This document profiles Dr. Amish Sanghvi and his qualifications and expertise in spine surgery. It outlines his medical training and fellowships in spine surgery, minimally invasive spine surgery, and stem cell research. It also lists some of his achievements including national awards and publications. The document describes Dr. Sanghvi's areas of expertise, which include various spine surgeries and conditions. It provides examples of some of his patients' cases and outcomes.
Spine Arthroplasty or Artificial Disc Replacement is a new term which is used more and more in international scientific meetings and publications starts to dominate the scenery. The last three decades have been the most revolutionary in the history of spine treatment. The 80’s were dominated by the development of modern implants for internal segmental fixation such as pedicle screw systems and others. In the 90’s „Mini-open“ as well as „closed“ endoscopic techniques replaced the majority of conventional surgical approaches . Progress in biological and biochemical research seems to open new perspectives in fusion technology. We must not forget that bony fusion of a functional spinal unit is non physiological and it is associated with a variety of proven and (yet) unproven undesired effects and sequelae. At the beginning of this century, the progress in implant technology open a new dimension for spinal reconstructive non-fusion surgery. A variety of new implants are used today for: nucleus pulposus, total disc replacement, dynamic posterior reconstruction systems, posterior shock absorbers and injectable intradiscal materials. Cervical Disc Replacement is a Motion preserving surgery, Treat painful / pathologic process while restoring/maintaining motion, Decreased stress in adjacent levels, May prevent problems of adjacent segment disease, secondary surgery, pseudoarthrosis.
Comparing arthroplasty (ACDR) vs fusion (ACDF) most of the studies are in favour of (ACDR) because of, Higher neurologic success, Earlier return to work, Degrees of maintained motion, Adjacent Segment Degeneration 5 yrs, Statistically significant better scores (NDI, Arm pain, VAS, and SF-36 scores), lower revision rate (Reoperation rate for ACDF – 11.3% vs 2.9% ACDR)
Spine Arthroplasty or Artificial Disc Replacement is a new term which is used more and more in international scientific meetings and publications starts to dominate the scenery. The last three decades have been the most revolutionary in the history of spine treatment. The 80’s were dominated by the development of modern implants for internal segmental fixation such as pedicle screw systems and others. In the 90’s „Mini-open“ as well as „closed“ endoscopic techniques replaced the majority of conventional surgical approaches . Progress in biological and biochemical research seems to open new perspectives in fusion technology. We must not forget that bony fusion of a functional spinal unit is non physiological and it is associated with a variety of proven and (yet) unproven undesired effects and sequelae. At the beginning of this century, the progress in implant technology open a new dimension for spinal reconstructive non-fusion surgery. A variety of new implants are used today for: nucleus pulposus, total disc replacement, dynamic posterior reconstruction systems, posterior shock absorbers and injectable intradiscal materials. Cervical Disc Replacement is a Motion preserving surgery, Treat painful / pathologic process while restoring/maintaining motion, Decreased stress in adjacent levels, May prevent problems of adjacent segment disease, secondary surgery, pseudoarthrosis.
Comparing arthroplasty (ACDR) vs fusion (ACDF) most of the studies are in favour of (ACDR) because of, Higher neurologic success, Earlier return to work, Degrees of maintained motion, Adjacent Segment Degeneration 5 yrs, Statistically significant better scores (NDI, Arm pain, VAS, and SF-36 scores), lower revision rate (Reoperation rate for ACDF – 11.3% vs 2.9% ACDR)
Introduction: Partial or complete aplasia of the posterior arches of the atlas is a well-documented anomaly but a relatively rare condition caused by a defect in their closure. This condition is usually asymptomatic so most are diagnosed incidentally.
Case report: We report the case of a patient who presents a defect of the posterior arch of atlas.
Conclusion: There is a variety of the congenital defects of the arch of the atlas. Further studies are required on these lesions in order to take possible protection measures against trauma, and the selection between conservative or surgical treatment.
Percutaneous fixation of bilateral anterior column acetabular fracturesApollo Hospitals
The treatment of displaced acetabular fractures with open
reduction and internal fixation has gained general acceptance. This is done either by anterior, posterior or combined approaches depending on the location of these fractures. These procedures may be associated with various complications like significant blood loss, infection, lengthy operative times, heterotopic ossification and neurovascular complications.
