The Neurosurgery & Spine department at Aster Hospital provides extensive treatment & care for all ailments related to the brain, spinal cord, and peripheral nervous system. Some of the neurological treatments offered are for stroke, brain tumors, and head injuries as well as spinal treatments for spinal tumors, disc herniation, cervical/ lumbar spondylosis, sciatica, and congenital spinal deformities. As an expertly skilled neuro-spine team, it consists of experienced neuro and spine surgeons who work in collaboration with specialty nurses, rehabilitation therapists and radiology technicians to provide customized and comprehensive treatment to all patients.
We have some of the best specialists from around the world, they bring years of experience and offer evidence-based treatment to ensure the best care for you.
We provide comprehensive treatment for all types diseases under one roof. Our highly experienced doctors supported by especially trained clinical staff, ensure the best care for you.
Well equipped with the latest medical equipment, modern technology & infrastructure, Aster Hospital is one of the best hospitals in India.
Intracranial pressure monitoring
Outpatient (6 days in a week), Inpatient, follow-up clinic
24 hours emergency services
Comprehensive Neuro rehabilitation services
Nerve conduction studies (NCS)
Evoked potential (VDP, SSEP, BERA)
Nerve and muscle biopsies
Video EEG monitoring
Routine 32 channel digital video EEG
Round-the-clock, long-term 128 channel video EEG monitoring
Functional MRI and WADA study to assess eloquent cortex regions.
3T MRI and an exclusive intraoperative MRI
PET (positron emission tomography)
SPECT (single-photon emission computerized tomography)
SSEP (Somatosensory Evoked Potential)
MEP (Motor Evoked Potential)
Different surgeries available:
Lobectomy (e.g. temporal lobectomy)
Multiple Subpial Transections
Mesial temporal sclerosis
Focal cortical dysplasia
Lesions like ganglioglioma, DNET
This comprehensive rehabilitation regimen can help the patient to maximise and regain normal muscle movement and function after a stroke or for neurological conditions such as:
Spinal cord injury
Brain perfusion imaging
Ictal SPECT imaging
Technetium TRODAT imaging
I - 131 MIBG therapy for malignant neuroendocrine tumours
Neuropsychology is the systematic evaluation of higher cognitive abilities including intelligence, memory, academic skills, cognitive and language, attention span, sensory motor, problem solving abilities, executive abilities, visual motor skills and personality/emotional functioning. The Neuropsychology Clinic at the Aster Centre of Excellence in Neurosciences offers:
Cognitive evaluation/ rehabilitation/ remediation in patients with neurological conditions like epilepsy, stroke, Alzheimer’s disease, Parkinson’s disease and tumours
Study of functional aspect of brain through pre & post-operative evaluation
Study of decline of cognitive skills in the elderly
Evaluation of changes in thinking/ behavior pattern with people with serious illnesses
Evaluation/ management of behavioural problems
Counselling/ management of depression and anxiety
Counselling and management of depression and anxiety
Molecular diagnosis and genetic mutation analysis
Occupational therapy and rehabilitation for patients with neurological/ physical disabilities
Speech therapy for patients with language disabilities
Flat panel bi-plane vascular hybrid cathlab
Fourth generation Time of Flight 16 Slide PET CT
True Beam Linear Accelerator for high-precision radiotherapy
Low radiation CLARITY cath lab
256 slice Philips iCT scanner
3 Tesla Wide Bore Digital MRI
GE SPECT-CT OPTIMA NM 640 Gamma Camera EPIQ
Image fusion for guided biopsies
OR 1 Karlstroz fusion integrated, Green OT certified Operation Theatres with autopilot anaesthesia
Stealth Station Navigation
C- Arm for surgical imaging
Dedicated ICCA (IntelliSpace Critical Care and Anaesthesia) Neuro ICUs
Level 3 Paediatric ICU
ORI Fusion Digital Integrated Operation Theatres With 22 Operating Rooms that are on par with some of the largest in the world, Aster Medcity, for the first time South India, introduces ORI Fusion Digital Integrated Operation Theatres using Karlstorz OR1 Fusion - Asia Pacific’s first complete digital integration system.
