Shaad Bidiwala MD PA

Shaad Bidiwala MD PA Dr. Bidiwala is a board certified neurosurgeon with interests in minimally invasive spinal surgery, spine and brain tumors, and machine-brain interfaces.
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07/21/2023

One of the most challenging things we do - and much of what we do do - is to salvage surgeries done elsewhere when things didn’t go quite as expected.

This is a 60YO lady with a fracture of the T10 vertebra that resulted in severe back pain. A surgeon at another hospital had tried to fix this by doing a vertebroplasty - that is, injecting cement into the vertebral body - hoping to cement the bone fragments together and stabilize the fracture.

Unfortunately the patient not only experienced worsening of the back pain after surgery, but also developed a searing pain that wrapped around her rib cage on the left hand side.

A CT showed the cause of her problem immediately. The cement had leaked out of the bone and had “set” into a rocklike mass pushing against her spinal cord and nerve roots. To make matters worse, the fracture was still unstable, accounting for her persistent and worsening back pain leaving her unable to stand upright, let alone walk.

At surgery we first placed screws and rods to stabilize the fracture. Then we exposed the spinal cord, the nerves, and the rocklike mass pushing against both. To reduce the risk of paralysis that could result from retracting the spinal cord, I used a high speed drill to “core out” the cement mass, and then gently pulled the resulting hollow shell away from the spinal cord:

The patient had excellent relief of her back pain and was able to walk a few days after the surgery. A few months later she still reported some residual nerve pain in her ribs but it had improved dramatically and we expect it to continue disappearing as the nerve heals.

Our patient is accustomed to being the best of the best in everything she does. It was truly an honor for our entire team to be a part of her recovery and we wish her the best of luck during the process.

*exact demographic details altered to protect anonymity.

Though most of what we do as neurosurgeons is spinal surgery, occasionally we are called to match wits with much more co...
02/27/2023

Though most of what we do as neurosurgeons is spinal surgery, occasionally we are called to match wits with much more complex situations involving the brain.

One such call came at 1230AM from an emergency room that I cover: a patient who had lost a fight with a nail gun.

As tempting as it was to simply pry the nail out of this patient’s skull through the hole in the skin and go home, the appropriate process took approximately seven hours longer.

We began by obtaining a CT of the patients head to make sure there wasn’t an active hemorrhage that would have required a larger, more urgent surgery.

The CT did not show a significant hemorrhage, so we obtained a four vessel angiogram - a roadmap-like picture of the blood vessels in the brain, obtained by one our expert neuroradiologists - to see if there had been damage to any of the major blood vessels of the brain, so that our team could be prepared to repair them if necessary.

The nail had miraculously *missed* every major blood vessel in this patients brain. We proceeded to surgery with a sense of relief but caution.

At surgery, I first exposed the patient’s carotid artery in the neck, just in case there *was* a vascular injury that the angiogram had missed. I identified a point on the carotid artery that I would close off with a metallic clip in case uncontrollable bleeding occurred while removing the nail.

After this, I incised the skin around the nail, removed bone around the nail, opened the covering of the brain, and removed the nail carefully and slowly, *under direct visualization* so that I could identify and fix any bleeding in case it occurred. After removing the nail, only minimal bleeding was seen and this was stopped by injecting a hemostatic gel into the hole left by the nail. To finish, we irrigated throughly, placed a mesh over the skull defect and closed. the muscle and skin tightly with suture.

We were grateful that the patient came out of surgery without skipping a beat. There were no neurological deficits and the patient was discharged home several days later.

**Pictures were shared with the patients permission, but all identifying information has been removed.

This is a nice 70YO lady who had a several year history of severe back pain and right leg pain. She tried and failed med...
07/25/2022

This is a nice 70YO lady who had a several year history of severe back pain and right leg pain.

She tried and failed medical management, physical therapy and injections. Her MRI showed a grossly misaligned spine with a spondylolisthesis of L4 on L5 in which the L4 vertebral body was literally slipped forward on the L5 vertebral body with compression of the nerve roots in between, explaining both her mechanical back pain and leg pain.

At surgery we performed a minimally invasive MAS-TLIF. We made two small 1.5-inch incisions and implanted Nuvasive ReLine screws. The screws were used to distract across the malaligned vertebrae, while we removed bone and disk and implanted a Nuvasive titanium CoRoent TI spacer - or “cage” filled with the patients own bone. Surgery took approximately 2.5 hours and the patient went home two days later.

At several months out, our patient is doing wonderfully. Xrays show normal alignment and her back pain and leg pain have resolved. We wish her much luck in getting back to her normal life and are excited and honored to be a part of her recovery!

Address

17151 Dallas North Tollway
Addison, TX
75001

Opening Hours

Monday 8:30am - 5pm
Tuesday 8:30am - 5pm
Wednesday 8:30am - 5pm
Thursday 8:30am - 5pm
Friday 8:30am - 5pm

Telephone

(214) 823-2052

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