What are the types of head-spine-injury-trauma surgery?

1. Craniotomy: This surgical procedure involves removing a portion of the skull to access and treat injuries to the brain. It may be performed to address bleeding, remove blood clots, repair damaged blood vessels, or treat other traumatic brain injuries.
2. Spinal Fusion: In cases of spinal fractures or instability, spinal fusion surgery may be performed. This procedure involves fusing two or more vertebrae together using bone grafts and metal hardware to stabilize the spine.
3. Decompressive Surgery: This surgery aims to relieve pressure on the brain or spinal cord by removing or alleviating structures causing compression. It is often performed in cases of severe head or spinal injuries.
4. Intracranial Pressure Monitoring: In certain traumatic head injuries, monitoring intracranial pressure is crucial. This may involve inserting a device to measure pressure directly within the skull, guiding decisions on the need for surgery or other interventions.
5. Fixation of Spinal Fractures: Surgical stabilization of spinal fractures may involve the use of hardware such as screws, rods, or plates to realign and secure the damaged vertebrae.
6. Repair of Spinal Cord Injuries: Surgical procedures may be employed to repair or stabilize the spinal cord after trauma. This could include removing fragments of bone, tissue, or foreign objects that may be impacting the spinal cord.
7. Hematoma Evacuation: In cases where there is bleeding within the brain (intracranial hematoma), surgery may be necessary to evacuate the blood clot and relieve pressure on the brain.
8. Spinal Cord Decompression: Surgical decompression may be performed to relieve pressure on the spinal cord, especially in cases of spinal cord injury or compression.
9. Ventricular Shunt Placement: In certain traumatic brain injury cases, the accumulation of cerebrospinal fluid (hydrocephalus) may occur. Ventricular shunt placement involves inserting a tube to redirect excess fluid, reducing pressure on the brain.

A multidisciplinary team, including neurosurgeons, orthopedic surgeons, and trauma specialists, collaborates to provide comprehensive care in head-spine-injury-trauma cases. The choice of surgery depends on the unique characteristics of each case and the ultimate goal of stabilizing and restoring neurological function.

Individuals who are eligible for head-spine-injury-trauma surgery:

• Experience Severe Head and Spine Trauma:

1. 1. • Individuals who have sustained significant trauma to both the head and spine, such as in motor vehicle accidents, falls, or high-impact injuries.

• Have Critical Head Injuries:

1. 1. • Those with traumatic brain injuries, intracranial hematomas, skull fractures, or other severe head injuries that require surgical intervention.

• Suffer from Spinal Fractures or Instability:

1. 1. • Individuals with spinal fractures, dislocations, or instability due to trauma, which may necessitate spinal fusion or other stabilization procedures.

• Show Signs of Neurological Compromise:

1. 1. • Individuals experiencing neurological symptoms such as loss of sensation, motor function, or altered consciousness due to head and spine injuries.

• Have Life-Threatening Conditions:

1. 1. • Individuals with injuries that pose a threat to life or long-term neurological function if not promptly addressed through surgical intervention.

• Failed Conservative Management:

1. 1. • When conservative treatments or non-surgical approaches are insufficient to address the severity of head and spine injuries.

• Optimal Candidates for Surgery:

1. • Individuals who, despite the challenges of surgery, are deemed optimal candidates based on their overall health, age, and the potential for significant improvement in outcomes.

Evaluation process:

Primary Assessment and Stabilization:

Emergency medical personnel conduct a primary assessment to stabilize the patient’s condition. This involves assessing and addressing immediate life-threatening issues, ensuring airway, breathing, and circulation are stable.

Diagnostic Imaging:

Imaging studies, such as CT scans or MRI, are performed to visualize and assess the extent of injuries to the head and spine. These studies provide critical information for surgical planning.

Neurological Examination:

A comprehensive neurological examination is conducted to assess cognitive functions, motor skills, reflexes, sensory capabilities, and signs of increased intracranial pressure.

Spinal Examination:

A thorough examination of the spine is performed to assess for spinal cord injuries, fractures, or instability. This includes assessing motor function, sensation, and reflexes in different regions of the body.

Intracranial Pressure Monitoring:

In cases of severe head injuries, intracranial pressure monitoring may be implemented to directly measure pressure within the skull.

Laboratory Tests:

Blood tests are conducted to assess for signs of infection, anemia, or other abnormalities. These tests help provide a comprehensive overview of the patient’s overall health.

Conservative Management Assessment:

If applicable, the response to conservative treatments, such as medications or other non-surgical interventions, is evaluated.

Surgical Consultation:

A consultation with neurosurgeons, orthopedic surgeons, and trauma specialists is conducted to discuss the potential need for surgical intervention. This may involve a collaborative decision-making process.

Discussion of Risks and Benefits:

The medical team discusses the potential risks and benefits of surgical procedures with the patient or their legal guardian. Informed consent is obtained.

Preoperative Assessments:

Preoperative assessments, including cardiac evaluations and other relevant tests, are conducted to ensure the patient is fit for surgery.

Multidisciplinary Collaboration:

A collaborative approach involves ongoing communication between different specialists, including neurosurgeons, orthopedic surgeons, anesthesiologists, and critical care teams.

Emergency Interventions:

In cases of life-threatening conditions, emergency surgical interventions may be initiated promptly to address critical issues and prevent further harm

Proficiency of Dr Vishaka:

Hydrocephalus (increased fluid in the brain): The procedure involves an endoscopic third ventriculostomy and CSF diversion (VP shunt) to treat complex hydrocephalus.

1. Craniosynostosis (abnormal head shape due to untimely cranial sutures fusion) surgeries: Helmet therapy is a technique that is used in both endoscopic and open surgery.
2. Spinal dysraphisms(Spina Bifida)- (spinal abnormalities present by birth) – surgical repair
3. Encepahaocles repair surgery.
4. Vascular conditions and stroke surgeries: revascularization surgeries for moya moya disease.
5. Pediatric brain and spine tumour surgeries.
6. Pediatric brain and spine infection surgeries: Endoscopic and open surgeries for brain and spine infections.
7. Pediatric traumatic brain and spinal injury.
8. Antenatal counselling for congenital fatal neurosurgical conditions.

Dr Vishaka is the best neurosurgeon in Hyderabad, specializing in craniosynostosis surgery, which is only done in a few centres in India. Dr Vishaka Patil, M.B.B.S, DNB (AIIMS) New Delhi, M.Ch (IPGMER SSKM) became a Member of  “The Royal College of Surgeons, Edinburgh” (U.K.) a highly successful and best pediatric neurosurgeon in Hyderabad, Telangana with 13 years of experience, is among the topmost pediatric neurosurgeons in the Rainbow group of hospitals at Hyder Nagar and Banjara Hills.