Dr. Dilip S. Kiyawat has wide experience in treating spinal disorders. cervical disc prolapse, lumbar spine disc prolapse, spinal trauma, spinal tumors, osteoporotic vertebral collapse. MRI is the choice of investigation to clinch the correct diagnosis. The large majority of back problems can be treated with nonsurgical methods usually referred to as conservative therapy. This includes bed rest, pain medications, muscle relaxants, lumbar traction, IFT (Interferential therapy) and spinal exercises. A majority of cases get good benefit from such therapy. Recurrence of pain and discomfort needs further treatment in the form of surgical intervention. Surgical treatment : 1. Microdiscectomy- through a 20 to 25 mm opening with the help of a microscope the abnormal disc is approached and nerve root is relieved of compression by removing the offending part of the disc. Patient can be discharged the next day 2. Endoscopic discectomy- through a tiny 10 to 12 mm opening the abnormal disc is approached using an endoscope and the nerve root is relieved of compression by removing the abnormal part of the disc. 3. Spinal stabilization - In cases of spinal instability due to fracture or degenerative disease the spinal segment needs to be stabilized. This procedure involves inserting titanium screws into the safe areas of the vertebrae at two or more levels and are fixed with titanium rods to stabilize the spinal segments. 3. Vertebroplasty- Osteoporosis in old subjects with trivial trauma often leads to vertebral collapse, a condition rendering the patient bed bound due to extreme intensity of pain they suffer. Such patients are dramatically benefitted by the procedure vertebroplasty where a biocompatible cement is injected in to the collapsed vertebral body. This offers immediate dramatic relief to pain and enables the patient to mobilize the same day.

Types of brain tumours- Primary brain tumors are tumors that originate in the brain itself, as opposed to secondary tumors that spread to the brain from other parts of the body. The brain tumours are categorized based on their cell of origin, behavior, and location. Some common primary brain tumor types include: Gliomas: they originate from the cells within the brain and include- Glioblastoma multiforme (GBM) Astrocytoma Oligodendroglioma Ependymoma Meningiomas: These tumors originate in the meninges, the membranes that surround the brain and spinal cord. Pituitary adenomas: Tumors that develop in the pituitary gland, which is located at the base of the brain. Medulloblastoma: A type of tumor that typically occurs in the cerebellum, often in children. Schwannomas: Tumors that develop from Schwann cells and are typically found on the nerves. Craniopharyngiomas: These tumors are usually located near the pituitary gland and affect the endocrine and neurological systems. Pineal gland tumors: Tumors that develop in or near the pineal gland, which is responsible for regulating sleep and wake cycles. Ependymomas: These tumors occur in the lining of the ventricles in the brain and the central canal of the spinal cord. Hemangioblastomas: Tumors that are often associated with von Hippel-Lindau disease and typically occur in the cerebellum or spinal cord. Chordomas: Tumors that usually develop at the base of the skull or along the spine. It's important to note that the treatment and prognosis for these tumors can vary widely based on their type, location, and other factors. I

Management of head injuries 1. Extensive scalp laceration- . The bleeding is controlled by suturing the scalp. . The skull is trephined and blood clot is removed and the bleed 2. Penetrating injury and depressed fracture of the skull- The penetrating foreign body is removed and the depressed fracture is brought to its correct alignment. 3. Extradural Haematoma- This is usually caused by a skull fracture injuring an underlying artery of the dura mater. This life-threatening condition needs ultra-urgent surgical intervention. The results of such treatment are very gratifying if performed in time. The patient who otherwise would have lost their life gains consciousness within hours and recovers. 4. Brain contusion and Acute Subdural Haematoma- Severe injuries to the brain lead to contusion and laceration of the brain and sometimes rupture of bridging veins on the surface of the brain. This results in the accumulation of blood clots on the surface of the brain under the dura mater. The brain becomes tense leading to an increase in intracranial pressure and rapid deterioration in consciousness and often come. The patients have to be supported by a ventilator and treatment started with Mannitol, glycerol, etc. to reduce intracranial pressure. Such patients usually run a risk of brain stem compression due to herniation (shifting) of the brain. Immediate surgical intervention is needed by doing a large decompressive craniectomy. In this surgery, a large portion of the skull is lifted off and the dura mater is widely opened to allow the swollen brain to bulge outwards thus relieving the compressive effect from the brain stem. Results of this surgery are also gratifying provided the procedure is completed in time before any irreversible damage to the brain stem could take place.