Spine Surgery

DOCTORS

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Dr (Prof) S Rajasekaran

Chairman, Dept of Orthopaedics, Trauma & Spine Surgery.

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Dr Ajoy Prasad Shetty

Senior Consultant

Spine Surgery

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Spine Surgery



Over the last 25 years, the Spine Surgery unit of Ganga has provided comprehensive services in alleviating the pain and improving the functional ability of patients. The unit is one of the largest tertiary care referral centres in India and so far, more than 12000 spine surgeries have been performed.


The unit is headed by Prof S Rajasekaran, and comprises of two Consultants Dr Ajoy Prasad Shetty and Dr Rishi M Kanna. The clinical team includes eleven Spine Fellows, ably supported by three physician assistants and spinal physiotherapists to provide specialised care to all patients with spinal pathologies.


Clinical Expertise


On the clinical side, the unit aims to provide safe spine surgery through expertise and experience. Bolstered by periodic technological advancements, the unit currently has one Intra-operative computer navigation system, two 3D navigation image intensifiers, intraoperative spinal cord monitoring systems and advanced cell saver technology, the only centre in the country to have all under one roof.


SAFE SPINE SURGERY – A REALITY


  1. Ganga hospital is the first unit in the Asia Pacific region to install the BrainLab CT AIRO navigation services for computer aided spine surgery. This ensures safety and precision.
  2. Intra-operative neuromonitoring enables performance of complex spinal cord surgery without risking injury to the spinal cord.
  3. Cell Saver machines enable long and complex surgeries maintaining patients' safety.
  4. The availability of the latest spinal implants allow safety and precision in surgery.
  5. High resolution 1.5 Tesla MRI scanner, Siemens Symphony CT scanner and digital radiographs provide the best imaging support to accurately diagnose diseases.



Year 2015 2016 2017 2018 2019 2020 (upto march)
Lumbar microdiscectomy 435 291 373 361 390 121
Lumbar microdecompression 196 212 201 195 157 61
Transforaminal Lumbar Fusion 464 564 499 473 596 193
Thoracic decompression, fusion 6 39 31 68 59 10
Spinal infections - Surgery 114 110 88 74 44 32
Anterior cervical microsurgery 244 235 233 341 263 98
Posterior cervical decompression 149 179 170 188 170 52
Spinal fractures - Surgery 316 238 305 269 287 122
Percutaneous biopsy 93 78 87 74 77 32
Scoliosis/kyphosis surgeries 168 199 193 166 155 39
Spinal cord Surgeries 31 28 12 33 49 14
Tumor surgeries 55 23 34 17 9 9
Vertebroplasty/kyphoplasty 8 26 21 38 10 19
Spinal injections 234 348 350 404 516 175
Miscellaneous 108 92 132 164 160 84
Total 2621 2662 2729 2865 3003 1089

Research and Spine Surgery


The unit is well known internationally for its path breaking research works in the field of disc biology. It has been the proud recipient of many international awards such as

International

  • North American Spine Society Outstanding Research Award consecutively for 2019 & 2020
  • Asia Pacific Spine Society Best Clinical Research Award for 2019
  • Asia Pacific Spine Journal Award for Best Clinical Paper for 2019
  • Asia Pacific Spine Society Basic Science Research Award for 2019
  • Asia Pacific Spine Journal Award for Best Basic Science Paper for 2019
  • ISSLS Prize for Spine Research for the year 2017
  • ISSLS Prize for Spine Research for the year 2013
  • ISSLS Prize for Spine Research for the year 2010
  • ISSLS Prize for Spine Research for the year 2004
  • ‘EuroSpine Open Paper Award’ for 2008 for his research demonstrating that Disc Nutrition in spine can be modified by Calcium channel Blockers.
  • Macnab LaRocca Research Award of ISSLS in 2005
  • Sofamer Danek Award for the best Scientific presentation internationally by the International Society for the Study of Lumbar Spine thrice for the years 1996, 2002 & 2006.

The unit has also more than 200 journal publications in spine surgery and many chapters in international textbooks.

SERVICES OFFERED

Microsurgical Procedures

Ganga hospital offers options for minimally invasive surgery like microsurgical discectomy for lumbar and cervical disc prolapse and lumbar microdecompression surgery. The procedure is performed with the use of an Operating Microscope which can be performed with small incision surgery. The advantages of the microsurgical procedure include reduced post-operative pain, lower blood loss, and shorter indoor hospital stay.

