Best Doctors in India for Spina Bifida Treatment
- Top Neurosurgeon | Fortis Memorial Research Institute | Gurugram, India
- 32+ years’ experience
- Fortis Memorial Research Institute
Profile Highlights:
- Dr. Rana Patir is one of the most experienced and highly qualified Neurosurgeons in India.
- He holds an extensive experience of 32+ years as a neurosurgeon and has performed more than 10,000 neurosurgical procedures till date.
- Dr. Patir is an expert in all kinds of neuro and spine surgeries with a specialization in minimally invasive brain and spine surgery, Epilepsy surgery, pediatric neurosurgery, and neurovascular surgery.
- Orthopedic Surgeon and Spine Surgeon, Chennai, India
- Over 23 years’ experience
- Apollo Hospitals Greams Road
Profile Highlights:
- Dr. Ravi Venkatesan is a spine surgery specialist from Chennai, Tamil Nadu.
- His experience in spine surgery, orthopedics, and spine deformity surgery date back nearly 23 years.
- Dr. Venkatesan has performed several surgeries and has been an active member of various orthopedics groups.
- Many organizations have recognized his service and have awarded him for his dedication.
- Top Neurosurgeon | Apollo Hospitals, New Delhi, India
- 35+ Years Experience
- Indraprastha Apollo Hospital, New Delhi
Profile Highlights:
- Dr. S.K. Sogani is a highly respected Neurosurgeon with over 35 years of experience, currently affiliated with Apollo Hospitals Indraprastha in New Delhi.
- Holding an MBBS, MS, and MCh, Dr. Sogani is renowned for his expertise in treating complex neurosurgical conditions such as craniosynostosis, epilepsy, multiple sclerosis, and Moyamoya disease.
- His surgical prowess extends to intricate procedures like craniotomies, spinal fusions, and pediatric neurosurgeries, with over 5,000 successful cases to his credit.
- Neurosurgeon and Spine Surgeon, Gurugram, India
- Over 15 years’ experience
- Artemis Hospital, Gurgaon
Profile Highlights:
- Dr. S K Rajan is a renowned Neurosurgeon in Gurugram who specializes in open as well as minimally invasive spinal surgeries and has performed over 3000 complex spinal surgeries for diseases and disorders.
- Dr. S K Rajan’s expertise lies in Craniovertebral Junction and Lumbosacral Junction surgeries and is also an expert in spinal fracture surgeries, slipped discs, canal stenosis, and surgery for spinal tumors and spinal tuberculosis.
- Orthopedic & Spine Surgeon, Chennai, India
- Over 33 years’ experience
- Apollo Hospitals Greams Road
Profile Highlights:
- Dr. Sajan K Hegde is a highly regarded Spine Surgeon in India who is presently serving as a Senior Consultant Spine Surgeon at both Apollo Cancer Centre and Apollo Hospital, Greams Road in Chennai.
- With over 30 years of experience, he specializes in advanced treatments for spinal deformities, spondylolisthesis, and spinal tuberculosis.
- Dr. Hegde is a pioneer in robotic-assisted spine surgery across the Asia-Pacific and is the only surgeon in India to perform non-fusion scoliosis correction techniques.
- His expertise encompasses a wide range of spinal conditions and advanced surgical procedures like spinal fusion, discectomy, laminectomy, and vertebroplasty.
- Neurosurgeon, Gurugram, India
- Over 22 years’ experience
- Fortis Memorial Research Institute
Profile Highlights:
- Dr. Sandeep Vaishya is a renowned Neurosurgeon in India, with over 22 years of proficient experience in the field of advanced neurosurgery.
- He has closely worked with some of the top-notch institutes and hospitals in India.
- Dr. Vaishya is regarded as one of the top surgeons of Gamma Knife Surgery in South Africa and is also considered a renowned surgeon for brachial plexus injuries.
- Additionally, Dr. Vaishya specializes in minimally invasive and image-guided neurosurgery, intracranial tumor surgery (including skull base tumors), functional neurosurgery, spinal surgery, and brachial plexus & peripheral nerve surgery.
- Top Neurosurgeon and Spine Surgeon | Apollo Hospital, New Delhi, India
- 33+ Years Experience
- Indraprastha Apollo Hospital, New Delhi
Profile Highlights:
- Dr. Sudheer Kumar Tyagi is a highly esteemed Neurosurgeon with over 33 years of exemplary experience in the field of neurosurgery.
- Affiliated with Apollo Hospitals Indraprastha in New Delhi, Dr. Tyagi holds an MBBS, MS, and MCh in Neurosurgery.
- His career is marked by a dedication to advancing neurosurgical techniques and improving patient outcomes through precise and innovative surgical practices.