Fractures and fracture dislocations of the tarsometatarsal jointMurugesh M Kurani
Here I have discussed an article from Journal of Bone and Joint Surgery. The presentation includes classification, treatment, results and complications. Lets share and learn.
Periprosthetic fractures are the third most common reason for revision total hip arthroplasty. Surgical treatment of periprosthetic fractures belongs to the most difficult procedures due to the extensive surgery, elderly polymorbid patients and the high frequency of other complications. The aim of this study was to evaluate the results of operatively treated periprosthetic femoral fractures after total hip arthroplasty.
We evaluated 47 periprosthetic fractures in 40 patients (18 men and 22 women) operated on between January 2004 and December 2010. The mean follow-up period was 27 months (within a range of 12-45 months). For the clinical evaluation, we used modified Merle d'Aubigné scoring system.
In group of Vancouver A fractures, 3 patients were treated with a mean score of 15,7 points (good result). We recorded a mean score of 14,2 points (fair result) in 6 patients with Vancouver B1 fractures, 12,4 points (fair result) in 24 patients with Vancouver B2 fractures and 12,8 points (fair result) in 7 patients with Vancouver B3 fractures. In group of Vancouver C fractures, we found a mean score of 16,2 points (good result) in 7 patients.
Therapeutic algorithm based on the Vancouver classification system is, in our opinion, satisfactory. Accurate differentiation of B1 and B2 type of fractures is essential. Preoperative radiographic images may not be reliable and checking the stability of the prosthesis fixation during surgery should be performed.
Percutaneous fixation of bilateral anterior column acetabular fractures: A ca...Apollo Hospitals
The treatment of displaced acetabular fractures with open
reduction and internal fixation has gained general acceptance. This is done either by anterior, posterior or combined approaches depending on the location of these fractures. These procedures may be associated with various complications like significant blood loss, infection, lengthy operative times, heterotopic ossification and neurovascular complications.
There are clinical situations where open reduction is either
not feasible (due to associated medical problems) or when the fractures are not significantly displaced, then minimal invasive means of internal fixation of these fractures seems to be an attractive option. Percutaneous screw fixation of the anterior column of the acetabulum has been a challenging task because of its unique anatomy (narrow corridor of bone) and risk of intra-articular penetration.
Functional and radiological assessment of displaced midshaft clavicle fractures treated through open reduction and internal fixation surgery using pre-contoured locking compression plates
Study of current pattern of Cervical Spondylotic Myelopathy and to evaluate t...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Introduction: Partial or complete aplasia of the posterior arches of the atlas is a well-documented anomaly but a relatively rare condition caused by a defect in their closure. This condition is usually asymptomatic so most are diagnosed incidentally.
Case report: We report the case of a patient who presents a defect of the posterior arch of atlas.
Conclusion: There is a variety of the congenital defects of the arch of the atlas. Further studies are required on these lesions in order to take possible protection measures against trauma, and the selection between conservative or surgical treatment.
Percutaneous fixation of bilateral anterior column acetabular fracturesApollo Hospitals
The treatment of displaced acetabular fractures with open
reduction and internal fixation has gained general acceptance. This is done either by anterior, posterior or combined approaches depending on the location of these fractures. These procedures may be associated with various complications like significant blood loss, infection, lengthy operative times, heterotopic ossification and neurovascular complications.
Fractures and fracture dislocations of the tarsometatarsal jointMurugesh M Kurani
Here I have discussed an article from Journal of Bone and Joint Surgery. The presentation includes classification, treatment, results and complications. Lets share and learn.
Periprosthetic fractures are the third most common reason for revision total hip arthroplasty. Surgical treatment of periprosthetic fractures belongs to the most difficult procedures due to the extensive surgery, elderly polymorbid patients and the high frequency of other complications. The aim of this study was to evaluate the results of operatively treated periprosthetic femoral fractures after total hip arthroplasty.
We evaluated 47 periprosthetic fractures in 40 patients (18 men and 22 women) operated on between January 2004 and December 2010. The mean follow-up period was 27 months (within a range of 12-45 months). For the clinical evaluation, we used modified Merle d'Aubigné scoring system.