The integration enables real-time sharing of images, videos and medical reports, which not only facilitates virtual participation from any location in the world, but also helps the rest of the surgical team to monitor the patient closely during the operative procedure, much to the benefit and safety of the patient undergoing the surgery.
Aster Medcity is also the first surgical facility in the state to offer Robotic Surgery using high-precision da Vinci Surgery Robot.
Want to find out more about the treatment? The answer to your questions can be found below.
What is a seizure?
A Seizure is a condition in which sudden, uncontrolled electrical irregularity occurs in our brain. It may cause changes in behavior, movements or feelings, and levels of consciousness.
How long do seizures usually last?
Usually, a seizure may last from a few seconds to a few minutes, based on the type of seizure.
If I have a seizure, then does it mean that I have epilepsy?
Not always. Seizures can also happen because of other medical problems. These problems include:
A high fever.
Alcohol or drug withdrawal.
Low blood sugar.
What are the steps for epilepsy surgery?
Once you are being considered for epilepsy surgery, you will have to undergo three major steps
consensus decision and
In pre-surgical evaluation, we decide the specific portions of your brain which are responsible for this epilepsy with different tests, clinical evaluations, etc. And a team of doctor specialists from various related fields meet together to discuss and reach a consensus about the type of surgery you will need. A final plan is decided in the multidisciplinary meeting.
Why test sudomotor function?
A sudomotor function test is a quick and reliable way of identifying certain types of neuropathies. The presently available tests detect only 50-60% of neuropathies. This test helps the clinician to identify small fiber neuropathies and improve diagnostic accuracy.
What is a stroke?
Stroke is sudden onset weakness in one half of the body due to the blood supply to part of the brain is interrupted or reduced, preventing brain tissue from getting oxygen and nutrients.
What is Seizure?
A seizure is a sudden, uncontrolled electrical disturbance in the brain. It can cause changes in your behaviour, movements, or feelings, and in levels of consciousness.
Is There a Cure for Parkinson's Disease?
There is currently no cure for Parkinson's disease, but treatments are available to help relieve the symptoms and maintain your quality of life.
Why choose Aster MIMS for Neurosurgery?
Aster MIMS offers highly qualified and dedicated neurosurgeons. Our facility put forward advanced guidance and the latest technology, as well as a warm, family-like atmosphere, we are well known for the quality of care we provide.
Aster Mims neurosurgeon Dr. Jacob P. Alappat is nationally recognised as well. Our certified doctors and nurses monitor the progress of our patients round the clock.
What are the types of neurological disorders?
Neurological disorders are differentiated based on the following:
- Genetic defects: Alzheimer's, Parkinson's, and epilepsy can run in families.
- Anatomic or structural defects: Bell's palsy, cervical spondylitis, carpal tunnel syndrome.
- Degenerative changes due to age: stroke, dementia, precipitation of Parkinson's.
- Blood supply issues(vascular) like brain damage, memory loss, and vascular dementia.
- Cancer: paraneoplastic disorders of the nervous tissues can cause problems like loss of consciousness, loss of muscle movement, thinking, memory, and sensory perception.
- Injuries and trauma related: can be due to physical(acute spinal cord injury, ALS, Ataxia) or emotional trauma(adverse childhood experiences can precipitate neurological symptoms).
- Infections: several viral infections can cause neurological disorders like meningitis, encephalitis, chickenpox, and polio.
- Seizure disorders: epilepsy.
Are all neurological disorders incurable?
Neurological disorders hamper the quality of life, are severe, and can be fatal. Though most are still incurable, many treatment outcomes depend on causative factors. With advanced medical procedures and palliative care, many symptoms can be improved and reversed in some cases.
What role does the spine play in neurological disorders?
Your spine connects your limbs and lower body to the brain with the help of nerve fibers and nervous tissue. Any damage to the spine can cause neurological disorders and vice versa. Spinal cord disorders have the potential to cause long-term & severe neurological issues.
What is neurosurgery?
Neurosurgery is a branch of medicine that deals with surgeries related to the nervous system. The doctors who specialize in this field are known as neurosurgeons. These specialist diagnose and surgically treat conditions of the brain and spine and also provide expertise in -
- General neurosurgery
- Brain tumour surgery
- Complex spine disorders
- Stereotactic radiosurgery
- Vascular diseases.
