Page 35 - WNS 2022 Program Book-Final version

Restoring Neurosurgeons to Non Operative Brain Surgery (NO BS):
Why Restoring NO BS Neurosurgical Leadership is Critical
John R. Adler, Jr. Stanford University
Created by neurosurgeons, NO BS is currently the single most commonly
billed neurosurgical operation for brain tumor in the United States. Neverthe-
less, a bottom-up analysis suggests that today significant numbers of patients
that might benefit from NO BS are not being treated with this optimal pro-
cedure;globally the number is estimated to be greater than 4 million patients
per year. This glaring deficit should represent an important public health con-
cern both in the US and throughout the world. While the cost and complexity of
existing NO BS systems is a major source of this situation, which is now being
addressed, the lack of greater involvement by neurosurgeons may be equally
problematic. Meanwhile, there is growing evidence that precision radiation can
function as an anatomically precise non-invasive neuromodulatory agent, that
could augment other tools like DBS, HIFU and TMS. Without neurosurgical
involvement and leadership, neurosurgeons may miss out on the next big
thing in the treatment of functional brain disorders.

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