In group of Vancouver A fractures, 3 patients were treated with a mean score of 15,7 points (good result). We recorded a mean score of 14,2 points (fair result) in 6 patients with Vancouver B1 fractures, 12,4 points (fair result) in 24 patients with Vancouver B2 fractures and 12,8 points (fair result) in 7 patients with Vancouver B3 fractures. In group of Vancouver C fractures, we found a mean score of 16,2 points (good result) in 7 patients.
Therapeutic algorithm based on the Vancouver classification system is, in our opinion, satisfactory. Accurate differentiation of B1 and B2 type of fractures is essential. Preoperative radiographic images may not be reliable and checking the stability of the prosthesis fixation during surgery should be performed.
Percutaneous fixation of bilateral anterior column acetabular fractures: A ca...Apollo Hospitals
The treatment of displaced acetabular fractures with open
reduction and internal fixation has gained general acceptance. This is done either by anterior, posterior or combined approaches depending on the location of these fractures. These procedures may be associated with various complications like significant blood loss, infection, lengthy operative times, heterotopic ossification and neurovascular complications.
There are clinical situations where open reduction is either
not feasible (due to associated medical problems) or when the fractures are not significantly displaced, then minimal invasive means of internal fixation of these fractures seems to be an attractive option. Percutaneous screw fixation of the anterior column of the acetabulum has been a challenging task because of its unique anatomy (narrow corridor of bone) and risk of intra-articular penetration.
Functional and radiological assessment of displaced midshaft clavicle fractures treated through open reduction and internal fixation surgery using pre-contoured locking compression plates
Study of current pattern of Cervical Spondylotic Myelopathy and to evaluate t...iosrjce
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
The presentation discusses evidence based medicine in the stream of Orthopaedics. Here I have discussed a case of Ipsilateral Intertronchanteric and Femoral shaft Fracture and its various treatment modalities. The presentation was done at J.N. Medical College Belagavi, India. Lets share, discuss and keep learning.
1. SPINE SURGERY at its BEST!
MEDICAL QUALIFICATIONS:
MBBS-M P Shah Medical college, Jamnagar, Saurashtra University
MS(Orthopedics)-M P Shah Medical college, Jamnagar, Saurashtra University
DNB fellowship in Spine Surgery from Asia’s largest spine institute, Indian Spinal Injuries
center, New Delhi under guidance of Dr H S Chhabra
Fellowship in Minimally Invasive Spine Surgery and Disc Arthroplasty from Magdeburg
University, Germany under guidance of Dr Jorg Frenke
Fellowship in Stem cell research from Milan University, Italy under guidance of professor Dr
Alfredo Gorio
ACHIEVEMENT AND AWARDS:
National Gold Medalist in final examination of DNB fellowship in Spine Surgery for getting first
rank among all India candidates.
Dr Patrick Kluger award for Best published paper for the year 2011 in the field of Spine
Surgery for his research paper tiltled ‘Thoracic myelopathy due to ossification of ligamentum
flavum: a retrospective analysis of predictors of surgical outcome and preoperative neurological
status’,Feb 2011,European Spine Journal, 20(2), 205-15
AREAS OF EXPERTISE:
Endoscopic Spine Surgery for Degenerative spinal disorders like Disc prolapse, Lumbar canal
stenosis
Minimally Invasive Spine Surgery for many spinal diseases including spinal fractures
Pediatric and Adult Spinal Deformity correction and spinal osteotomies for like Kyphosis,
Scoliosis and Spondylolisthesis
Total Disc Replacemet(TDR) of cervical and lumbar spine for degenerative disc problems
Complex reconstructive spinal surgeries for Spinal Tumours and Spinal Tuberculosis
Kyphoplasty /Vertebroplasty for Osteoporotic and pathological spinal fractures
Anterior and posterior cervical surgeries for cervical disc prolapse and cervical myelopathy
Occipito-cervical junction surgeries for upper cervical injuries and instabilities
Anterior and posterior spinal fixations of cervical, thoracic and lumbar spine
RESEARCH PRESENTATIONS:
Dr Amish Sanghvi Presented more than 20 papers at various national and international conferences
MS(Ortho), DNB fellow (Spine), FMISS(Germany), FSCT(Italy) INTERNATIONAL PUBLICATIONS:
SANGHVI AV, Chhabra HS, Nigam V, Tandon V, Mascarenhas AA. Permanent cardiac
Consultant Spine surgeon and Rehabilitation specialist pacemaker for cardiac arrest following cervico-dorsal spinal injury. European Spine Journal. 2009
amishsanghvi@rediffmail.com, M-9998043393 July;18 Suppl 2:254-7.
