Past and present

State Institution “Romodanov Neurosurgery Institute, National Academy of Medical Sciences of Ukraine”

The Kyiv Research Institute of Neurosurgery was established in 1950 at the Kiev Research Institute of Psychoneurology in accordance with directive #2201 issued by the Council of People’s Commissars of the USSR on 10.31.1940 “On a network of medical research institutes”.

In postwar years, the establishment of a powerful neurosurgical institution in Ukraine was initiated by Professor Oleksandr Ivanovych Arutiunov, a prominent neurosurgeon, disciple and follower of Academician M.N.Burdenko, who later became a founder of the modern Ukrainian neurosurgical school.

1950–1964 Olexandr І. Arutiunov	1964–1993 Аndriy P. Romodanov	1993–2013 Yuriy P. Zozulya	since February 2013 Eugene G. Pedachenko

Order #439 issued by the Minister of Health of the USSR on July 3, 1950 approved the structure and staff of the Kyiv Research Institute of Neurosurgery totaling to 291 staff positions. The first paragraph in the Order says: reorganize the Kiev Research Institute of Psychoneurology into the Kyiv Research Institute of Neurosurgery, which is the legal successor to the Kiev Research Institute of Psychoneurology.

The Regulations on the Institute were approved by the Ministry of Health of Ukraine on August 4, 1950. Departments of neurooncology, acute injury of the central and peripheral nervous system, neuro-vascular pathology, restorative neurosurgery and pediatric neurosurgery were created. From its first days, the Institute became the clinical base of the Department of Neurosurgery of the Kiev Extension Course Institute for Medical Practitioners.

For 10 months, during the reorganization of the Institute of Psychoneurology, P.S.Tarasenko remained its director, and after the reorganization in 1951, the Institute was headed by its founder, Prof. O.I.Arutiunov, until 1964. For 30 years (from 1964 to 1993), Academician A.P. Romodanov was director of the Institute after A.P. Romodanov’s death in 1993, the Institute was named after him. For 20 years (from 1993 to February 2013), the Institute was headed by an academician of the National Academy of Sciences and the National Academy of Medical Sciences (NAMS), Yu.P.Zozulya Since February 2013, the Institute, which today is called the State Institution “Institute of Neurosurgery named after acad. A.P.Romodanov of the NAMS of Ukraine”, has been led by Vice President of the World Federation of Neurosurgical Societies, Chief Independent Specialist of the MoH and the NAMS of Ukraine in the specialty “neurosurgery”, Eugene Georgiovych Pedachenko.

In different years outstanding neurosurgeons worked at the Institute: from 1945 – I.D.Virozub, A.P.Romodanov, P.G.Tananayko, from 1946 – O.A.Krister, Ya.I Faynzilber, from 1948 – V.S.Mykhailovskyi, B.A.Pelts, P.O.Pronzeliev, T.M.Sergienko, from 1950 – Yu.P.Zozulya, G.P.Pedachenko, from 1952 – Yu.S.Brodsky, from 1953 – L.Ye.Pelekh, O.P.Korol, from 1954 – O.A.Laponogov, from 1959 – O.P.Burlutskyi, V.G.Stanislavskyi, from 1961 – Ya.V.Patsko, Yu.D.Sosnov, from 1967 – R.M.Trosh, as well as neurologists: A.D.Dinaburg, O.L.Dukhin, I.S.Glushkova, M.K.Horets-Brotman, psychiatrists: A.L.Abashev-Konstantynovsky, L.P.Rozumovska-Molukalo, A.G.Dzevaltovska, neuropathomorphologists: B.S.Hominskyi, Yu.M.Kvitnytskyi-Ryzhov, I.O.Brodska, T.P.Verkhohliadova, A.T.Nosov, M.I.Shamaiev, neuroradiologists: T.D.Podolskyi, Ya.I.Geynisman, L.P.Pankeieva, G.S.Danylenko, Ts.M.Sorochynskyi, and other specialists, laid the foundation for Ukrainian neurosurgical science.

The Institute’s main areas of activity include scientific development and ensuring modern level of diagnosis and treatment of diseases and injuries of the central and peripheral nervous system, namely: pathogenesis, diagnosis and treatment of injuries of the central and peripheral nervous system and their consequences; surgical and combined treatment of brain tumors; study of their molecular-genetic characteristics; surgical treatment of lesions of the spine, spinal cord and its roots; treatment of irrepressible pain syndromes; functional and restorative neurosurgery; pediatric neurosurgery; surgical treatment of brain vascular pathology; experimental and clinical problems of treatment of severe epilepsy and Parkinson’s disease; study of the mechanisms and efficiency of action of stem cells; neyroimunology; radioneurosurgery.