- Neurosurgeon, Gurugram, India
- 20 + years’ experience
- Medanta-The Medicity, Gurgaon
Profile Highlights:
- Dr. Sudhir Dubey is a distinguished neurosurgeon with an illustrious career spanning decades, marked by groundbreaking contributions to the field of neurosurgery.
- As the Chairman of Neurosurgery at Medanta, Gurugram, Dr. Dubey has performed over 10,000 neurosurgical operations, solidifying his reputation as one of the foremost experts in the field.
- Dr. Dubey’s academic journey is as impressive as his clinical achievements. He graduated with top honors from King George’s Medical College, where he was awarded the prestigious Sir Rupkishan Das Gold Medal in his final year of MBBS.
- Orthopedic Surgeon & Spine Surgeon, Gurugram, India
- Over 28 years’ experience
- Medanta-The Medicity, Gurgaon
Profile Highlights:
- As the Director of Orthopaedics at Medanta, The Medicity in Gurugram, Dr. Mathur has been instrumental in establishing a state-of-the-art Spine Unit at the hospital, performing around 400 surgeries annually.
- Dr. Vineesh Mathur is a distinguished Orthopaedic Spine Surgeon with over 28 years of experience.
- He has a remarkable track record of more than 6,000 successful surgeries.
- Orthopedic Surgeon and Spine Surgeon, Mumbai, India
- Over 20 years’ experience
Profile Highlights:
- Dr. Vishal Peshattiwar is a leading Spine Surgeon in Mumbai specializing in Minimally Invasive Spine Surgeries (MISS)
- He has an experience of more than 2 decades in spine surgery and holds the credit of performing over 4000 spinal surgeries to
- He is the first in India to use the MISS technique on a patient with liver failure and Tuberculosis.
- Dr. Vishal Peshattiwar’s most notable case till date was performing a Revision Spine Surgery through MISS on the oldest patient in India.
Best Hospitals in India for Spina Bifida Treatment
Hospital Highlights:
- Apollo Hospitals is a private healthcare group in India, with its headquarters based in Chennai. Established in 1983 by Dr. Prathap C. Reddy, the group offers a wide range of medical treatments and services across various specialties.
- It is renowned for emphasizing innovation and utilizing cutting-edge medical technologies into patient treatment.
- Known as India’s first corporate hospital, Apollo Hospitals is often credited for pioneering the private healthcare revolution in the country.
- With clinics and hospitals located all throughout India, Apollo Hospitals is a nationwide healthcare organization. Its presence can also be found in foreign countries.
- Preventive health examinations, medical and surgical treatment, and diagnostic centres are just a few of the services that the Apollo group provides.
- The group has several centres of expertise, including Cardiac Sciences, Neurosciences, Orthopedics, Emergency Care, Cancer Care, and Organ Transplantation.
- City: Chennai, India
Hospital Highlights:
- RIMC is a multi-specialty hospital in a sprawling area of 36 acres located in Chromepet, Chennai, Tamil Nadu, India.
- The facility has 450 beds including 130 critical care beds, 9 operating rooms, modern reference laboratories and radiology services, and is conveniently located near road, rail and air transportation.
- RIMC is led and managed by world-renowned physicians committed to healthcare.
- RIMC offers the broadest range of clinical care, education, and research. The hospital offers state-of-the-art technology and modern treatment facilities designed to provide health care at an affordable cost.
- Rela Institute is driven by patient needs, comfort and confidence.
- City: New Delhi, India
Hospital Highlights:
- Fortis Hospital in Shalimar Bagh is a multi-super specialty hospital that strives to provide world-class patient care by leaving no stone unturned.
- Fortis, Shalimar Bagh, with 262 beds and a 7.34-acre footprint, provides the best level of medical care through its team of doctors, nurses, technicians, and management professionals.
- City: Bengaluru, India
Hospital Highlights:
- Established in 2007, the Apollo Hospitals Bangalore is a 300-bed multispecialty hospital situated in Bannerghatta Road, Bangalore.
- Equipped with the state-of-the-art technology, it is a leading hospital dedicated to providing healthcare needs to patients with compassion and expertise.
- It is the first hospital to have completed the highest number of Robot Assisted Heart Surgeries in India.
- Over the years, it has successfully conducted some of the rarest medical procedures such as spinal angiolipoma excision, autologous chondrocyte implantations, and tibial tuberosity shift with MPSL reconstruction.
- The Apollo Hospitals Bangalore has the reputation of performing the greatest series of airway stents in the country.
- Additionally, the hospital is known for providing comprehensive treatment in specialties such as gastroenterology, urology, gynecology, oncology, colorectal surgery, etc.
- The “The Minimal Access Surgery Centre” (MASC), one of Apollo Hospitals, Bangalore’s premier Centres of Excellence, is devoted to the use of minimally invasive surgical procedures.
