Neurosurgery Innovations by Dr. Kamran Aghayev
New Approaches Built on Proven Techniques
Not all innovations in neurosurgery rely on new technology such as AI and robotics. Often, innovation means refining an established technique so that it solves a problem the original could not.
Dr. Aghayev’s techniques start from traditional operations and change the part that limited them: how much of the rib can be removed, which bone growths can be reached, or how few parts a spinal fusion needs.
Contributions to Neurosurgery
Techniques Developed by Dr. Kamran Aghayev
Many advances in neurosurgery came from improving operations that already existed.
PURED, surgery for DISH and SLIF are Dr. Aghayev’s contributions of that kind. Each one is described in his published work or in the case studies on this site.
What was the problem with previous approaches for Thoracic Outlet Syndrome?
Most operations for Thoracic Outlet Syndrome (TOS) reach the first rib from the front, above the collarbone, or from under the arm. From those directions the nerves and vessels lie over the rib, so removing the whole rib is difficult. Pieces of rib left behind are a known reason for symptoms to come back and for a second operation.
How does the PURED approach work?
Dr. Aghayev developed PURED (Posterior Upper Rib Excision and Decompression) in 2015. The first rib is reached from the back, in line with the rib itself, so it can be removed completely while the nerves and the artery are left in place. The scalene muscles are then released and the nerves and vessels freed.
What do the published results show?
In his 2023 paper in World Neurosurgery, Dr. Aghayev reported 80 PURED operations in 61 patients, performed from 2015 to 2023 and followed for about three years on average. Patients rated their improvement at 91.5% on average: 55 described it as excellent and 6 as good, and none reported a fair or poor result. Complications (an opened pleura, Horner syndrome and a bleed at the top of the lung) occurred in some patients, and none was permanent.
PURED Procedure for Thoracic Outlet Syndrome
What challenges existed in traditional DISH treatment?
Treatment for DISH usually manages the symptoms rather than the bone growths that cause them. Growths in the neck are sometimes removed surgically, but growths in the chest are rarely operated on, because of where they sit and how complex the surgery is. Many patients are left with long-term pain and stiffness.
How does Dr. Aghayev approach DISH surgically?
Dr. Aghayev removes the bone growths (osteophytes) themselves, an operation that is rarely performed in the chest. The aim is to take away the source of stiffness, compression and pain while protecting the structures around it. It is considered for patients whose symptoms come from growths pressing on nearby organs, such as swallowing, digestive or heart-rhythm problems.
What has he seen in his patients?
One patient with long-term pain and limited movement reported pain relief and better movement after the operation. Another, who had heart-rhythm, digestive and blood-pressure problems as well as pain, reported improvement in each after the growths were removed. These are individual cases, not a study. You can read them in the case studies in the Blog section.
DISH Treatment: Options and When Surgery May Help
DISH Disease: Symptoms, Diagnosis and What It Means
What are the disadvantages of the conventional spinal fusion approach?
The standard spinal fusion technique, transpedicular screw fixation, relies on many hardware parts: stabilizing a single disc level takes 14 separate components. Each part adds a point where wear, loosening or a failed fusion can occur. The L5–S1 level, between the lumbar spine and the sacrum, is especially demanding because it moves more than the levels above it.
How is Dr. Aghayev’s SLIF technique different?
Sacrolumbar interbody fusion (SLIF) stabilizes L5–S1 with two screws placed through the disc from the sacrum into L5, together with an interbody cage, with no rods or additional screws. It was designed for L5–S1, including spondylolisthesis, and can be combined with standard techniques such as TLIF and ALIF.
What do the published results show?
Dr. Aghayev and colleagues described SLIF in Spine Surgery and Related Research in 2024. The technique was tested on cadavers, in a computer (finite element) model and in eight patients. All eight patients improved in pain and disability scores, and CT scans showed a solid fusion in each. In the computer model, SLIF allowed a similar range of motion to TLIF, with lower stress on the screws and less shear deformation, in healthy and in osteoporotic bone.
Dr. Aghayev's Contributions in His Own Words
Watch the Video: Personal Innovations in Neurosurgery
I believe that any scientist—whether a clinical scientist or a basic scientist—passes through several career stages. Initially, you assume that science is all about publishing papers. That's what everybody else expects: the more you publish, the higher your impact, and that's what drives the industry.
Approximately 10 years ago, I hit a point in my career when I figured out that I didn’t want to focus on publications anymore—I wanted to create innovations, things that matter. So, the first question was: 'What is innovation? What truly matters?'
I defined 'innovation' for myself as a contribution that changes the field in an irreversible way. Once you make it, the field is changed in such a way that there’s no turning back.
– Dr. Kamran Aghayev, Associate Professor of Neurosurgery
Dr. Kamran Aghayev presenting ‘Personal Innovations in Neurosurgery’
Azerbaijan Neuroscience Conference | 28.09.2024 (English)
What Comes Next
Dr. Kamran Aghayev continues to develop and test new techniques.
Follow him to hear about new work as it is published.