How long does it take to recover from neurosurgery?
The recovery period usually depends on the type of surgery one has undergone. Many people feeld tired for several weeks after undergoing a neurosurgery and suffer from headaches, facing difficulty in concentration. It usually takes up to 4 to 8 weeks to recover from a surgery and your incisions may be sore for about 5 days after surgery.
Are there any side-effects of brain surgery?
Side effects of brain-surgery include -
- Difficulty in breathing
- Issues with memory
- Mood swings
- Painful or swollen calf
- Weakness in arms and legs
- Improper vision
- Difficulty in hearing.
Is the Deep Brain Stimulation (DBS) A Well Established form of Therapy ?
This therapy started developing in 1987 and is backed by decades of research, innovation, and experience. There is a lot of clinical evidence and it is supported by 5 Level 1 clinical studies—the highest quality of evidence. As of 2017, more than 150,000 people have received Deep Brain Stimulation (DBS) worldwide.
What Are The Benefits Of Deep Brain Stimulation (DBS) In Parkinson’s Disease?
The following are 6 major outcomes of the Deep Brain Stimulation (DBS) procedure:
- Reduces dyskinesia and fluctuations
- Up to 5 additional hours of good movement without dyskinesia
- Treats tremors and rigidity
- Improves activities of daily living
- Works day and night
- Improves quality of life.
Are You A Candidate For Deep Brain Stimulation (DBS)?
A lot of research has gone into finding the a suitable patient for Deep Brain Stimulation (DBS). Preliminary screening can be done by answering following four questions to see if Deep Brain Stimulation (DBS) therapy may be useful for you.
- Are your medicines not able to control your symptoms completely throughout the day – Yes/No
- Is troubling dyskinesias (involuntary excessive movements) becoming a problem for you? – Yes/No
- Has your frequency and dosage of DA drugs increased in the last few months? – Yes/No
- Are drug combinations causing side effects such as: sleepiness, nausea, hallucinations, confusion/other thinking problems, lightheadedness upon standing, behavioral/personality changes? – Yes/No
"Yes" to some of the questions above provides you a guidance and you should further ask your doctor if Deep Brain Stimulation (DBS) Therapy is right for you. Deep Brain Stimulation (DBS) might be able to help you."Yes" to some of the questions above provides you a guidance and you should further ask your doctor if Deep Brain Stimulation (DBS) Therapy is right for you. Deep Brain Stimulation (DBS) might be able to help you.
What is Endoscopic spine surgery?
Endoscopic Spine Surgery (ESS) is a procedure performed through small incision with help of tubular system assisted with endoscope to visualize the surgical field. ESS is an advanced form of Minimal Invasive Surgery aimed at providing lesser recovery time, early return to work and less post-operative pain than traditional spine surgery methods with improved visualisation.
This procedure is performed with a fibre optic tube with light and lens. Through this the muscles are not cut but are pushed aside to permit small tube to enter the spine and a very small high-definition camera is used to see the spine anatomy.
What are benefits of Endoscopic spine surgery?
- Target oriented surgery - less trauma muscle and soft tissue
- Minimal bone removal - Spinal stability is preserved
- Less blood loss
- Lesser infection rates
- Reduced requirement of post - operative analgesia
- Through this the patients are mobilised and can be discharge the same day with proper post-operative instructions.
- ESS procedure can be performed using regional or local anaesthesia instead of general anaesthesia, decreasing the risk of general anaesthesia in elderly patients or patients with co-existing medical conditions.
What constitutes a healthy back?
Our spine is nature’s extraordinary miracle. Several complex structures come together to provide the human body with a fine balance of protection, support, strength and movement. A healthy spine is not just the bony segments but a combination of several ‘supporting structures’ - protective discs, strong muscles and attached ligaments and tendons. The 24 bony segments or vertebral bodies or vertebrae in the spine are interspersed with a tough, yet soft gel-like cushion or shock-absorber, called intervertebral disc. The muscles surrounding the spine or ‘para-spinal muscles’ are attached to the bones through ligaments. Together these structures, called the ‘natural tension band’ provide mobility, strength and protection to the back. The core of our spine’s movement, structure and flexibility comes from complex biomechanics of the bony vertebrae and supporting structures. Often compared to a ‘crane’, it is said that for the spine to be stable, all elements must be intact and function in unison.
