L3 kyphoplasty fr osteoporosis fractures 

Mechanical trombectomy done fr mca occlusion

 

 

 Dr Vineet Saggar M.B.B.S, Ms, Mch( Neurosurgey)

 Consultant Department of Neurological and Spinal Surgery

 IVY Superspeciality Hospital Sec-71, Mohali. Punjab

 

 Dr Vineet Saggar is an alumnus of D.A.V college Chandigarh sec-10.After his MBBS from Maulana Azad Medical College (M.A.M.C) New Delhi  in 2002 ,  he did his Post Graduation in General Surgery from Safdarjung Hospital(2002-2005). He  went for his training in MCh Neuro Surgery at S.M.S Medical College Jaipur. At Jaipur he got  the privilege of working  with one of the pillars of Spinal Surgery -Prof. R.S. Mittal under whom he trained for almost 2yrs. After completing his MCh in July 2009, he trained under Prof. S.R. Dharker one of the pioneers of Micro- Vascular Neurosurgery in Rajasthan and India.   Before joining Ivy Hospital as consultant Neuro Spinal Surgeon, he headed Department of Neurosurgery at  Adesh Medical College Bathinda  for some time. He has special interest in Spinal Surgery and Skull-Based Micro Neurosurgery. Apart from many national and international  publications, he   also has research publications on Head Injury to his credit.

Publications:

1.       Abnormal Migration of shunt in Pitutary fossa. The internet Jounral Of Neurosurgery;Vol 5 No. 2.

2.       Hemostatic Abnormalities in Patients with Closed Head Injuries and Their Role in Predicting Early Mortality. J Neurotrauma.2009 Vol 26(1-4)

3.       Bilateral pupil-sparing oculomotor nerve paralysis with multiple cranial nerve palsies and hormonal imbalance following head trauma. Report of a rare case with clinicopathologic correlation. Indian Jounral of Neurotrauma. VOLUME 6 | NUMBER 1 | JUNE 2009

4.        Penetrating injury to cervical spine from a nail gun.Indian Jounral Of Neurotrauma.VOLUME 6 | NUMBER 2 | JUNE 2009

5.       . Isolated cysticercosis Of  Inferior rectus Muscle. Under Publication( Indian Jounral Of Medical Practitioners).

 

 

                 

Department of Neuro Spinal Oncology(Brain and spinal Cancer surgery) IVY Hospital

Department of Neurospinal surgical oncology  made its beginning under the able guidance of Dr Vineet Sagger in August 2010 and has touched new heights ever since. We in or department  are now performing complex cranial and spinal  tumour surgeries such as posterior fossa tumours  , skull base neuro surgery, spinal tumours apart from complex  Corpectomies and cervical laminectomies  for OPLL(ossification of posterior longitudinal ligament) apart from cervical and lumbar spinal fixations. Most of these patients of Cervical and Lumbar PIVD are being discharged next day following the surgery and we at Ivy Hospital plan to make it a Day care surgery very soon.

Case 1:

A 45 Yrs old Lady presented with complaints of bilateral radiating pain in legs  and faecal incontinence. MRI of spine had revealed large tumour extending from D-12 vertebral body to L-5 level measuring approx 12 cms in size. Patient was operated by Dr Vineet Saggar on Monday and complete  tumour removal was done and patient was discharged on Wednesday without any neurological deficit. This patient was refused surgery at many centers across Punjab .However such spinal tumour surgeries are being routinely done at IVY hospital by Dr Vineet Saggar

                                                 

Postop Pic of The Tumour                               Intra operative Picture Of The tumou

 

                  

MRI Showing Large Tumour From D-12 To L-5 Level            Patient Just Before Discharge

Case 2

A 50 year old man present with paraplegia and  severe pain in  back for past one day following trivial trauma MRI revealed  D-9  vertebral collapse with cord compression secondary to metastatic involvement. Patient underwent laminectomy tumour biopsy and pedicle screw fixation and was discharged the next day

 

           

MRI showing vertebral collapse and cord compression     Xray post operative showing pedicle                     

                                                                                              screws and Rod Fixation of spine

 

Case 3

A 50 year old female presented with severe pain upper back radiating to bilateral upper limbs. MRI revealed Tumour at D-1 level .Patient was successfully operated and discharged the next day.