The structure of the Institute includes research departments: clinical, diagnostic and laboratory experimental. The Institute’s clinical base includes 15 specialized units with 361 beds. Annually, about 5-7,000 operations are performed. The policlinic unit annually provides specialized counseling to more than 30,000 patients.

In its early years, the Institute’s staff focused on dealing with long-term effects and complications of injuries of the skull, brain and spinal cord, the peripheral and in particular autonomic nervous system. Later, research efforts focused on issues of diagnosis and surgical treatment of acute traumatic brain injury, neurooncology, treatment of pain syndromes, study of the pathogenesis of edema-swelling, acute prolapse of the brain. New areas of neurosurgery were developed: further study of the etiology and pathogenesis of acute cerebrovascular disturbance, diagnostics and surgical treatment of cerebral hemorrhagic strokes (G.P.Pedachenko, L.Ye.Pelekh, O.P.Burlutskyi), study of the pathogenesis and treatment of spinal cord compression, study of the dynamics epileptogenic foci and epilepsy surgery, stereotactic surgery for extrapyramidal hyperkinesia. A model of the cryotome, developed by Prof. O.O.Laponohov and the staff of the Institute of Physics of Ukraine, won a Gold medal at the international exhibition in Leipzig in 1972. In 1977, A.P.Romodanov and O.O.Laponohov were awarded a State Prize of Ukraine in Science and Technology for the introduction stereotaxic operations and cryogenic equipment in neurosurgical practice.

Original methods of diagnostic and therapeutic childbirth traumatic brain injury were developed for which A.P.Romodanov and Yu.S.Brodskyi was awarded the academician M.N.Burdenko prize (1982).

Starting from the 1970s, microsurgical equipment was successfully introduced and methods for surgical interventions were developed, improved and implemented to treat cerebral gliomas penetrating the median structures in case of basal, cranioorbital, parasagittal meningiomas, pituitary and cerebellopontine angle tumors; techniques of removing deeply located intracerebral tumors using cryosurgical technologies were improved. It theoretically and experimentally was proven that the carbon dioxide laser could be used to remove intracerebral tumors (Yu.P.Zozulya, V.D.Rozumenko); a laser surgery technique using high-energy lasers was developed.

At the same time new principles of research were introduced according to the type of social service contract (social order) – the Republican (164) (1978-1990) traumatic brain injury research program (led by A.P. Romodanov, G.P.Pedachenko) was implemented. Later (in 2007-2012), the NAMS and Ministry of Health approved the Sectorial scientific and technical program “Medical care for traumatic brain injury” (headed by E.G.Pedachenko, Y.P.Zozulya). The results of these programs are summarized in monographs and manuals: “Traumatic brain injury and general somatic pathology” (1992), “Modern views on the pathogenesis of closed traumatic brain injury” (1996), “Traumatic brain injury. Clinical guidance” (1998, 2001, 2002), “Clinical traumatic brain injury epidemiology” (2002), “Traumatic brain injury: Modern Principles of emergency care assistance” (2009), “Polytrauma” (2012) and others.

Modern methods of minimally invasive surgery for spine pathology were implemented and improved. In 1995, on the initiative of Prof. E.G.Pedachenko, the Institute opened the department of laser and endoscopic spinal neurosurgery – the first one in Ukraine and the CIS; the following technologies were introduced: puncture laser microdiscectomy, puncture vertebroplasty techniques, transcutaneous transpedicular fixation, dynamic interspineous stabilization and endoscopic technology. The research findings received a State Prize in Science and Technology (E.G.Pedachenko, S.V.Kuschaiev, E.I.Slynko, 2008) and were published as the monograph “Endoscopic spinal neurosurgery” (2000), “Puncture vertebroplasty” (2005).

The study of an important scientific, practical and social problem of diagnosis and treatment of peripheral nerve injuries was awarded a State Prize of Ukraine in Science and Technology (Yu.P.Zozulya, V.I.Tsymbaliuk, M.M.Suliy, 1996). Implanted current stimulated systems of domestic production were developed and introduced for patients with persistent pain syndromes, lesions of peripheral nerves and spinal cord.

After the Chernobyl disaster the Institute studied the effect of low dose radiation on the CNS. It was established that the nervous system lacked resistance to radiation, and a gradual development of post-radiation encephalopathy was shown. A series of works devoted to the study of biochemical processes in the radiation-affect CNS was awarded the O.O.Bohomolets Prize. (Yu.P.Zozulya, D.A.Sutkovyi, 1999).

The development of diagnostic and therapeutic interventions for spinal fluid circulation disorders, which cause hydrocephalus and severe atrophic brain damage, resulted in industrial production of domestic cerebrospinal fluid shunting systems and was awarded a State Prize of Ukraine (Yu.P.Zozulya, Yu.O.Orlov, M.V.Plavskyi, 2001).