What is causing my unresolved back pain?
Pain that just doesn’t go away can be frustrating and agonizing. If you have been suffering from unresolved back pain despite medication, physiotherapy, and other pain-relieving treatment, please be assured that you are not alone. Chronic back pain is more common than you would imagine. In fact, it has been noted that as many as 60% Indians cope with significant back pain, some or the other time in their lives. The most common cause of chronic back pain is age related degeneration of the spinal discs. Though aging is a natural process, in some individuals it may lead to unmanageable and incessant pain. The pain may or may not be accompanied by numbness, weakness and stiffness. Another common cause of severe back pain is stress or sports injury. For example, sudden surge in activity or lifting heavy loads can sometimes lead to spinal complications beyond a simple muscle spasm. In most cases, root cause of pain and weakness is some pressure or impingement on highly sensitive structures like spinal cord or nerves, due to:
- excess bony growth (osteophytes)
- damage to the disc leading to displacement of the inner core (herniated disc)
- drying up of the discs leading to reduction in the opening between two adjacent vertebrae
- dislocation of the spinal joints (spondylolisthesis)
- fractures due to osteoporosis.
How can a Spine Specialist help me?
Visiting a spine surgeon does not mean you will need spine surgery! A specialist can understand and interpret the root cause of your back pain through some simple tests like X-rays, MRI or CT Scans. Also a spine specialist has comprehensive training and experience to understand spinal anatomy, correlate symptoms to pathology, and recommend and offer surgical or non-surgical treatment options. This makes them much better-equipped to manage your spinal issues effectively.
What are my options? What will life be like post-surgery?
Traditional methods of spine surgery, or ‘open procedures’ require long incisions down the middle of the back and stripping of muscles and ligamentous attachments to the spine. Moreover, the muscles are pulled and held apart to grant a surgeon access to the spine for the surgery duration. This can range from one hour to several hours. The invasive and traumatic nature of open spine surgery, compromises the vital supporting structures of the spine that play an important role in maintaining the strength and flexibility of your back. This method of surgery will address a surgeon’s operative goal, i.e. relieving the pressed nerve or spinal cord. However, it compromises on the natural anatomy and exposes the patient to weakness of the back post-surgery leading to compromised muscle strength and flexibility, and pain.
What is epilepsy?
Patients having two or more seizures or a tendency to have recurrent seizures, are termed to be having epilepsy.
What are the major types of seizures?
Sometimes it is difficult to determine when a person is having a seizure. A person with a seizure may look confused or as if they are staring at something that is not there. Other seizures can cause a person to fall, shake, and become unaware of what’s going on around them.
Seizures are classified into two groups.
Generalized seizures affect both sides of the brain.
Focal seizures affect just one area of the brain. These seizures are also called partial seizures.
What causes epilepsy?
Epilepsy can be caused due to various conditions that affect a person’s brain. Some known causes include:
Traumatic brain injury or head injury
The cause of epilepsy is unknown for 2 in 3 people. This kind of epilepsy is termed as cryptogenic or idiopathic.
Developmental anomalies of the brain
Loss of oxygen to your brain. Example: Birth time
What is pre-surgical evaluation for epilepsy surgery?
The pre-surgical evaluation consists of various domains. Most important is video EEG followed by investigations like MRI, PET scan, SPECT scan. This MRI scan performed here is not the regular MRI but a customized scan which will depend on recordings of your video EEG. A neuropsychological assessment is also a vital part of presurgical evaluation which gives important insight into the localization and potential problems you will be having after surgery. Once all these investigations are ready, it is generally discussed in meetings to reach a consensus about the plan.
When to consult a Neurologist?
Neurologist opinion is required when the patient has signs and symptoms of disorders related to the brain, spinal cord, peripheral nerves, and muscles<
How to identify stroke?
Unexpected numbness or weakness in the face, arm, or leg, especially on one side of the body. sudden confusion, trouble speaking, or difficulty understanding speech. Sudden trouble seeing in one or both eyes. Sudden in trouble walking, dizziness, loss of balance, or lack of coordination.
