Dr Arvind Sharma

14/07/2023

Spine deformity surgery is one of the most complex surgery. It involves a lot of dedication and hard work.the principles of deformity surgery are quite different from normal routine spine surgery.we recently corrected such a lumber deformity surgery in a middle age female. This was one of the kinds of surgery at SMS Hospital and well covered by the media. Thanks to team aesthesia, my unit head Dr Ashok Gupta, Dr Jitendra Shekhawat and Dr Rakesh singh boss for the value edition.

27/05/2023

CP angle surgeries are one of the complex procedures in Neurosurgery. Redo surgeries of this region are even more difficult. A young male came to us who was operated elsewhere 1 year back with post operative radiation. Gadolinium enhanced MRI Brain showed large residual CP angle mass. Re-exploration of previous surgical scar done. There were a lot of adhesions due to previous surgery and post operative radiation. Gentle dissection done around and tumor margins defined. It was fibrous and nonsuckable with moderate vascularity.. tumor excision done upto brain stem. In the region of brain stem planes was not well defined and as we touched the tumor it was causing bradycardia. So that small part of the tumor left behind deliberately to prevent extra harm to the patient. Surgery took around 8 hrs. Post operative period was uneventful.post operative imaging showed small residual tumor around brain stem.

18/05/2023

Sometimes CV junction pathologies are so difficult to understand and treat due to deviations from normal anatomical development. One such patient came to us with complaints of weakness of all four limbs. Mri CV junction revealed AAD with Basilar invagination with complete fusion of C1 vertebra with occipital bone. On further evaluation with CT CV junction there was complete fusion on C1 posterior arch with occipital bone with vertical C1-C2 joint. CT angiography of vertebral artery suggestive of single right side supply. Patient operated with per operative traction. C1-C2 joint opened so that BI reduced and further drilled to promote fusion. Spacer insert. C1 lateral mass and C2 pedicle screw insert. Post-operative period was uneventful. Imaging after surgery showed complete reduction of BI with opening of foramen magnum.

15/05/2023

News paper coverage of recently done brain stem to dorsal region spinal tumor

13/05/2023

Cavernous sinus is considered as no man's land for any neurosurgeon. It is one of the most compact and complicated structures in the brain. Although very small yet it contains 4 cranial nerves i.e 3,4,5,6, CN, internal carotid artery, sympathetic plexus.pathogy of this region can cause inability to move eyeball, facial numbness. A middle Aged female came to us with similar complaints. On further evaluation she was found to have the right cavernous sinus mass. After explaining all possible outcomes to surgery, the patient was taken to OT. Pre operative Lumber drain insert. RT pterional craniotomy done. Lumber drain opened and around 40-50 ml CSF drained so that the temporal lobe can be retracted. Extradural exposure of cavernous sinus done. Optic nerve de roofing done. Optic strut drilled and anterior clinoid process taken out. Cavernous sinus opened and the whole tumor was taken out. It was moderately firm and vascular. Whole of intracavernous part of ICA decompressed. Complete hemostasis achieved. Post operative there was no deficit to the patient. Post op MRI showed complete resection of mass. Images are attached.

10/05/2023

Intramedullary tumours of spinal cord are most difficult to operate. The rate of morbidity and mortality is very high in the post operative period in these tumors. We operate such a case of 30 years female with complaints of numbness and weakness in all four limbs. Mri showed the intramedullary tumour extends from the brain stem to D2 level. Pre-operative power was 4/5 in all limbs. After all the pros and cons of the surgical outcome, the patient agreed for surgery. Posterior fossa to D3 laminectomy done. Tumor identified at D2 region. Plane developed in between tumor and cord tissue. dissection done cranially. Tumor taken out in the totto. Surgery lasts for 6 and half hours. Post operative power in both lower limb was 4/5 and in upper limb was 3/5 which gradually improved upto -4/5. Post operative Mri imaging showed complete tumor removal. The surgery was having great help from the anesthesia side especially Dr Shobha purohit ma'am and Dr Neelu.

02/05/2023

Atlanto-Axial dislocation with Basilar invagination is a complex disorder of Craniovertebral junction.this disorder can cause weakness in all four limbs, tightness in all limbs and sometimes lower cranial nerves palsy. Its evaluation includes multidimensional CT scan of CV junction along with 3D reconstruction along with dynamic scan along with vertebral angiogram and MRI to evaluate cord status. A middle aged female comes to us with the problems of weakness in all limbs along with difficulty in swallowing. Patient further evaluated and found to have AAD and Basilar invagination. Surgery done on this patient with opening of C1-C2 joint and fusion using cage so that BI can reduce with occipeto-cervical fixation. Post operative period was uneventful. After two months of follow up, swallowing becomes normal and weakness improved drastically. As compared to preoperative images, post operative images showed complete reduction of AAD and BI

01/05/2023

Another great day from the surgeon's perspective. A middle aged female with complaints of ataxia and headache comes to us. On further evaluation of the patient, there was a large epidermoid in the posterior fossa compressing the cerebellum and brain stem. The anterior limit of the tumor was reaching up to the anteriolateral surface of the brain stem. After proper counseling the patient underwent surgery. Retrosigmoid occipital craniectomy done with complete excision of tumor done. Post operative period was uneventful.

24/04/2023

A large sphenoid wing meningioma was operated by a couple of days back. It was a huge tumor compressing brain stem medially. The middle cerebral artery was adhered to the anterior superior surface of the tumor. Left frontoparietal craniotomy done and complete tumor excised. Surgery lasts for 5 hrs. The post operative period was uneventful.

23/04/2023

Fracture of the upper cervical spine is common nowadays because of high velocity trauma. These cases have high mortality and morbidity. Treatment of these patients requires dedicated spine expertise and care. This is an illustration of a similar case treated with C1-C2 fixation. Post operative period was uneventful.

11/04/2023

On World Parkinson's day, an article about general awareness

21/02/2023