Functional Neurosurgery
Advanced functional neurosurgery targeting neural circuits in movement disorders and selected neurological diseases — deep brain stimulation, navigation-guided (stereotactic) biopsy and spinal cord stimulation, delivered with a precise, tissue-preserving approach.
Our Approach to Functional Neurosurgery
Functional neurosurgery targets not the structure of the brain and nervous system, but the way it works. The goal is to rebalance disrupted electrical activity within the neural networks and circuits that regulate movement, pain or muscle tone. Rather than removing diseased tissue, this approach aims to modify the relevant circuit with precision while preserving surrounding tissue. In this way, it seeks to bring symptoms under control and improve quality of life.
At the heart of this precise surgery lies the integration of advanced imaging, neuronavigation and neurophysiological monitoring. When high-resolution MRI and CT images are combined with real-time navigation systems and electrophysiological recordings, millimetric targeting can become possible. This layered planning helps protect critical neural structures and allows procedures to be carried out with as little tissue disruption as possible.
Functional neurosurgery is not a single procedure but a comprehensive process that includes careful assessment, individualized planning and long-term follow-up. Prof. Dr. Erdinç Civelek evaluates each patient's clinical picture, expectations and general health in detail, coordinating surgical and medical treatments so that they complement one another. This approach offers an evidence-based, realistic framework in which safety remains the priority.
Deep Brain Stimulation (DBS)
Deep brain stimulation is an established treatment used in movement disorders such as Parkinson's disease, essential tremor and dystonia. In the procedure, fine electrodes are placed into specific deep regions of the brain that regulate movement; these electrodes are connected to a pulse generator implanted under the skin, a device sometimes known as a brain pacemaker. By delivering regular electrical impulses, it aims to reorganize the activity of disrupted circuits.
One of the most important features of deep brain stimulation is that it is a reversible and adjustable form of neuromodulation. Stimulation parameters can be programmed non-invasively according to the patient's response and changing needs over time; when required, stimulation can be reduced or stopped altogether. This flexibility makes it possible to tailor the therapy to each patient and to better control symptoms such as tremor, rigidity and slowness of movement.
It is important to emphasize that deep brain stimulation is a treatment that aims to control symptoms rather than cure the underlying disease. In carefully selected patients, it can meaningfully improve daily quality of life by reducing medication doses and drug-related fluctuations. However, outcomes can vary from patient to patient, which is why appropriate candidate selection and the establishment of realistic expectations are an inseparable part of the process.
Navigation-Guided (Stereotactic) Biopsy
Navigation-guided biopsy is a precise diagnostic method that allows tissue to be sampled safely from lesions located in deep or functionally eloquent regions of the brain. Frameless neuronavigation technology works from the patient's own imaging data, making it possible to plan the safest route to the target lesion. In this way, an accurate sample can be obtained through a far smaller intervention than open surgery.
The most important advantage of this method is that it minimizes the impact on surrounding healthy brain tissue. Real-time navigation helps the surgeon advance with millimetric accuracy while making it easier to avoid critical vessels and nerve structures. A sample taken through a small entry point allows pathological examination to clarify the nature of tumors or other lesions.
Accurate diagnosis is the foundation of appropriate treatment. Navigation-guided biopsy contributes to building the correct treatment plan by obtaining reliable tissue samples even from lesions that are difficult or risky to remove surgically. The results are evaluated together with oncology and radiology teams, laying the groundwork for an individualized, comprehensive treatment strategy for each patient.
Spinal Cord Stimulation (Spinal Pacemaker)
Spinal cord stimulation is an established treatment option for chronic neuropathic pain that cannot be adequately controlled with medication and other methods. It may be considered particularly in failed back surgery syndrome and in nerve-related pain radiating into the arms or legs. In this method, epidural leads are placed over the region of the spinal cord that carries pain signals, and these are connected to a pulse generator implanted under the skin.
A distinctive feature of this treatment is that a trial period can be carried out before a permanent device is implanted. During the trial, the patient personally experiences the reduction in pain and the improvement in daily life; only when sufficient benefit is seen is a permanent system planned. This approach allows the suitability of the therapy to be assessed in advance and supports a more informed decision.
Spinal cord stimulation is a reversible and adjustable method; stimulation parameters can be programmed according to the patient's pain, and the system can be removed if necessary. The aim is not to eliminate pain entirely, but to reduce it meaningfully and thereby improve mobility and quality of life. Because outcomes can vary from person to person, appropriate candidate selection and realistic expectations are also of great importance in this therapy.
How It Works: Neuromodulation and Technology
At the core of neuromodulation lies the idea of reorganizing dysfunctional neural circuits through targeted electrical stimulation. Rather than removing diseased tissue, the excessive or irregular activity of the circuits that give rise to pain or movement disorders is balanced with finely tuned stimulation. This approach reflects a protective treatment philosophy that works in harmony with the nervous system's own functioning.
The success of the process rests on three fundamental elements: accurate targeting, individualized programming and reversibility. Electrodes placed at a target defined by advanced imaging and navigation are stimulated through the generator under the skin. Stimulation parameters can be readjusted many times, non-invasively, according to the patient's response. The ability to stop the system when it is not beneficial or when required is one of the greatest strengths of this technology.
Neuromodulation is not merely the placement of a device; it is a multidisciplinary process that requires collaboration across fields such as neurology, pain medicine, physical therapy and radiology. Coordinating surgical intervention, medical treatment and rehabilitation is decisive for the durability of the results and for the patient's overall wellbeing. This holistic approach ensures that the technology is used as effectively as possible.
Candidate Selection, Safety and the Process
The success of functional neurosurgery depends largely on selecting the right patient. Each patient is assessed through detailed clinical evaluation, imaging and, where necessary, multidisciplinary consultation; the expected benefit of the intervention is carefully weighed against its potential risks. This meticulous evaluation helps identify the patients who may benefit most and supports the establishment of realistic expectations.
As with any surgical intervention, neuromodulation methods carry risks such as infection, bleeding or device-related problems. Sharing these risks openly with the patient forms the basis of an informed decision-making process. The aim is not to eliminate the disease entirely, but to control symptoms and improve quality of life; this framework is set out transparently from the very beginning.
Treatment does not end with the placement of the device; regular follow-up and programming are an inseparable part of the process. Stimulation parameters are readjusted according to the patient's changing needs over time, so that benefit can be sustained. Functional neurosurgery does not replace medication and rehabilitation; it is part of a holistic model of care that complements them.
You may request an appointment for an assessment or a second opinion on this subject.
Request Appointment