MRI of patient showing large tumour at D1 level

Case 4

 A 45 year female present in OPD with complaints of giddiness and frequent falls associated with headache and vomitings . MRI brain revealed large tumour in posterior fossa. Patient was operated by us and after six hours of surgery highly vascular tumour was removed and patient made complete recovery postoperatively.

    

MRI showing large tumour in cerebellum Tumour after removal        Patient just before   

                                                                                                                    Discharge

 

Case 2.

A 60 yr old man from Kurali presented with History of mild trauma followed by weakness all four limbs which was progressing and he came to us in quadriparetic state and was bed ridden from past 1 month. CT and MRI cervical spine revealed segmental OPLL behind 4^th cervical vertebra. Patient underwent C 4 Corpectomy and C3 To C5 Fusion using bone graft and implant. Next day patient was discharged in walking condition.

    

 MRI showing Cord.               CT Cervical spine showing calcification behind C 4    Patient first post operative day                                                                                     compression at C4 Level        body and causing canal compromise                        

                                 

                           Figure 4.     X ray post op. showing cervical implant at C4 level

                                                 

                   

 

 

Spinal surgeries being Done at IVY hospital:   

1.Cervical spine Fixations

 2.Cervical  Discectomiues

3.Spinal tumours

4.  Lumbar Discectomies    (Microdiscectomies)    

5. Pedicle screw Fixations

 6. Lateral Mass fixations( Cervical)

 Microvascular Neurosurgery At IVY Hospital

Microvascular Neurosurgery at IVY Hospital also made its beginning under Dr Vineet Saggar in Aug2010 when a case of ruptured MCA aneurysm was operated in Emergency. A 24 yr young male presented in emergency with sudden loss of consciousness of  6 hrs duration C T head  revealed Massive frontoparietal ICH with intraventricular extension. A large 2.5 cms giant MCA bifurcation aneurysm was found and clipped During surgery .Since then microvascular aneurysm clipping is being regularly performed at IVY hospital by Dr Vineet Saggar.

                                                        

Fig 1&2 Pre Op CT scan images showing ICH with Intraventricular Extension

  FIG 3&4 Post Op Scan showing removal of clot and Aneurysm Clips in situ

Patient just before discharge

Department of Neuro interventional surgery

p-Com aneurysm

Post coiling

Acom aneurysm coiled

Post coiling basilar top aneurysm

 

Core Neurosurgical Procedures being done at IVY Hospital by Dr Vineet Saggar

1 Head injuries- EDH, SDH, Depressed Fractures , CSF Rhinorrhoea

2 Tumour Surgeries

3.VP Shunt Surgeries For  Hydrocephalus

4.Decompressive Craniotomies For Stroke

 5.Thrombolysis For stroke

 6.Skull Base Neurosurgery

 7. Orbital Tumours

                                

                                                                                                                                                                                                                            

 

RARE ENDOVASCULAR SURGERY PERFORMED AT IVY HOSPITAL

  22 yrs Male severe head injury following rta. Rt side pupil dilated pl pr negative . Steroids given fr suspected traumatic optic neuropathy. CT BRAIN  traumatic SAH snd skull base fractures. Pt gradually improved in consciousness.  Rt side pl pr negative . Left side vision improved from FC counting at 1m to fc at 6 m by 14 days . On 14 day sudden deterioration of vision with exopthalmos . Bruit  present Dsa confirmed ccf

                           Left eye swollen due to CCF.

                               DSA SHOWING CCF

POST COILING IMAGES OF CCF

Improvement in eye symptoms and vision immediate post surgery.

Coiling of wide necked p-com Aneurysm

60 yrs female presented to us with headache followed by loss of consciousness. Ct Angio revealed wide necked p-com aneurysm . Patient opted fr coiling and it was coiled without any further deficit to the patient . First pic wide necked p-com aneurysm.  Second pic post coiling

Neuro and Spine Surgeon, Mohali House Number 1766, 1st Floor, phase 5, Sahibzada Ajit Singh Nagar, Punjab 160059 098559 90990 https://g.co/kgs/bMRzRn

Rare LENTICULOSTRIATE ARTERY aneurysm operated by https://www.google.co.in/url?sa=t&source=web&rct=j&url=http://www.neurosurgeoninchandigarh.com/&ved=0ahUKEwi4476Ct9HSAhWMOI8KHa-8CQw4ChAWCCkwAQ&usg=AFQjCNEWcxJ03RU0249rCA4HnwzOnKPYww&sig2=G4pqnHFg2a18boTDYOHROgat Chandigarh mohali punjab

