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Radiosurgery – Non-Invasive Brain Surgery in Israel

Radiosurgery – Non-Invasive Brain Surgery in Israel

The Radiosurgery Unit at Sheba Medical Center is a highly advanced subspecialty of the Department of Neurosurgery, and is the leading center for non-invasive brain surgery in Israel. Radiosurgery provides nonsurgical treatment, using state-of-the-art technologies and computer systems to precisely deliver ionizing radiation to intracranial targets. Neither skin nor bones need to be cut to perform radiosurgery, so anesthesia and hospitalization are not generally required.

Sheba opened the first radiosurgery unit in the Middle East in 1992, and we offer this progressive, non-invasive brain surgery in Israel for national and international patients. Multidisciplinary experts collaborate to custom-design the most effective treatments for each patient.

Non-Invasive Brain Surgery

How Does Radiosurgery Work?

Using 3D imaging, radiosurgery administers high doses of radiation to the affected tissues, targeting them precisely to minimize damage to the surrounding healthy tissue. Each individual radiation beam has almost no effect on the tissues it passes through, but at the point where all the beams intersect – a high dose of radiation is delivered.

Radiosurgery (similar to other forms of radiotherapy) works by damaging the cell’s DNA. Consequently, the targeted cells can no longer reproduce, and they shrink instead. Over time, blood vessels that nourish the tumor also close off, depriving the tumor of its blood supply.

On the day of treatment, the patient undergoes imaging tests (CT, MRI) to scan the head or spine. The resulting images provide essential information that enables Sheba’s doctors to define the exact parameters of the cancerous tissue that needs to be destroyed. The patient then lies on a robotic table that pivots according to the predetermined computer settings, and we use a Novalis accelerator to deliver the targeted ionizing radiation.

Radiosurgery of the brain and spine is usually performed in a single, painless session that takes about half an hour. Following this non-invasive brain surgery in Israel, the patient is released home and can return to normal daily activities immediately.

FUS Treatment

At Sheba, focused ultrasound (FUS) is another advanced therapy provided by the Radiosurgery Unit. While FUS is FDA-approved, it is still only available at a few facilities in the US.

FUS, a non-invasive treatment for essential tremor, does not require electrodes or any surgery, thereby eliminating any risk of infection. Focused ultrasound waves travel through the skull and skin to precisely destroy the desired area of the brain. The waves create heat to ablate brain tissue in a very specific area. The targeted delivery of FUS is guided by MRI, a radiation-free imaging technique that enhances patient safety.

There is no age limit for candidacy for FUS therapy; Sheba’s doctors evaluate each case individually. Possible side effects include trouble with walking, altered sensation, or difficulty moving. However, most of these complications are mild and short-term.

How FUS Treatment at Sheba Changed Fereidoon Ghasri’s Life

When “Feri” Ghasri was 27 years old, he developed a tremor in his hand. He was diagnosed with essential tremor (ET), which eventually worsened to the degree that he had to drop out of engineering school. His quality of life was seriously compromised, and after 35 years of suffering deeply due to ET – Feri began to search for an effective medical solution to alleviate his condition. His research led him to Sheba Medical Center for FUS treatment – non-invasive brain surgery in Israel. After only one session of FUS, the benefits were immediately clear.

On the day of treatment, the patient undergoes imaging tests (CT, MRI) to scan the head or spine. The resulting images provide essential information that enables Sheba’s doctors to define the exact parameters of the cancerous tissue that needs to be destroyed. The patient then lies on a robotic table that pivots according to the predetermined computer settings, and we use a Novalis accelerator to deliver the targeted ionizing radiation.

“I tried to draw and write just before the procedure, and it was shaky and uneven. I then tried again immediately after the treatment, and my family and I were amazed. I could draw and write clearly! I could take a drink of water without spilling it,” shares Feri. “It was beyond exciting – it was the beginning of my new life!”

What Conditions Do We Treat at the Radiosurgery Unit?

Brain and spinal cord tumors

Benign and malignant; radiosurgery may also be used to treat brain metastases (cancers that have spread to the brain)

Chronic pain/head and spinal cord trauma

Several techniques can be used to provide relief from chronic pain, including spinal cord stimulation, ablative spinal procedures, and motor cortex stimulation

Pituitary tumors

The pituitary gland controls various hormones in the body; radiosurgery can shrink the tumor and decrease the effects on pituitary hormone regulation

Congenital vascular malformations

Hemorrhaging intracranial blood vessels can increase the risk of impaired brain function and even death; over time, radiosurgery can cause the affected blood vessels to seal

Trigeminal neuralgia

A chronic pain disorder resulting from overstimulation of the trigeminal nerve, which is responsible for transmitting sensory information between the face and the brain

Tremors and movement disorders

FUS (focused ultrasound) can be used to treat tremors linked to neurological disorders, such as essential tremor and Parkinson’s disease

Why choose Sheba for radiosurgery in Israel?

Sheba’s medical staff comprises highly qualified specialists, such as radiation physicists, oncologists, and neurosurgeons who work together to personalize and optimize each patient’s treatment. To make the most of our doctors’ premier skills, we equip our campus with top-of-the-line and minimally invasive technologies for neurosurgery, including advanced stereotactic instrumentation, new computer technology, microelectrode recording equipment, high-field MRI, and focused ultrasound (FUS).

  • To date, Sheba’s Radiosurgery Unit has treated more than 5,000 patients since it was founded in 1992 – making our team one of the most experienced in the region.
  • Yearly, we care for about 230 adult and pediatric patients with benign and malignant cranial tumors, as well as patients with vascular malformations of the brain.
  • We have performed over 400 stereotactic radiosurgery procedures for Parkinson’s disease and other movement disorders.

Our Doctors

Roberto Spiegelmann

Roberto Spiegelmann, MD

Senior Staff Neurosurgeon, Department of Neurosurgery Head, Stereotactic Radiosurgery Unit and Functional Neurosurgery Service
Dr. Spiegelmann received his medical degree from the Universidad de la República, Uruguay. In December 1992, he founded Sheba Medical Center’s Radiosurgery Unit, the first facility of its kind in the Middle East. Dr. Spiegelmann has been active in spreading knowledge about radiosurgery on a national and international level, and he pioneered the combined approach of microsurgery and radiosurgery in Israel. As the first functional neurosurgeon in the country, Dr. Spiegelmann introduced GPI pallidotomy, deep brain stimulation, and open functional procedures to the array of options for non-invasive brain surgery in Israel. He has a particular expertise in treating chronic pain and movement disorders. Dr. Spiegelmann is a world-renowned member of several international professional societies.
Read More

Uzi Nissim, MD

Senior Staff Neurosurgeon, Department of Neurosurgery
Dr. Nissim is a highly-trained neurosurgeon, with particular expertise in radiosurgery.

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