Categories
Surgical Procedures

Endoscopic Rhizotomy

Endoscopic Rhizotomy

The lower back is supported by the spine. It helps us in sitting down, standing and bending back and forth. The Medial branch in the spine is small nerves which innervate the Facet joints. Facet joints connect different backbone of the spine. It’s this Facet joints which helps us in sitting down. However, there are times when our lower back movement becomes restricted. When this happens, it limits your ability to do a common task like sitting down and getting up. In such a scenario, one needs to consult a good Spine surgeon.

The surgery to heal or overcome this condition is known as “Endoscopic Rhizotomy” Surgery. This is a surgery which works well in eliminating your back ailments.

Endoscopic Rhizotomy is the minimum variant surgery performed on the medial branch. This surgery is usually performed under deep sedation. A surgeon would only use a small incision to do the surgery.

Most people prefer this Surgery due to its immense benefits. Some of the benefits of this surgery are:

  1. Minimal surgical process.

Most lower back surgeries use lots of tools. Such is not the case here. In this surgery, there are very little surgical instruments used. This makes it minimal.

Being minimal it is also very soothing for the patient.

  1. Shorter recovery time.

Everyone has heard about surgeries and their recovery time. The recovery time in Endoscopic rhizotomy is very less. You don’t need to stay in hospital. One can go back home the same day. You may be advised to wear a belt as a precaution till you recover fully.

  1. Maintains spine morbidity.

Spine if not morbid affects the lower back. This surgery is beneficial in maintaining spinal morbidity. As there is very little scarring in the surgery. It has very little effect on the spine. In the long run, it helps in maintaining spine morbidity.

  1. High success rate.

The chances of this surgery being successful are very high. It prevents the future regrowth of damaged medial branch nerve by removing it. It is extremely efficient in healing all your lower back problems.

  1. Good visual control.

Most surgeries don’t have visual control. This is not the case in this surgery. Endoscopic rhizotomy has visual control. A Surgeon can view the area to be operated via camera. It helps in doing the surgery in the right section

  1. Prevents Blood loss

Being invasive there is very little or no blood loss at all. The area cut is very precise and small. This helps in lowering blood loss.

It is the need of the hour to have a healthy lower back. One must consult a good surgeon for a successful Endoscopic rhizotomy.

Categories
Profile

Dr. Kalyan Bommakanti

I’m Dr. Kalyan Bommakanti, graduated from Osmania Medical College, the premier Medical College for the state of Telangana and Andhra Pradesh. I got through EAMCET with a top rank in order to enroll at Osmania which is by far the most competitive and highly reputed Medical College in the state of Telangana that strives for clinical excellence each year. I was chosen as the best outgoing student in Microbiology and was also very active at organizing events such as College day, Sports day and Youth fests which furthered my faith in a team effort. Osmania general Hospital is the largest hospital in Andhra Pradesh and Telangana that caters to the poor. I developed a keen sense of responsibility and compassion while treating the poor at Osmania. 

Neurosurgery is an advanced and highly competitive field of study and offers limited seats. It is usually a 3 year course upon completion of a 3 year course of general surgery. Nizam’s Institute of Medical Sciences and a few others like the All India Institute of Medical Sciences (AIIMS) and NIMHANS (National Institute of Mental Health and Neurological Sciences) offers a 5 or 6 year Neurosurgery program. NIMS has only 2 seats in the 5 year/6 year program available each year for the entire state of Telangana and Andhra Pradesh.

I have post graduated and super specialized at Nizam’s after being the top rank holder in the entire state in order to secure a seat. 

Endoscopic Neurosurgery is a specialized branch of Neurosurgery with as few as 4-5 surgeons being trained in both Telangana and Andhra Pradesh. As opposed to open surgery, endoscopic neurosurgery is minimally invasive and provides better results when applied to the correct patient. High definition imaging allows better visualization of deeper operative cavities and allows surgeons to pinpoint tumor locations. At NIMS I have developed this field. . Endoscopic neurosurgery can be applied to various brain pathologies, spine pathologies and particularly skull base pathologies. Endoscopic neurosurgery has a steep learning curve and requires a lot of dedication and many years of training. 