A 24year male presented to us in emergency with sudden onset loss of consciousness followed by seizures.  Patient was intubated and CT head was done which revealed  SDH right FTP region, and temporal haematoma and SAH. CT angio revealed aneurysm distal to ICA bifurcation and proximal to MCA BIFURCATION.  Patient was operated via right Forto-temporoparital craniotomy with clipping of aneurysm which was arising from junction of large lenticulostriate branch of right MCA just proximal to bifurcation.  Patient was discharged after one month after surgery without GCS of E4VtM6 with left hemiparesis and is still recovering.

Fig 1-4.CT ANGIOGRAPHY SHOWING aneurysm distal to ICA bifurcation and proximal to MCA BIFURCATION. Lenticulostriate artery aneurysm.

Fig5 plain CT images showing temporal haematoma with SAHIL AND SDH.

FIG 6 CT ANGIOGRAPHY  SHOWING LENTICOSRIATE ARTERY MCA JUNCTION ANEURYSM. 

FIG 6 and 7. POST operative scans.

Giant Distal MCA ANEURYSM (M2-M3) junction aneurysm operated by us with good outcome at chandigarh mohali punjab

A 55 year old lady presented to our opd with severe headache for past two days with two episodes of seizures.  She also complained of numbness and tingling of her left hand and arm. A provisional diagnosis of intracranial SOL was made and MRI was done . MRI showed a giant aneurysm in left MCA . CT ANGIOGRAPHY  revealed  giant aneurysm of left M2 -M3 JUNCTION.  Patient was operated via left fronto temporal craniotomy with clipping of giant MCA ANEURYSM. Patient was discharged 5 days after surgery  without any deficit.

FIG.1-5. CT ANGIOGRAPHY SHOWING GIANT DISTAL MCA ANEURYSM ON LEFT SIDE. FIG 6 POST OP CT. PIC OF PATIENT POST OP.

Large bilobbed MCA bifurcation aneurysm operated by us at Ivy hospital with good outcome

  A 45 year old lady presented to our emergency  with complaints of headache  followed by loss of consciousness  . CT head revealed SAH with large  haematoma  in temoropaietal region. CT Angiography  revealed large bilobbed aneurysm  at MCA bifucation  on right side. Patient  was operated via right Forto-temporoparital craniotomy with clipping of aneurysm  and removal of haematoma. Pt was discharged  without any deficit

Fig. 1 . CT HEAD SHOWING SAH WITH HAEMATOMA

FIG. 2,3. ANGIOGRAM SHOWING LARGE BILOBBED  MCA BIFURCATION ANEURYSM . 

FIG 4 POST OP CT OF THE PT.

PIC 5 PT AT FOLLOW UP.

Large wide necked MCA BIFURCATION ANEURYSM operated by us at ivy hospital mohali chandigarh punjab with good outcome

A 70 year old female presented to us with sudden onset severe headache followed by loss of consiousness. CT angio brain revealed large aneurysm at MCA bifurcation left side and small aneurysm at M2-m3 junction distal  to it. Patient underwent leftpterional craniotomy with clipping of aneurysm. 
CT ANGIO BRAIN SHOWING LARGE ANEURYSM AT MCA BIFURCATION LEFT SIDE WITH SMALLER ANEURYSM DISTAL TO IT AT M2-M3 JUNCTION. IMAGES 12 34

Images 5 and 6 post op ct

Picture 7 patient just before discharge.
POST OP CT

Large Acoustic Schwannoma operated by Dr Vineet Saggar Neurosurgeon mohali chandigarh punjab

A 55 yrs female presented to us with complaints of headache right sided hearing loss and Ataxia. Clinical examination  revealed rt sided senosineural hearing loss with mild facial wakes lmn type and decreased  gag reflex on right side. Crebellar signs were more pronounced on rt side. MRI revealed large CP angle mass on right side compressing  brain stem . Patient underwent  right Retro mastoid Suboccipital craniotomy with complete removal of mass with preservation  of facial nerve  function.

MRI showing right CP angle mass.
CT showing complete  removal of mass.