On the basis of the research, improvements occurred in methods of diagnosis and surgical treatment of spinal cord and spine tumors, vascular tumors and arteriovenous malformations of the spinal cord, neurocompression pain syndromes of the lumbar spine. These results were summarized in the monographs “Spinal vascular malformations and tumors” (2000), and “Spinal cord and spine tumors” (2010).

In 1987, experimental research began into restorative capabilities of transplanted embryonic tissues. In 1989, the world’s first transplant of embryonic neural tissue was performed on a patient with cerebral palsy (V.I.Tsymbaliuk, L.D.Pichkur). As of today, the restorative neurosurgery clinic has the greatest experience in the world of transplantation of embryonic nerve tissue in patients with different types of organic brain damage. Fundamental research into new biotechnologies received a State Prize of Ukraine in Science and Technology (V.I.Tsymbaliuk, 2002).

Surgical treatment of arterial aneurysms and arteriovenous malformations of the brain, stenotic lesions of main cerebral arteries using microsurgical and endovascular technologies was developed and improved (O.A.Tsimeyko, L.M.Yakovenko, M.U.Orlov). The latest endovascular methods of embolization with coils, adhesive compositions, stenting were for the first time introduced and implemented in Ukraine.

Diversified fundamental research began in a new area i.e. neuroimmunology, led by Prof. M.I.Lisianiy, aimed at studying the interaction between the normal and diseased nervous and immune systems; the research findings are consolidated in multiple monographs.

The beginning of the XXI century marked a new stage of scientific activity – exploration of gene therapy possibilities. It was shown that gene therapy – through the transfection of brain tissue with plasmid vector carrying the gene APOE2 or APOEZ – significantly inhibits the development of secondary brain lesions in experimental TBI, and contributes to the regression of damage-caused structural and functional disorders (V.V.Biloshytskyi).

A new level of precision neurosurgical operations using a modern surgical navigation system for brain tumors is ensured through telemonitoring, which developed and introduced into clinical practice by Prof. V.D.Rozumenko.

The possibilities and informative level diagnostic research significantly increased, which include CT, MRI, functional MRI, cerebral radionuclide angiography, single photon emission computed tomography, cerebral angiography, computerized electroencephalography. Comprehensive analysis of diagnostic tests makes it possible with a high degree of probability to establish a diagnosis and choose an optimal treatment strategy for each patient.

In October 2010, s new department of neuroradiology and radioneurosurgery began its operation. Radioneurosurgical operations are performed out using the Trilogy linear accelerator..

In 2014, the Institute created a Department of adjuvant methods of treatment of malignant brain tumors and a Neurosurgery department of Experimental and Clinical Pharmacology, and in 2015 – a Department of Neurophysiology and Department of Epidemiology and neurosurgical disease forecasting.

Currently, the State Institution “Institute of Neurosurgery named after Acad. A.P.Romodanov of the NAMS of Ukraine” is the main institution in Ukraine in the field of neurosurgery; it is the leader in diagnosis and treatment of neurosurgical diseases. The scientific-organizational department of the Institute coordinates a wide network of neurosurgical units across Ukraine, ensures the publication of thematic scientific collections, the “Ukrainian neurosurgical journal”, methodological guidelines and newsletters; organizes for neurosurgeons of Ukraine congresses, conferences, workshops, and training schools with international participation.

To improve specialized neurosurgical care delivery to the population of Ukraine, medical care standards and unified clinical protocols of medical care for patients with neurosurgical pathology, as well as indicators of care quality were developed.

The Institute has actives scientific schools on neurotrauma, neurooncology, brain and spinal cord vascular pathology, minimally invasive spinal neurosurgery, neurotransplantation, neuroimunology, led and developed by leading specialists of the Institute: NAMS Academician E.G.Pedachenko, NAS and NAMS Academician Yu.P.Zozulya, NAMS Academician V.I.Tsymbaliuk, Corr. Member of NAMS M.I.Lisianyi. Throughout its life the Institute has regularly conducted training of scientific personnel, candidates and doctors of sciences – both national experts and foreigners, as well as training of physicians through clinical studies on neurosurgery. To encourage young employees to research, a scholarship named after O.I.Arutiunov for young scholars was instituted in 2014.

Today the Institute is equipped with high-tech equipment that allows solving theoretical and practical problems of neurosurgery at a qualitatively new level. The Institute continues to introduce new and improved microsurgical, endoscopic, electrostimulation, laser, stereotaxic, navigational and radiosurgical technologies, biotechnologies, nanotechnologies for patients with various brain and spinal cord pathologies. Much attention is given to research in neurosurgery for certain programs (government, sectoral). Integrated basic and applied research within these programs allows recommending new treatment technologies for medical practice. An example of such programs is the sectorial scientific and technical program “Medical treatment for traumatic brain injury” of the NAMS and Ministry of Health, the State Program “Health of the Nation” and the “State program of prevention and treatment of cardiovascular and cerebrovascular diseases”).

