division. Your coordinator will provide assistance with every step of your arrangements, treatment, and follow-up at Sheba.
Nahshon Knoller, MD
Director, Department of Neurosurgery
Dr. Knoller established the General Trauma Service at Sheba and headed it until 1997. At the same time, he joined the Neurosurgery Department – specializing in cutting-edge head and spine surgeries. He treats and analyzes the entire range of spine and head pathologies. Dr. Knoller received his medical degree from the Hebrew University of Jerusalem and completed a residency in neurosurgery at Sheba Medical Center. He also finished a continuing education program in the field of head, spine, and spinal injury, at the Shock Trauma Center in Baltimore, MD, an internationally recognized center for neurosurgical injuries.
Sheba Medical Center
Nahshon Knoller, MD
Zvi Cohen, MD
Director, Neurosurgical Oncology Service
Deputy Chair, Department of Neurosurgery
As the director of Sheba’s Neurosurgical Oncology Service, Dr. Cohen is the head of a top-tier, multidisciplinary team. His particular expertise is in the treatment of brain tumors and pituitary adenomas, and he is skilled in performing image-guided surgical removal of brain tumors. He has many published medical articles on brain tumors and performed clinical research on the effects of the latest drugs used to treat malignant brain tumors. He received his medical degree from the Sackler Faculty of Medicine, Tel Aviv University.
Jacob Zauberman, MD
Senior Physician, Department of Neurosurgery
Dr. Zauberman specializes in pediatric neurosurgery, brain tumors, endoscopic brain surgery, and hydrocephalus. He graduated from the Faculty of Medicine at the Technion, Israel Institute of Technology, in Haifa. Afterwards, he completed his residency in neurosurgery at Sheba.
Following his residency, Dr. Zauberman specialized in brain tumors at the Brigham and Women’s Hospital, Boston, MA, before completing a fellowship in pediatric neurosurgery at the Children’s Hospital in Seattle, WA.
Dr. Zauberman joined Sheba’s staff as a Senior Neurosurgeon, practicing in the fields of pediatric neurosurgery, hydrocephalus, endoscopic surgery, brain tumors and epilepsy surgery. He has published many scientific articles in neurosurgery.
Prof. Moshe Hadani, MD
Ex-Senior Physician, Department of Neurosurgery
Prof. Hadani is a leading neurosurgeon in Israel, with more than 40 years of professional experience. He is a renowned expert in the surgical treatment of pituitary tumors and benign brain tumors. He also specializes in the treatment of vascular diseases of the brain. Prof. Hadani has successfully performed more than 2,000 complex, advanced operations. He served as Director of Sheba’s Department of Neurosurgery for over 20 years and was a leading developer of the intraoperative MRI, now used worldwide in brain surgery. Presently, Prof. Hadani is engaged in clinical research in neurology and develops new treatment techniques for brain disease.
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