Endoscopic anterior skull base surgeries are one of the difficult surgeries to master. They require a close cooperation and team work between a neurosurgeon and ENT surgeon ( who is specially trained at endoscopic skull base). Our team includes an ENT surgeon with special training in advanced rhinology and endoscopic skull base. Since the last three years we have been working together and have operated extensively for various skull base lesions like pituitary adenomas, clival chordomas, craniopharyngiomas, extensive skull base fungal lesions, sino-nasal carcinomas with intracranial extension, CSF rhinorrhea, cavernous sinus thrombosis. We are looking forward to further develop this
field
.

The most important skill required for Endoscopic Neurosurgery is hand-eye coordination. In order to sharpen my skills required for this, I have attended a number of cadaveric workshops and performed a number of cadaveric dissections. The workshops were mostly conducted by surgeons of International repute belonging to many different countries and these surgeons are pioneers in developing Endoscopic Neurosurgery. 

With my extensive experience and also having authored quite a few articles in journals of National and International repute; when it comes to treating my patients, I strongly adhere to the great principles of love, care and compassion. I believe in taking forward all my colleagues together as a team to achieve the best results in Neurosurgery. Every patient is dealt with utmost love and compassion and with an obligation to cure, nourish and alleviate suffering.


DR. KALYAN

NeuroSurgeon & Spine Surgeon

Dr. Kalyan Bommakanti is an eminent neurosurgeon. He has over 10 years of involvement as a Faculty and Consultant for neurosciences

Professional experience

Jan 2021 – Present: 1.Senior Consultant Neuro and Spine surgeon
Global Gleneagles Hospital, Hyderabad. 2. Senior Neuro and spine surgeon, Shenoy Hospital, Secunderabad. 3. Advanced Neuro and Spine clinic, Secunderabad

Mar 2016 – Dec 2021: Consultant Neuro and Spine surgeon
Medicover hospital, Hyderabad.

Sep 2012 – Mar 2016: Assistant professor
Nizam’s Institute of Medical Science’s, Hyderabad.

April 2012 – Sep 2012: Lecturer
Nizam’s Institute of Medical Science’s, Hyderabad.

Jun 2011 – April 2012: Assistant Professor
Adesh Institute of Medical Science’s and Research, Bathinda, Punjab.

Nov 2010 – May 2011: Junior Consultant Neuro and Spine surgeon
Global Hospital, Hyderabad

PUBLICATIONS

1.Bommakanti K, Alugolu R, Chittem LR, Patil M, Purohit AK. Fulminant holocord intramedullary tubercular abscess withenigmatic presentation. Surg Neurol Int. 2013;4:32. doi:10.4103/2152-7806.109506.

2. Bommakanti K, Ankathi P, Uma P, Malladi S, Laxmi V. Cerebral abscess and calvarial osteomyelitis due to Burkholderia pseudomallei. Neurol India. 2010;58(5):801-802. doi:10.4103/0028-3886.72188.

3. Mudumba V, Bommakanti K, Chittem L. Dorsal spine involvement in Takayasu arteritis. Neurol India. 63(4):616-7. doi:10.4103/0028-3886.162090.

4. Bommakanti K, Somayajula S, Suvarna A, et al. Pre-operative and post-operative cognitive deficits in patients with supratentorial meningiomas. Clin Neurol Neurosurg. 2016;143:150-8. doi:10.1016/j.clineuro.2016.02.033.

5. Bommakanti K, Panigrahi M, Yarlagadda R, Sundaram C, Uppin MS, Purohit AK. Optic chiasmatic-hypothalamic gliomas: is tissue diagnosis essential? Neurol India. 2010;58(6):833-840. doi:10.4103/0028-3886.73738.

