TREATMENT WE OFFER

Endovascular coiling

What is endovascular coiling?
Endovascular coiling is a technique for treating intracranial aneurysms that is done through a very small tube (a catheter). The catheter is introduced through a needle puncture most often through an artery in the leg. The catheter can then be painlessly navigated through the arterial system until the tip of the catheter is placed within the sac of the aneurysm.

“Coils” are very soft threads of wire, usually platinum, that have a pre-specified shape when they are unsheathed from the catheter. A series of coils are carefully placed into the aneurysm, filling the sac with the soft coils and preventing blood from flowing into the aneurysm. Plugging the aneurysm in this way greatly reduces the chances of the aneurysm rupturing in the future. Although aneurysm coiling is not a painful procedure, it can take several hours during which time the patient must remain very still, and for that reason these procedures are most often done under general anaesthesia.

What is the estimated recovery time?
Recovery time depends upon the presenting symptoms of the patient. For patients with unruptured, asymptomatic aneurysms, it is typical to be discharged home the day after the procedure. Most patients will experience minimal symptoms after the procedure, such as tenderness at the puncture site or some post-anesthetic fatigue, but usually regular activities can be resumed in just a few days. Patients presenting with a ruptured aneurysm or AVM hemorrhage, however, require a longer recovery, which often includes physical and occupational therapy.

Microsurgical clipping

What is microsurgical clipping?
Microsurgical clipping is a procedure that requires making a small opening in the skull to allow direct access to the blood vessels supplying the brain. The procedure is performed under general anesthesia. An operating microscope is positioned over the opening in the skull, and using the microsurgical technique, the aneurysm is identified and a very small titanium clip is placed across the neck of the aneurysms, permanently closing the defect in the arterial wall.

What is the estimated recovery time?
For patients with an unruptured aneurysm who undergo microsurgical clipping, expect to be hospitalized for 3 to 4 days before being discharged. Normal activities can be resumed within 2 to 3 weeks. For patients who present with ruptured aneurysms, the minimal period of hospitalization is 2 to 3 weeks regardless of treatment (surgical or endovascular). Rupture of an aneurysm is a type of stroke, and many of the patients who present with rupture require additional treatment for a complete recovery, including additional inpatient and outpatient rehabilitation.

Skull base surgery

What is skull base surgery?
When an aneurysm forms in the skull base, it requires extremely precise, skilled care. We use advanced imaging technology to help determine the exact location of the aneurysm or malformation, and then select one of several minimally invasive techniques to safely address the condition. Some of those options include:

• Endoscopic Endonasal Surgery, which relies on a camera inserted through the nasal passage and up to the skull base.
• Radiosurgery uses highly precise radiation waves to eliminate malformations with little impact to the surrounding tissues. Laser thermal ablation involves creating a tiny opening in the skull, through which we insert a laser probe to address the malformation.
• Keyhole surgery requires removal of a small amount of bone from the skull, granting access to the brain to find and address the problem.
• Craniotomy involves removing a larger portion of bone to access the malformation or AVM.

Spine Procedures and Conditions We Treat

If you or a loved one is dealing with a painful spine condition, you’re probably going through a range of emotions, from confusion and fear to anger, wondering if there’s a solution in sight. And we can empathize.

Our teams know exactly what you’re going through, what information you need to ease your concerns, and how to help you decide on the treatment plan that’s right for you, whether it involves surgery or not.

SPINAL TUMOR

What is a spinal tumor?
A spinal tumor is an abnormal mass of tissue that grows around part of the vertebrae/spine, spinal cord, or nerves. Either benign or malignant (cancerous), they can originate in the vertebra (primary) or travel to the spinal area from another area of the body (metastatic).

What are the most common types of treatments for spinal tumors?
If a tumor is benign and not growing rapidly or causing pain, simply monitoring the tumor may be the best course of action. However, if a tumor is cancerous or causing harmful symptoms, treatment can include expert surgical removal of the tumor.

SPINAL STENOSIS

What is spinal stenosis?
Spinal stenosis refers to the narrowing of the spinal canal, constricting the nerves and spinal cord within.

How experienced is Dr Rushikesh Gadhvi in treating spinal stenosis?
Spinal stenosis affects more than 11% of the Indian population. Each year, we treat hundreds of patients that suffer from this painful condition, both conservatively and surgically.

What are the most common types of treatments for spinal stenosis?
Treatments depend on the severity of the case. Whenever possible, we begin with nonsurgical treatments such as pain management and physical therapy. If surgery is deemed the best option, our team employs spinal decompression to create more space for the nerves to relieve pain and/or weakness.

SPONDYLOLISTHESIS

What is spondylolisthesis?
Spondylolisthesis refers to the slippage of a vertebra, either forward or backward, in relation to the vertebra above and below it. Patients suffering from spondylolisthesis often experience symptoms that gain in severity over time, leading to severe pain that limits the ability to live a full and active life.

What are the most common types of treatments for spondylolisthesis?
In most instances, pain management is deemed the most suitable treatment. This can include physical therapy, medications, steroid injections, chiropractic therapy and hot/cold therapy. However, in more severe cases, spinal fusion surgery is recommended, although this is often a final option, as the recovery time can be extensive.

Sciatica

What is sciatica/disc herniation?
Sciatica is a term that refers to the pain that you feel in your back and legs, usually from degenerative disc disease. Disc herniation refers to a gelatinous portion of the disc which can herniate or expel and compress neural structures, causing pain, weakness, numbness, and incontinence. This can progress to become a neurosurgical emergency in some cases.

What are the most common types of treatments for sciatica/disc herniation?
Depending on the anatomic problem, sciatica/disc herniation can often be treated with a simple, minimally invasive decompression, as opposed to a decompression with fusion, which is only required if the pathology is more complex. Our expertise in both minimally invasive techniques, as well as our experience with spinal decompression and fusion techniques set us apart from other spinal programs.

Failed Back Surgery Syndrome

What is Failed Back Surgery Syndrome?
Failed back surgery refers to the persistence of significant back pain or leg pain despite having already had back or spine surgery. There are several potential reasons for failed back syndrome. Sometimes, you may need a spinal fusion in addition to nerve decompression. Other times, the pain could be generated from other sources other than the spine.

What are the most common types of treatments for Failed Back Surgery Syndrome?
The first step is diagnosing the underlying reason for failed back surgery. If the pain does not originate from the spine, we may be able to address the condition conservatively. Revision spinal surgery is commonly performed after thorough discussion with your treating neurosurgeon, with a strong focus on establishing realistic goals and expectations. For patients with failed back surgery due to damaged nerves, spinal cord stimulation may be a viable approach.

SCOLIOSIS

What is scoliosis?
Scoliosis is an abnormal curve of the spine. It can happen in young children as they are growing, and if left untreated, can become incredibly painful and often times debilitating. Scoliosis also occurs in older patients, due to arthritis or muscle and tissue degeneration.

How experienced is the NeuroCure team in treating scoliosis?
Surprisingly, 1 in 100 people have some form of scoliosis, however slight. Because of the relatively common occurrence, our NeuroCure team is exceptionally equipped to diagnose, treat and monitor scoliosis cases, both in children and adults.

What are the most common types of treatments for scoliosis?
This depends on the degree of the curvature. A small curvature may just require observation. For children, a brace is often used to correct the deformity as the bones continue to grow. In extreme cases, a spinal fusion surgery may be required.