- In 2013, THE WEEK-A C Nielsen, Best Hospital Survey ranked Apollo Hospitals Bangalore as the 2nd best multi-speciality hospital in Bangalore.
- City: Mumbai, India
Hospital Highlights:
- Gleneagles Global Hospital The 450-bed facility comprises of 17-stories, housing state-of-the-art infrastructure, and advanced medical care facilities.
- The hospital offers end-to-end clinical, surgical, and diagnostic services. It is equipped with a team of eminent medical professionals aided by qualified nurses and medical staff
- The Hospital offers advanced Endoscopic procedures, Hepatobiliary and Liver Surgeries, Surgical and Medical Gastroenterology, Bariatric Surgery, and Robotic surgery.
- The hospital is a center of excellence for Orthopedics, Joint Replacement, Knee Replacement, and Hip Replacement surgery.
- City: Hyderabad, India
Hospital Highlights:
- CARE Hospitals were established in the year 2000, by CARE Group.
- The multispecialty hospital has 435 beds, including 120 critical care beds, with an annual inflow of 180000 outpatients and 16,000 in-patients.
- The hospital provides specialty medical services in Cardiology, Cardiothoracic Surgery, Pediatric Cardiology, Pediatric Cardiothoracic Surgery, Neurology, Neurosurgery, Nephrology, and Urology.
- The hospital has the first dual source, 128 slice CT scanner (for high precision cardiac imaging) – the first of its kind in south India.
- The hospital offers a wide range of accommodation facilities for the convenience of its varied patient base, ranging from general wards to super deluxe rooms.
- City: Mumbai, India
Hospital Highlights:
- Fortis Hospital in Mulund is a 315-bed multi-speciality tertiary care hospital with five JCI accreditations that offers a wide variety of diagnostic and treatment services. The Fortis Hospital in Mulund delivers patient-centred treatment with cutting-edge technology, highly skilled and experienced surgeons, and paramedical staff.
- This institution houses Maharashtra’s largest multi-organ transplant centre. It is also the first heart transplant centre in western India to conduct 100 or more consecutive heart transplants in under four years. It is the only hospital in the city to have multi-organ transplants and has handled the youngest patient for angioplasty. Fortis Hospital Mulund now boasts the first advanced surgical robot in central Mumbai.
- Cardiology and heart surgery, urology, nephrology, neurosciences, orthopaedics, digestive care, emergency and critical care, and maternity care are among the services provided by the hospital.
- City: New Delhi, India
Hospital Highlights:
- Manipal Hospitals, Dwarka, is a super-specialty hospital in Dwarka, New Delhi, which is a part of Manipal Hospitals Group.
- The hospital aims to provide the best treatment on par with international standards at a fraction of the cost.
- Equipped with 380 beds, the hospital is also one of the new age hospitals which are equipped fully with state-of-the-art infrastructure, cutting-edge technology as well as the latest and advanced clinical practices. The hospital also has 13 modular Operation theatres with 118 beds which are solely meant for critical care.
- The hospital comprises internationally acclaimed doctors and highly professional and experienced hospital and medical staff who are able to provide preventive, therapeutic, and diagnostic services all under one roof.
- City: Chennai, India
Hospital Highlights:
- Located in Chennai, India, MGM Healthcare is a top multispecialty hospital that provides all medical services under one roof.
- Since its founding in 2019, MGM Healthcare has quickly become a leading national referral centre, creating several innovative flagship initiatives.
- MGM Healthcare combines next-generation medical and digital technologies to provide better patient results.
- With 12 centres of excellence, more than 400 inpatient beds, 100 intensive care unit beds, and 24/7 emergency care, MGM Healthcare leaves no chance in redefining the patient experience in Chennai.
- MGM Healthcare boasts 250+ expert doctors across 30+ departments, including Cardiology, Pulmonology, Neurology, Obstetrics & Gynaecology, and more.
- They house 12 specialized Centres of Excellence, including Neurosciences, Orthopaedics, and Multi-Organ Transplantation.
- Their team of doctors, nurses, and paramedics works together to give every patient individualized treatment.
Hospital Highlights:
- Lilavati Hospital & Research Centre is India’s premier multi-speciality tertiary care hospital and has been recognised as a global medical excellence centre.
- Lilavati Hospital & Research Centre has built an unrivalled level of trust with its patients over the years, thanks to a solid foundation that comprises cutting-edge facilities, the best medical competence, research, education, and charity endeavours.
- The hospital is quite proud of the fact that it now serves patients from all kinds of backgrounds, not just from the United States but from all around the world.
- The hospital has a total of 323 beds, one of the largest Intensive Care Units (ICUs), 12 Operation Theatres with modern amenities, over 300 consultants, and almost 1,800 personnel.