6. Bommakanti K, Gaddamanugu P, Alladi S, et al. Pre-operative and post-operative psychiatric manifestations in patients with supratentorial meningiomas. Clin Neurol Neurosurg. 2016;147:24-29. doi:10.1016/j.clineuro.2016.05.018.

7. Chittem L, Bommanakanti K, Alugolu R. “Precipitation sign”: a new radiological sign for spinal intramedullary tubercular abscess. Spinal Cord. 2014;52 Suppl 1:S1-2. doi:10.1038/sc.2014.31.

8. Datar G, Shinde A, Bommakanti K. Technical consideration of transforaminal endoscopic spine surgery for central herniation. Indian J Pain. 2017;31(2):86. doi:10.4103/ijpn.ijpn_37_17.

ORIGINAL WORKS, PRESENTATIONS

1.Pre-operative and post-operative cognitive deficits and psychiatric manifestations in patients with supratentorialmeningiomas. Submitted as thesis for the award of M.Ch to the Nizamʼs Institute of Medical Sciences and presented as apaper in AP NEUROCON 2010, Warangal.

2. Optic-Chiasmatic Hypothalamic gliomas: Is tissue diagnosis essential? Original article. Presented as a paper in APNEUROCON 2009, Rajahmundry and 11th Annual Conference of Skull Base Surgery Society of India, Hyderabad-2010.

3. Deep Brain Stimulation for Idiopathic Parkinsons disease: NIMS experience of 23 cases. Presented as a paper at and APNEUROCON-2007, Kurnool and 9th Annual Conference on Stereotaxy, Functional Neurosurgery, Course on Radio Surgery and Hands on Workshop on Neuronavigation, Hyderabad-2006.

4. Intracranial Ependymomas: NIMS experience of 41 cases. Presented as a paper in 55TH Annual Conference of Neurological Society of India, Madurai-2006. 5. Surgical management of gliomas on eloquent cortex: Nuances. Presented at glioma update, Nizamʼs Institute of medical
sciences, Hyderabad, 2015.

6. Hydrocephalus : Current trends. Presented at 65th Annual conference of Neurosurgical Society of India, Hyderabad, 2015.

7. Role of cadaveric dissection in shortening the learning curve for trans-nasal endoscopic pituitary surgeries. 9thInternational conference on Endoscopic Endonasal Skull Base Surgery, Madurai-2014.

8. Glasgow Coma Scale- Common errors, CNN-CME for neuro nurses, Hyderabad-2015.

9. Nursing care for patients with aneurysms and AVMʼs, CNN-CME for neuro nurses, Hyderabad-2015.

Presentations as invited speakers/Faculty / Teacher in workshops or conferences

1.Glasgow Coma Scale- Comon errors. CNN-CME for neuro nurses, Hyderabad-2015.

2. Nursing care for patients with aneurysms and AVMʼs. CNN-CME for neuro nurses, Hyderabad- 2015.

3. Indo-Japan neurosurgical meet and live surgeries-2018, Hyderabad

4.10th International Cadaveric Workshop and Training Course- 2018, Bangalore.

5.1st Live course on transforaminal endoscopic lumbar spine surgery under LA, 2018, Jalgoan.

6. Live operative workshop on transforaminal endoscopic spine surgery, Indore, 2019.

7.Prof P.S. Ramani’s Annual Basic course in spinal surgery, Mumbai,2021

EDUCATION

2017: Training in advanced fully endoscopic transforaminal surgery
Sushrutha institute of orthopaedics and traumatology.


2016: Observership and Cadaveric workshop in fully endoscopic transforaminal surgery
(Outside-In technique) Max-More spine, Germany.


2016: Training in fully endoscopic transforaminal surgery. Sushrutha Institute of orthopaedics and traumatology.


2005 – 2010 : Magister Chirurgiae (M.Ch-Neurosurgery -5 Years)
Nizam’s institute of Medical Sciences, Hyderabad.