Spinal Injections

Spinal injections are pain relieving techniques used for therapeutic or diagnostic purposes. They can be performed to diagnose the source of back or neck pain (diagnostic) or can be used as a treatment to relieve pain (therapeutic). Most spinal injections are performed as one part of a more comprehensive treatment program including an exercise program to improve spinal mobility and stability (strengthening exercises). Spinal injections are performed under X-ray guidance, called Fluoroscopy. This confirms correct placement of the medication and improves safety. A liquid contrast (dye) is also injected before injecting the medication. If this contrast does not flow in the correct location, the needle is repositioned and additional dye is injected until the correct flow is obtained. The medication is not injected until the correct contrast flow pattern is achieved.

Spinal Cord Injury Rehabilitation

Annually India sees 20,000 new cases of Spinal Cord Injury. Spinal cord injury can have devastating consequences for both the individual patient and his or her family. Specialised treatment institutes for Spinal Cord Injury Rehabilitation is largely non-existent in India. Ganga Hospital’s Spinal Cord Injury and Rehabilitation Centre forms one of the three specialised centres catering to the needs of the Spinal Cord Injured. The rehabilitation centre offers a 5,000 square feet indoor exercise area with all modern equipment for spinal cord injury rehabilitation. The centre has a dedicated team of 10 physiotherapists and rehabilitation physician to ensure an optimal rehabilitation program. The facility offers space for gait training, orthotic provision, wheelchair conditioning, and a basketball court for physical rehabilitation.

Minimally Invasive Surgeries (MIS)

Minimally Invasive Surgeries (MIS) refer to Spinal surgeries performed through small incisions with less disruption to the muscles. This can result in quicker recovery, decreased operative blood loss, and speedy return to normal patient functioning. Not all patients are appropriate candidates for MIS procedures. The Surgeon decides on the suitability to treatment through the MIS technique. At Ganga Hospital, minimally invasive surgeries are performed for the following conditions: herniated discs of the cervical and lumbar spine, lumbar spinal stenosis, fusion for spinal instability, cementing techniques for vertebral compression fractures and intradural tumours of the spinal cord.

Navigated Micro Surgery:

The Spinal Cord works as a conduit between the Brain and the rest of the body by transmitting signals from and to the Brain. Damage to the Spinal Cord disrupts this function resulting in paralysis. Complex Deformity correction surgeries around the Spinal Cord entail a 1% risk of potential injury to the Spinal Cord depending on the severity of the Deformity and existing neurological compromise. Previously such problems were identifiable only at the end of surgery after the patient awakens from Anaesthesia. This problem has been greatly reduced by the availability of Spinal Monitoring systems. Spinal Cord Monitoring systems enable immediate identification of potential injury to the Spinal Cord during such surgeries. They can detect even small changes in the signals during the surgery so that serious injury to the Spinal Cord could be prevented. At Ganga Hospital, intraoperative continuous neural monitoring of the Spinal Cord function is available and is used for Deformity correction surgeries. Along with Navigation systems, this significantly improves the safety and accuracy of the surgery.

Scoliosis and Deformity Surgeries

Ganga Hospital is one of the few centres in the country to perform Deformity Correction Surgeries. Spinal Deformities include scoliosis, kyphosis, and their combinations. The correction of these deformities is a complex surgical procedure and needs expertise, experience and specialised equipment. At Ganga Hospital, such deformity surgeries are being performed since 1996 by experienced surgeons. Approximately 200 deformity surgeries are performed every year. The ability to perform such surgeries safely needs state of the art equipment and intensive Anaesthesia. The Unit is ably supported by experienced Anaesthetists who provide safe Anaesthesia and continuous perioperative care is provided for quicker recovery. Computer Navigation systems are available at Ganga Hospital since 2006, helping in inserting screws into the vertebral bones safely. The Spinal Cord is potentially at risk while inserting screws and correcting the Spine to straighten alignment. Spinal Cord Neural Monitoring is available at the Hospital, that enables the surgeon to monitor the Spinal Cord function during surgery.

AWARDS


Ganga Spine Microsurgery Course

To transfer the knowledge and experience of the unit, the spine department of Ganga Hospital in collaboration with Carl Zeiss started a unique microsurgical training centre equipped with a permanent wet lab utilizing the latest Zeiss operating microscopes and high quality surgical instruments.