What is Epilepsy?
Epilepsy is defined as having two or more unprovoked seizures.
What is the average age for dementia to begin?
The risk rises as age increases, especially after age 65. However, dementia is not a normal part of ageing, and dementia can occur in younger people. Family history. Having a family history of dementia puts you at greater risk of developing the condition.
What is a neurological disorder?
In medical terms, a neurological disorder can be defined as a disease, abnormality, or disorder affecting the brain, nerves, spinal cord, or nervous tissue present anywhere in the body. These disorders involve all electrical, biochemical, and structural problems related to the organs of the nervous system.
When to go to a neuro physician?
Symptoms that persist for a long time need to be reviewed by a neuro physician like
- Severe or chronic headaches.
- Chronic pain in the body which is not of skeletal origin.
- Dizziness or problems with body balance.
- Chronic numbness or tingling in feet, fingers, wrists, etc
- Mild tremors or chronic twitching of muscles.
- Confused thoughts, random train of thoughts, memory problems.
Neurological disorder vs mental illness/disorder?
Neurological disorders are caused due to malfunction or damage to the central/ peripheral nervous system.
Mental illnesses or disorders are manifestations of disturbed behavioral issues and emotional problems.
What is neuroscience?
Neurosciences is a scientific study of the nervous system. This is a multidisciplinary branch that deals with the cellular, functional, behavioral, evolutionary, computational, molecular, and medical aspects of the nervous system. Neurosciences also focuses on the human brain and analyzes how it regulates our body and our behavior.
What are the different types of surgeries performed by neurosurgeons?
Some of the procedures performed by neurosurgeons include -
- Microvascular decompression
- Peripheral nerve surgery
- Brain tumour excision
- Functional neurosurgery
- Pituitary surgery
- Cervical spine surgery.
What is brain surgery?
Brain surgery is a type of surgical procedure that is performed to correct the abnormalities of the brain such as tumours and aneurysms.
How much time does it take to recover from brain surgery?
Recovery from brain surgery depends on the type of surgery one has undergone. It is usually recommended to stay for a week at the hospital after brain surgery. During this period, your doctor will observe how your body is reacting to the surgery and medications and will recommend physical, occupational and speech-language therapy sessions to help you regain your overall strength.
What Are the Risk? Safety Profile Of Deep Brain Stimulation (DBS) Therapy?
Deep Brain Stimulation (DBS) has been in use for nearly 30 years. Any possible risks and complications are well known and can be easily predicted. It is a relatively safer procedure with minimal risk.
Our Deep Brain Stimulation (DBS) Speciality Clinic at the hospital can provide you with the detailed information on potential complications and risks involved in the procedure.
Can I Wait For Some Time Before Considering Deep Brain Stimulation (DBS)?
There is a window of opportunity where Deep Brain Stimulation (DBS) is helpful for you. Deep Brain Stimulation (DBS) Therapy is no longer an option when:
- Medications stop improving your symptoms
- There is severe disability.
- Surgery is not advisable for any other contraindication
Think Earlier – A lot of people assume that Deep Brain Stimulation (DBS) Therapy is a last-ditch effort to preserve your way of life. This however is not true, and Deep Brain Stimulation (DBS) should be considered and evaluated when your medications are becoming less effective at controlling your movements. Speaking with a Deep Brain Stimulation (DBS) expert can help you find the right answers - it's never too early to talk with your doctor about Deep Brain Stimulation (DBS), and it's important not to wait too long.
Steps In The Deep Brain Stimulation (DBS) Procedure
- Consultation with our doctors at Aster.
- If Deep Brain Stimulation (DBS) is a treatment option for you, extended examinations are conducted
- Once it has been established that there are no contraindications, and you have provided consent, we can proceed to the admission for the surgery.
- Pre—operative management of medication and preparation are conducted.
- Surgery is performed, and patients are usually kept awake with light sedation, to better test brain functions, effects and side effects.
- Patients are then introduced to the Deep Brain Stimulation (DBS) neurostimulator, it‘s programming, and functional testing
- Transfer to a rehabilitation clinic, if required.
- Regular aftercare for outpatients (at least once a year) and follow-up care for inpatients, if needed.