1995 – 2005: Bachelor of Medicine and Surgery (M.B.B.S)
Osmania Medical College.


1996 – 1998: Board of Intermediate education
Gautami Junior college, Hyderabad.


1986 – 1996: All India Secondary School Examination. Atomic Energy Central School, Hyderabad.

PRESENTATIONS AS CO-AUTHOR

1.Nuances in the management of C1-C2 fractures. Annual conference of Telangana and Andhra pradesh neuroscientitstsassosciation, APNSA, Guntur- 2013

2.Zig-Zag fusion for C1-C2 fractures. Neurotrauma, Dehradun-2014.

3. Lhermitte-Duclos-Disease as a cranial manifestation of Cowden syndrome- A case report,.Annual conference of telangana and Andhra Pradesh neuroscientists assosciation, APNSA, Guntur-2013.

4. Surgical outcome of intramedullary lesions. Annual conference of telangana and Andhra Pradesh neuroscientistsassosciation, APNSA, Hyderabad-2015.

5. Ossification of posterior longitudinal ligament and fluorosis. Annual conference of telangana and Andhra Pradesh neuroscientists assosciation, APNSA, Hyderabad-2015

6.B-Cell lymphoma mimicking intracranial meningioma. Annual conference of telangana and Andhra Pradeshneuroscientists assosciation, APNSA, Hyderabad-2015.

7. Acinetobacter Meningitis- Changing trends. Annual conference of Neurosurgical Society of India, Hyderabad, 2015.

8. Lhermitte Duclos disease: A series of 5 cases. 65th Annual conference of Neurosurgical Society of India, Hyderabad, 2015.

9. Conus hematomyleia: A rare complication of coagulopathy. 65th Annual conference of Neurosurgical Society of India, Hyderabad, 2015.

10. Inflammed interhemispheric arachnoid cyst. 65th Annual conference of Neurosurgical Society of India, Hyderabad, 2015

Conferences, CME and Workshops attended

1.Current Reviews in Brain & Spine Surgery, Hyderabad-2010.

2. Surgical Procedure for the Implantation of INS 400, New Delhi-2007.

3. IACP CON- 2006, First Annual Conference of Indian Academy of Cerebral Palsy, Hyderabad.

4. Annual conference of telangana and Andhra Pradesh neuroscientists assosciation, APNSA, 2007, Kurnool.

5. Annual conference of telangana and Andhra Pradesh neuroscientists assosciation, 2009, Rajahmundry. 6. Annual conference of telangana and Andhra Pradesh neuroscientists assosciation, APNSA, 2010, Warangal.

7. 10th Microneurosurgery Workshop, Chennai-2006.

8. 9th Annual Conference on Stereotaxy, Functional Neurosurgery, Course on Radio Surgery and Hands on Workshop onNeuronavigation, Hyderabad-2006.

9. International Conference on Medical Education and Technology, Hyderabad-2002.

10. Current Concepts in Spine Surgery, Hyderabad-2009.

11. C.E.R CI 2008 ( CANcer Care Education & Research Conference Internationale ), Hyderabad.

12. 11th Annual Conference of Skull Base Surgery Society of India, Hyderabad-2010.

13. 55TH Annual Conference of Neurological Society of India, Madurai-2006.

14. Advanced Asian-Australasian Course in Paediatric Neurosurgery, Banglore-2009.
15.Cadaveric workshop and short endoscopic neurosurgical trainning fellowship, Jabalpur-2011.

16. Endoscopic Endonasal Base of Skull Surgery and Sialendoscopy, Trichy-2012.

17. Endoscopic Endonasal Base of Skull Surgery and Sialendoscopy, Jaipur-2013.

18. Endoscopic Endonasal Base of Skull Surgery and Sialendoscopy, Madurai-2014.

19. 9th International conference on Endoscopic Endonasal Skull Base Surgery, Madurai- 2013.

20. Live Endoscopic Skull Base Surgery Workshop, Mumbai-2013

21.1st National Conference of Minimally Invasive Spine Surgeons of India, Ahmedabad-2014.