International and regional telemedicine consultations in the field “neurosurgery” and “children’s neurosurgery” are widely provided.

The State Institution “Institute of Neurosurgery named after acad. A.P.Romodanov of the NAMS of Ukraine” continues to efficiently and smoothly provide neurosurgical care to Maydan victims and soldiers wounded in the antiterrorist operation.

As of today, the State Institution “Institute of Neurosurgery named after acad. A.P.Romodanov has considerable creative potential, which is evidenced by annual fundamental and applied scientific research and development initiatives in various areas of neurosurgery.

As of 01.01.2015, the Institute’s has 1,151 staff, including 132 researchers (including three academicians, two corresponding members, 15 professors, 34 doctors and 74 candidates of sciences). Based on the results of clinical and experimental research, the Institute published more than 7,000 scientific works, 163 monographs and handbooks, 85 guidelines; more than 400 patents were obtained; 68 protocols of care for patients with neurosurgical pathology were developed and approved. In NAMS newsletters 115 innovations were published, and 44 new technologies were developed and registered.

Since the founding of the Institute, it has had its Academic Board; since 1976 the Specialized Academic Board for doctoral and master’s dissertations in the specialty “neurosurgery” has been active. Throughout the existence of the Specialized Academic Board, 83 doctoral and 351 PhD dissertations were defended.

Throughout the life of the Institute professional, collegial and friendly relations of the Institute with many allied institutions in Europe were established and expanded: Since 1970: Warsaw (PRP) neurosurgery clinic, Berlin (GDR) neurosurgical clinic of the Charite hospital and Belgrade (SFD) neurosurgical clinic, the K.Besta and K.Borsani neurological institute (Milan, Italy), the Institute of Neurosurgery named after acad. M.N.Burdenko of the Russian NAS and the Russian neurosurgical Institute named after prof. A.L.Polyenov, the Institute of Cytology of the Russian Academy of Sciences, the University of Toronto, the medical and sanitary public institution “Institute of Neurology and Neurosurgery of Moldova”.

In recent years, leading experts of the Institute have conducted master classes and lectures for doctors around the world: academician E.G.Pedachenko (US, Russia, Switzerland, Germany, Italy, Spain, etc.), academician V.I.Tsimbaliuk (Hungary, Belarus, Moldova, etc.).

In 1977, the Kyiv Research Institute of Neurosurgery was awarded the Order of the Red Banner for its great contribution to the development of neurosurgery. The Institute had and has on staff: 11 State Prize of Ukraine in Science and Technology laureates; 3 O.O.Bohomolets Prize winners; and 2 M.N.Burdenko Prize winners.

5 honored scientists of Ukraine, 10 distinguished doctors of Ukraine, and 5 honored physicians work at the Institute.

International awards: Albert Schweitzer Grand Gold Medal (Albert Schweitzer World academy of medicine), the election of the Vice-President of the World Federation of neurosurgical societies – Eugeniy Pedachenko; Diploma of Honorary Professor of the Institute of Neurosurgery named after M.N.Burdenka (RAMS) – Yu.P.Zozulya, the Vesalius Award from the American Association of Neurological Surgeons – V.I.Tsymbaliuk.

75 employees of the Institute are members of the European Association of Neurosurgeons and the World Federation of Neurosurgical Societies, 4 – Honorary Members of the Russian Association of Neurosurgeons, 8 are members of the International Antiepileptic League; also, Institute staff are members of 13 Foreign Associations 13 of professionals from other specialties.

The Institute, being a central institution in the field of neurosurgery, ensures the activity of the Troubleshooting committee “Neurosurgery” under the Ministry of Health and Academy of Medical Sciences of Ukraine. For years it has been scaling up a range of administrative and methodological activities to further the development of the neurosurgery service and improve specialized neurosurgical care in Ukraine.

For 40 years the Institute had the Board of the scientific society of neurosurgeons of Ukraine. In 1993 the Ukrainian Association of Neurosurgeons was established. The Institute of neurosurgery and the Ukrainian Association of Neurosurgeons founded the “Ukrainian neurosurgical journal”.

The Institute has neurosurgery departments of Bogomolets national medical university (since 1986) and the Shupik national medical academy of postgraduate education (since 1950) . It trains specialists through residency and scientific brainpower through postgraduate and doctorate studies. The Institute has ongoing advanced training thematic courses using specially developed curricula.

In recent years, despite economic difficulties the Institute – supported by NAMS of Ukraine and the Ministry of Health, has been equipped with high-tech equipment. Modern equipment allows it to solve theoretical and practical problems of neurosurgery at a qualitatively new level. The Institute of Neurosurgery successfully uses neuronavigation systems, endoscopic technologies, operating microscopes, angiographic equipment of the latest generation.

17.06.2015