The purpose of the course is to establish and strengthen the foundation of microsurgical skills in spine surgery. The course has two modules. In the clinical training module, the trainee spends two days in the operating theatre assisting and observing spinal microsurgeries. In the lab module, the trainee is given hands-on training in the wet lab. The course is designed to benefit practising orthopaedic surgeons, spine surgeons and neurosurgeons.


International Trainees

Malaysia

1. Dr Lim Phaik Gan,
2. Dr Abdul Halim Yusof
3. Dr Khoo Eng Hooi
4. Dr Ahmed Tajuddin Abdullah
5. Dr Ramachandran Arumugham


Srilanka

6. Dr. Devaka Rathnapala,
7. Dr. Kandeepan Kanagarathna
8. Dr. Priyance Bandujeewa Piyasena


Indonesia

9. Dr. Benny Lay
10. Dr. Igin Ginting
11. Dr Harjanto Effendi


Bangladesh

12. Dr Abu Baker,
13. Dr. Shahid Akon


Nigeria

14. Dr Akinniyi Oluwatoba Taiwo
15. Dr Shedul Lohman


Kenya

16. Dr David Kilonzo


Oman

17. Dr Kishore Kumar M


Philippines

18. Dr Paul M. Atienza


Singapore

19. Dr Shree Kumar Dinesh


Iraq

20. Dr Ali Saadun Al Khaykany
21. Dr. Hazim Moojid Abbas
22. Dr. Ardam Jamal Ahmed


Nepal

23. Dr. Pramod Baral
24. Dr. Bigyan Bhandari


Egypt

25. Dr Hatem Handy,
26. Dr. Muhammad Salman Zakzou


Netherlands

27. Dr Coen Jaspers


UK

28. Dr Anukul Kumar Deb Goswami


Dubai

29. Dr Tushar Dholakia


Germany

30. Dr. Nazeeh Abu-Dayyah


National Trainees

1. Dr Abdul Jaleel T K,Kerala
2. Dr Ajay Krishnan, Surat
3. Dr Akshay Jain, Indore
4. Dr Antony Joseph Thoppil, Kerala
5. Dr Arul Durai Arasu, Dindigul
6. Dr Ashok D, Trivandrum
7. Dr Ashok M Ghodke, Mumbai
8. Dr B V R N Varma, Vizag
9. Dr Bangari Swamy, Karimnagar
10. Dr Bikram Kar, Cuttack, Orissa
11. Dr Chandrappa M, Bangalore
12. Dr Gautam Prasad, Mumbai
13. Dr Gowrishankar Swamy LG,Bangalore
14. Dr I Satish Raju, Vizag
15. Dr Jay Deep Ghosh, Kolkatta
16. Dr Jim F Vellara, Thrissur
17. Dr K Sambasiva Rao, Tenali
18. Dr K. Shanmugasundaram, Pollachi
19. Dr Karthikeyan R, Coimbatore
20. Dr M Narayana Reddy, Chennai
21. Dr Madan Temker D, Bangalore
22. Dr Mallikarjuna Reddy, Karnataka
23. Dr Mathew P Daniel, Kerala
24. Dr Muthuraj, Nagercoil
25. Dr N.Dheen Mohamed Ismail, Chennai
26. Dr Natarajan S, Erode
27. Dr Natesh J, Bangalore
28. Dr P Gnanaprakash, Coimbatore
29. Dr P P Sunil, Thrissur
30. Dr Pankaj G Gujar, Maharashtra
31. Dr Pankaj Kandwal, Mumbai
32. Dr Rahul Singh, Saharanpur
33. Dr Rajeev Naik, Bangalore
34. Dr Rajendra U Mehta, Rajkot
35. Dr Rajesh Khanna G, Chennai
36. Dr Rajiv Shah, Vadodara
37. Dr Ramanand Mishra, Gorakhpur
38. Dr Rashid A S, Kerala
39. Dr Ravi K, Kerala
40. Dr Renjit Kumar J, Kerala
41. Dr S Jagadeesh Babu, Hyderabad
42. Dr Sachithanandam V, Erode
43. Dr Saheel Maajid, J & K
44. Dr Sandeep Surana, Ahmednagar
45. Dr Saurabh Chaudhary, Salem
46. Dr Shameer Ali.T.P, Kerala
47. Dr Shanmugasundaram P, Chennai
48. Dr Sudheer U, Kerala
