The surgical treatment of disorders and malformations of the brain and spine in childhood is uniquely challenging and complex. At the Great Ormond Street Hospital (GOSH) Department of Neurosurgery we have a core team of 6 full-time paediatric neurosurgeons, supported by specialist doctors, nurses and allied health professionals. We offer a comprehensive paediatric neurosurgery service 24 hours a day, 365 days a year.
We are the largest paediatric neurosurgery centre in the UK, performing over one thousand surgeries per year. Our practice is built on child-centred multidisciplinary teams, working in close collaboration with colleagues from Neurology, Neurophysiology, Craniofacial, Neuroradiology/Interventional Radiology, Neurodisability, the Children’s Epilepsy Surgery Service and Orthopaedics/Spinal Surgery. Every case referred to us is reviewed as a team, to ensure the best opinion and care is offered on an individualized basis.
Our large volume of complex cases has allowed our consultants to devote themselves to particular specialized conditions and surgeries, so the care of all children referred to the department is led by the most appropriate specialist to ensure the very latest knowledge and treatments are offered and the best outcomes are achieved.
Specialist areas of interest in the department include neuro-oncology (brain and spine tumours), epilepsy, craniofacial, spinal disorders including Chiari/craniocervical junction, neurovascular conditions, hydrocephalus, spasticity, neurotrauma/critical care and others.
Our team-based approach means that a consultant paediatric neurosurgeon is available 24/7 to deal with new referrals or any changes in condition of inpatients. We are a designated UK referral centre for Epilepsy Surgery, Craniofacial Surgery, Vein of Galen Malformation, Selective Dorsal Rhizotomy, and Stereotactic Radiosurgery (Gamma Knife).
The Neurosurgery Team is the largest paediatric neurosurgery unit in the United Kingdom. We perform around 1000 procedures each year and record some of the best outcomes for paediatric neurosurgery in the world.
- In 2016/17 the team conducted 124 epilepsy operations, of which 99% had no serious adverse events (grades 3-4).
- In 2016/17, the team conducted 69 surgical operations for spinal dysphraism, of which 99% had no serious adverse events (grades 3-4).
- In 2016/17, the team conducted 146 operations for brain tumours, of which 95% had no serious adverse events (grades 3-4).
- A total of 6343 operations have taken place at GOSH since 1/1/2013 and during that period the team has recorded a 0.4% mortality rate. 83% of this number related to an underlying condition and a further 5% was due to a cardiac complication.
In 2016/17 we performed the following number of operations:
- Brain tumour: 146
- Cerebrospinal Fluid (CSF) related: 229
- Epilepsy: 124
- Craniofacial: 203
- Cranio-Cervical Junction: 54
- Cranio – Other: 79
- Spinal Tumour: 13
- Spinal Dysraphism: 69
- Spinal – Other: 39
- Vascular related: 78
- Total: 1,034
Innovation and research
The Neurosurgery team and colleagues from across GOSH and the UCL Great Ormond Street Institute of Child Health come together to create new and better treatments for the benefit of children and families around the world. Consultants from the team lead or contribute to a number of research programmes in paediatric neurosciences.
Specialized technology and treatments include:
- Robot-assisted stereoEEG implantation
- Intraoperative MRI (due to come online late 2019)
- Integrated endoscopic operating room (Storz OR1)
- VisuaLase laser thermal interstitial therapy
- Minimally invasive craniosynostosis repair (spring-assisted and endoscopic)
- Frontofacial surgery with external distraction for syndromic craniosynostosis
- Vagal Nerve Stimulators
- Intrauterine myelomeningocoele repair
- Radical surgery for lipomyelomeningocoele/spinal lipoma
- Joint neurosurgical/orthopaedic operating for complex spinal deformity
- Selective dorsal rhizotomy for cerebral palsy/spasticity
- Gamma Knife stereotactic radiosurgery
- Endovascular treatment for aneurysm/AVM/vein of Galen malformation
- Surgical revascularization for moyamoya
- Robot-assisted brain tumour biopsy (including brainstem tumours)
- Frameless neuro-navigation
- Advanced neuro-imaging for brain tumours
- Endoscopic third ventriculostomy-choroid plexus coagulation (ETV-CPC)
- CSF access for treatment of metabolic conditions and malignancy tumour
Conditions we treat
- Hydrocephalus (including endoscopic management) and arachnoid cysts
- Tumours of the brain and spinal cord
- Spina bifida and spinal dysraphism
- Congenital malformations of the central nervous system
- Chiari malformation and disorders of the craniocervical junction
- Central nervous system infections
- Craniofacial surgery
- Surgical treatment of epilepsy
- Complex cervical spinal surgery
- Spasticity and Cerebral Palsy
- Trauma to the central nervous system
- Cerebrovascular disorders including arteriovenous malformation (AVM), aneurysms, moyamoya disease, and cavernoma