Condition treated by Endoscopic Spine Surgery
- Disc prolapse (slipped disc)
- Spinal Canal Stenosis (Cervical and lumbar – narrowing of spinal canal)
- Refractory back pain
- Spinal infection – for biopsy and debridement.
What are types of endoscopic surgery?
- Intralaminar technique - performed from the back of the spine between two laminae
- Transforaminal technique - performed from the / side of the spine (flank) into the neuroforamen(exit passage for the nerve ).
What can I do to maintain my spinal health?
A healthy back is a combination of healthy bones, mobile joints, and strong muscles. Unfortunately, a complex system like our back or spine is prone to issues arising from one or more malfunctioning elements. Any disturbance to the spine and it’s supporting structures due to aging, trauma, lifestyle stresses or other pathologies can lead to spinal complications, most commonly appearing as back or neck pain. Maintaining a healthy spine is almost non-negotiable to ensure a healthy, pain-free and active life. Simple activities such as maintaining healthy posture, regular exercise, good nutrition and regular exposure to the sun, go a long way in maintaining a healthy spine.
What should I be doing?
Managing your back pain is all about taking timely action. See a trained physician about your condition if pain persists for more than a week of home treatment and rest. Depending upon their assessment of your condition, a physician may advise you one or more of the following:
- Physical therapy including exercises and other treatments like heat, ultrasound, electrical stimulation to ease the pain and strengthen the back
- Anti-inflammatory or pain medication
- Epidural spinal injections to manage the pain supporting other treatment modalities
- Lifestyle modification.
Should I be worried?
A spine specialist may diagnose you as a candidate for surgery if they feel that your problem is advanced. The nature of the spine is such that degeneration or damage to one part can trigger a cascade which can start affecting other healthy parts as well. Therefore, a surgeon may suggest that in certain cases, surgery may be the right option for you. Spine surgery has been around for several decades and has evolved into a very safe procedure. Surgeons have the dual advantage of rigorous training and advanced technologies that ensure safe and satisfying outcomes. A large number of patients are known to have benefitted after spine surgery performed for conditions such as lumbar spinal stenosis, degenerative disc disease, disc herniation. Talk to your surgeon openly about your concerns!
What should I be asking before undergoing MISS?
Since MISS is technically challenging, enough care is taken on different aspects to ensure a safe and good outcome. It is important for you, as a patient considering MISS, that your surgeon is well-trained, and has enough experience of performing a wide range of spine key-hole surgeries. In addition, the hospital staff and infrastructure should also support performing these Minimally Invasive Procedures with accuracy, precision and safety. MISS is a way of life at Aster. More than 90% of the spinal surgeries here are done through minimally invasive techniques. Aster is probably the only hospital that ‘regularly’ does MISS for cervical pathologies and complex spine cases.
Dr. Umesh Srikantha, Head of Spine Services at Aster, has performed close to 2000 minimally invasive spine surgeries in the past seven years. His experience in MISS ranges from the most basic procedures like lumbar microdiscectomy, foraminotomy and decompression surgeries to the most complex spinal fusion procedures for advanced pathologies like tumors and high-grade spondylolisthesis. He is one of the top surgeon faculties in the country for MISS, having trained more than a hundred aspiring surgeons to adopt MISS through advanced training programs. The OR team at Aster has also been supporting MISS for the past seven years and is proficient with the use of complex MISS instrumentation and high-end technologies such as navigation and neuro-monitoring.
We all know how the advent of data connectivity, GPS and Google Maps, has simplified road travel for the common man. We rarely feel the need to stop and to ask for directions. More importantly, we are able to reach the correct destination in the shortest possible time. Similarly, modern and state-of-the-art hospitals invest in and routinely use surgical navigation technologies. The use of surgical navigation systems along with advanced pre-surgery planning software has revolutionized a surgeon’s ability to visualize the anatomy in 3D and perform more accurate surgeries even through smaller skin incisions and narrow tubes. In addition, the use of intra-operative neuro monitoring ensures critical nerve structures are monitored and protected through the course of Spine surgery. At Aster, these advanced enabling technologies are used routinely to ensure MISS is performed with utmost accuracy, precision and safety.
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