22. Minimally Invasive Spine Surgery Conference, Pune-2015.

23. Glioma Update, NIMS, Hyderabad- 2014.

24. OTO-2014: Hands on Temporal Bone Dissection and Live Ear Surgery Workshop, Hyderabad-2014.

25. Transnasal Endoscopic Skull Base Surgery Workshop, Mumbai-2015.

26. CNN- CME for Neuro-Nurses, Hyderabad-2015.

27. International Conference of Indian Academy of Cerebral Palsy, Hyderabad- 2014.

28. TAKA Microneurosurgery Workshop, Mumbai-2014.

29. CAN.C.E.R CI 2015 ( CANcer Care Education & Research Conference Internationale ), Hyderabad.

30. APNSICON 2015, Hyderabad.

31. NSICON 2015, Hyderabad.

32. Academy of Minimally Invasive Spine Surgery (ACMISST ), Goa- 2015.

33. Live surgery workshop on Transforaminal Approach, Hyderabad, 2015.

34. Cadaveric workshop on minimally invasive spine techniques, Bangalore, 2015. 35. 16 th Neuroendoscopy Fellowship Programme, N.S.C.B. Govt. Medical college and Hospital, Jabalpur (M.P), 2017

35.Transforaminal Stitchless Spine surgery under local anaesthesia (TSSULA) -2017

36.Transforaminal Stitchless Spine surgery under local anaesthesia (TSSULA) -2018, Hyderabad

37.Transforaminal Stitchless Spine surgery under local anaesthesia (TSSULA) -Dehradun

38.8th International Cadaveric Workshop and Training Course- 2016, Bangalore

39.9th International Cadaveric Workshop and Training Course- 2017, Bangalore

40.10th International Cadaveric Workshop and Training Course- 2018, Bangalore(Faculty)

41.1st Live course on transforaminal endoscopic lumbar spine surgery under LA, 2018, Jalgoan.(Faculty)

42.Live operative workshop on transforaminal endoscopic spine surgery, Indore, 2019(Faculty)

43.Indo-Japan neurosurgical meet and live surgeries-2018, Hyderabad (Faculty)

44.Prof P.S. Ramani’s Annual Basic course in spinal surgery, Mumbai,2021.(Faculty)

Awards Received

1.IInd prize in Table Tennis in graduation.

2. IInd rank in Science Talent Search Examination-1997 (Dr. A S Rao Awards Council).

3. VIth rank in Science Talent Search Examination-1998 (Dr. A S Rao Awards Council).

4. VIth rank in National Science (medical) Olympiad-1998.

5. IInd prize in Caption Writing (English) in Graduation.

6. Gold Medal and Certificate of Merit in the subject microbiology in Osmania Medical College for the year 2001.

7. Best outgoing student from the department of Neurosurgery, NIMS, 2010

Cadaveric Experience and Training

I stongly believe in sound anatomical knowledge and the usefullness of cadaveric dissections. Apart from various cadaveric workshops, which I have attended at various conferences, i have been regularly performing various cadaveric dissections for endoscopic endonasal and endoscopic spine procedures for the past 10 years at government medical colleges in hyderabad and Punjab. I have performed approximately 40-45 cadaveric dissections until now and 16 temporal bone dissections.

ENDOSCOPIC SPINE SURGERY EXPERIENCE

I have been introduced to endoscopic sine procedures by Dr. Satish Chandra Gore, when he has demonstrated live transforaminal approaches at Nizam’s institute of Medical sciences, in late 2014. Since then I have attended various workshops and conferences focussing on transforaminal approaches. Thrice, I have also practised the same approaches on cadavers at Osmania General hospital, Hyderabad. I have introduced the same approach at Nizams Institute of Medical Sciences and have been regularly performing the procedure since than. Until now i have approximately performed more than 500 minimally invasive and endoscopic spine surgeries.

Click for scheduling an appointment