49. Dr Sundararajan N D, Gopi
50. Dr Sunil Kumar H,Bangalore
51. Dr Thiraviam T, Nagercoil
52. Dr Tushar J Deore, Pune
53. Dr V.Surya Prakash Rao, Hyderabad
54. Dr Venugopal S, Bangalore
55. Dr Veushj Sharma, Punjab
56. Dr Vignesh Jayabalan S, Chennai
57. Dr Vishal Prakash Thakur, Mumbai
58. Dr Dangeti Ram Kishore, Rajahmundry
59. Dr Shantanu Anil Gunjotikar, Solapur
60. Dr Prabhakaran Jayaprakasan, Thrissur
61. Dr Chetan V Mudaliar, Bilaspur
62. Dr Hitesh L Kukadya, Surat
63. Dr V Ravi, Chennai
64. Dr C Ranganath, Bangalore
65. Dr Saurabh Kapoor, Delhi
66. Dr Palavali Maheswara Reddy,
67. Dr Deepu Sebastian, Kannur
68. Dr A Venkateshwar Rao, Secunderabad
69. Dr Ajay V Randive, Mumbai
70. Dr Bharath Kumar R, Trichy
71. Dr Ambarish Mathesul, Pune
72. Dr. Ashish Tomar, Haryana
73. Dr. Backiaraj Devaraj, Thanjavur
74. Dr. Ajaykumar Ajanavi, Trivandrum
75. Dr. Parthiban K.
76. Dr. Suhahish Roy, Kolkatta
77. Dr. Anindya Basu, Kolkatta
78. Dr. Srikanth Nara, Hyderbad
79. Dr. Daya Thirumala R, Vishakapatnam
80. Dr. Pawan Kumar Sharma, Rajasthan
81. Dr. Gaurav Sawhney, Chandigarh
82. Dr. Prakash Sitoula, Nepal
83. Dr. Ranjith Shaw, West Bengal
84. Dr. Moses Agunda, Nigeria
85. Dr. Subodh Borle, Burhanpur
86. Dr. Amarendranath Roy, Kolkatta
87. Dr. Venkatesan P, Thanjavur
88. Dr. Suresh Kumar M, Pondicherry
89. Dr. Suresh Cheekatla, Hyderabad
90. Dr. Navneet Kumar, Kolkatta
91. Dr. Md.Mohtashemul Haque, Bihar
92. Dr. Siddharth Sanjay Shah, Mumbai
93. Dr. Raghuraj Kundangar, Manipal
94. Dr. Ratanlal Rajesh Agarwal, Chennai
95. Dr. S. Karthikeyan, Palani
96. Dr. Sareesh Kumar, Kottayam
97. Dr. Mahendra Kolikonda, Telengana
98. Dr. Ramkinkar Jha, Gurgaon
99. Dr. Malayanathan, Pondicherry
100. Dr. Raminder Singh, Patiala
101. Dr. Naved Farid, Mumbai
102. Dr. Ashwinkumar Khandge, Pune
103. Dr. Nitin Ashok Bhalerao, Maharashtra
104. Dr. Rajesh Bahadur Singh, Varanasi
105. Dr. Vaibhao Narayan Gorde, Maharashtra
106. Dr. Vijay Kagane, Maharashtra
107. Dr. Tushar Ubale, Chembur
108. Dr. Bhukya Gopilal, Telengana
109. Dr. Deepak Datrange, Ahmednagar
110. Dr. Deepak Singh, Rajasthan
111. Dr. Pankaj Arora, Haryana
112. Dr. Vivek Vincent, Thrissur
113. Dr. V.I.Simon, Thrissur
114. Dr. Karthik Malepathi, Bangalore
115. Dr. M.Manoj Deepak, Theni
116. Dr. Harshad G Argekar, Mumbai
117. Dr. Abhijit Kale, Maharashtra
118. Dr. Nilay Chhastia, Surat
119. Dr. Mohammed Ashraf Pasha, Andhrapradesh
120. Dr. Ameer Theruvath, Kerala
121. Dr. Rajesh, Vishakapatnam
122. Dr. Sudeep Kumar, Madurai
123. Dr. Vinoth T, Madurai
124. Dr. Kulbhushan Kamboj, Delhi
125. Dr. Mantu Jain, Bhubaneswar
126. Dr. Vijay Anand, Maraimalainagar
127. Dr. Birendra Kumar, Jharkhand
128. Dr. Shivakumar H.C., Shimoga
129. Dr. Sekar, Tirunelveli
130. Dr. Chanda Srinivasa Rao, Telangana
131. Dr. Srinivas, Karimnagar
132. Dr. Moulidharan, Hosur
133. Dr. Pramod Sudarshan, Bangalore

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