Dr (Prof) S Rajasekaran
Chairman, Dept of Orthopaedics, Trauma & 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.
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.
| 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 |
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
The unit has also more than 200 journal publications in spine surgery and many chapters in international textbooks.
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 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.
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) 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.
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.
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.
Hunterian Professorship of the Royal College....
Consultant Medal Paper Award,Tamil Nadu Orthopaedic....
Dr RC Rallan Gold Medal for....
Association of Spine Surgeons of India....
Dr RC RALLAN Best basic science....
ASSI Best Basic Science Research Award....
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.
1. Dr Lim Phaik Gan,
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