SANGHVI AV, Chhabra HS, Mascarenhas AA, Mittal VK, Sangondimath GM. Thoracic myelopathy
due to ossification of ligamentum flavum – A retrospective analysis of predictors of surgical
outcome and factors affecting preoperative neurological status, European Spine Journal, Feb-
2011, 20(2),205-15.
SANGHVI AV, Chhabra HS, Mascarenhas AA, Tandon V, Nanda A, Mittal VK, Sangondimath GM.
Thoracolumbar spinal cord injury without radiological abnormality in an adult, In:Journal of Bone
and Joint Surgery (American volume)(under publication).
2. Spinal tumour – Early diagnosis and timely
surgery is the key to success
29 year woman with incidently diagnosed asymptomatic benign
osteoblastoma in D7 lamina when she got MRI for neck pain. Dr Amish
Sanghvi explained them the risks of future progression of tumour which
can lead to spinal cord compression and paraplegia. Surgery for removal
of tumour was therefore necessary but the surgery also carries a high risk
of paraplegia if not done properly at D7 level. The tumour was removed
successfully en-bloc (in one piece) and D6-D8 pedicle screw stabilization
was done. The woman was walking next day of surgery and is at present
completely symptom free doing her all activities of daily living.
Preoperative MRI and CT of D7 Osteoblastoma Postoperative x-rays after excision and fixation
3. Cervical fracture fixation – High cervical anterior
approaches are now possible
35 year old woman with Hangman’s fracture type-3
(traumatic spondylolisthesis of C2) with intact
neurology . Dr Sanghvi did C2-C3 anterior
cervical fusion and plating to achieve stability.
Preoperative CT showing Traumatic spondylolisthesis of C2 Postop C2-3 Anterior ACDF+plating
4. Spinal Tuberculosis and deformity correction in 3 year child
– Future risk of paraplegia avoided
The problem of childhood kyphosis and scoliosis need an early intervention to prevent
future problems and this 3 year girl had 65 degrees of kyphosis due to complete
destruction of D12-L1 bodies due to active tuberculosis. The girl was crying in pain
and was unable to stand and walk due to severe pain and kyphosis. The medical
management of Tubeculosis will eradicate the bacilli but not kyphosis. Such high
degree kyphosis if not corrected can lead to paraparesis due to cord compression as
the child will continue to collapse forward with growth. Hence the surgery was carried
out to correct and stabilize the kyphosis with posterior pedicle screw fixation and
transpedicular corpectomy and anterior bone grafting from posterior approach. AKT
was continued then to achieve eradication of disease. The girl is currently running
and playing without any problems.
Preoperative MRI and x rays showing 65 Correction and anterior+posterior fusion
degrees kyphosis
5. Paraplegia due to spinal fracture is not the end of the world – Its time
that we wake up!
• We all know that spinal fracture carries a high risk of permanent paralysis. Many times it does not recover
completely. Most of the surgeons after operating these patients forget the main aspect of treatment and that is
REHABILITATION. Such patients who remain permanently paraplegic/quadriplegic due to massive spinal cord
injury loose their profession and independence in the society. The develop a massive psychological depression
and live a miserable life. How many times do we really think that with current advances in spinal surgery
and rehabilitation they can be made completely independent in the society? They just need a structured
plan of rehabilitation which includes,
• Bladder/Bowel care, wheel-chair designing, Transfers and mobility training, self-care, assistive
techniques, home-modifications, vocational counseling, sports and outdoor training, sexual and fertility
training and above all self-earning and self-confidence.
• Vigorous efforts with latest methods of rehabilitation will not only make them independent but also gain self-
confidence. Dr Amish Sanghvi is not only a qualified spine surgeon but he has taken a specialized training in
Rehabilitation at Indian Spinal Injuries center who has the largest Rehabilitation Department of ASIA. We
therefore request all of you to refer these unaware paraplegica/quadriplegics to Dr Amish Sanghvi and his
rehabilitation team to make them live an independent and happy life in the society.
From Bed to Active life