Spina Bifida
Spina Bifida also known as neural tube defect, is a birth defect that occurs when your spine and spinal cord don’t form correctly. The neural tube is the structure in a developing embryo which eventually becomes the brain of the child, spinal cord as well as the tissues enclosing them.
In normal cases, the neural tube forms early during pregnancy and it closes by the 28th day after conception. In babies with spina bifida, one portion of the neural tube fails to close or develop properly, which results in defects in the spinal cord and the spinal bones.
Spine Bifida can be mild as well as severe, as it depends on the type of defect, location, size as well as complications. When required, early treatment for spina bifida will involve surgery, but the problem isn’t always resolved by such treatment.
Types of Spina Bifida
There are three main types of spina bifida, which include myelomeningocele, meningocele and spina bifida occulta.
1.Myelomeningocele- The most common and serious type of spina bifida which involves a sack outside the opening in the back of the baby somewhere in the spine, which contains parts of the spinal cord as well as nerves which will get damaged. People who have myelomeningocele can have physical disabilities which may be moderate to severe and some of such disabilities can include:
- Incontinence
- Difficulty in going to the washroom
- Inability in moving or feeling one’s legs or feet
2.Meningocele- Meningocele is another type of spina bifida which involves a sack of fluid outside an opening in the back of the baby. However, the sack doesn’t contain any part of the spinal cord, as there isn’t much nerve damage, this kind of spina bifida only leads to minor problems.
3.Spina Bifida Occulta- This is another mild type of spina bifida which also goes by the term ‘hidden spina bifida’, as it doesn’t cause any disabilities and might go unnoticed until later in life. Usually, there is no opening the in back of the baby but only a gap in the spine. In this type, there is also damage to the spinal cord or the nerves.
Symptoms of Spina Bifida
Each type of spina bifida shows different symptoms and they can vary from person to person as well.
Symptoms of myelomeningocele spina bifida can include:
- Over some of the vertebrae the spinal canal is open, often in the middle or lower part of the back
- Weak or paralyzed muscles in the leg
- Membranes and spinal cord pushed outside the back in a skin-covered sack
- Deformed feet
- Uneven hips
- Seizures
- Scoliosis
- Issues with the bowel and bladder
Symptoms of meningocele can include the following:
- Sack that is visible at birth
- Small opening at the back
- Membranes which are pushing out through the opening in the vertebrae into the sack
- Normal spinal cord development
Spina bifida occulta symptoms include- - No visible opening outside
- A gap in between vertebrae
- No fluid-filled sack outside the body
- Small cluster of hair on the back
- A small area of extra fat on the back
- Small birthmark such as a dimple on the back
Causes of Spina Bifida
All the exact causes of this ailment are still not understood properly. However, it is known that combination of genetics and environmental factors are involved. A child who is born with spina bifida might not have any relatives with this condition but genetics does play a factor. It is also believed that lack of folic acid (vitamin B-9) can play a role in this ailment. Other factors that are said to play a role include obesity, some kind of medications and uncontrolled diabetes in the mother.
Diagnosis of Spina Bifida
Pregnant women will be offered prenatal screening tests for checking for spina bifida and other birth defects. These tests aren’t perfect. Some mothers had positive blood tests have babies without spina bifida. Even if the result is negative, there is a slight chance that the spina bifida is present, so consider talking to your doctor regarding prenatal testing, its risks and you now need to handle the results.
Though spina bifida can be screened using maternal blood tests, typically ultrasound is used for diagnosis in most cases.
Maternal Serum Alpha-Fetoprotein test
For Maternal Serum Alpha-Fetoprotein test, a sample of the mother’s blood is drawn to be tested for alpha-fetoprotein, a protein that is produced by the baby. It’s quite normal for a little amount of AFP to cross the placenta and enter the mother’s bloodstream, but abnormally high levels of AFP suggests that the baby has a neural tube defect, which can be spina bifida, even though high levels of AFP don’t occur always in spina bifida.
Test to Confirm high AFP levels
Varying levels of AFP can also be caused by other factors, which include a miscalculation in the fetal age of multiple babies. Therefore, your doctor might order another blood test for confirmation, If the results are still high, you will need even further evaluation, which will include an ultrasound exam.
Other blood tests
Your doctor can perform the MSAFP test along with few other blood tests. Commonly done with the MSAFP test, their objective is to screen for other abnormalities like trisomy 21, not neural tube defects.
Ultrasound
Fetal ultrasound is the most accurate method for diagnosing spina bifida in the baby before delivery. Ultrasound may be performed during the first trimester and second trimester. Spina bifida can be diagnosed accurately in the second-trimester ultrasound scan. This exam, therefore, becomes quite important to identify and rule out congenital anomalies like spina bifida.
An advanced ultrasound can also detect signs of spina bifida, which includes an open spine or particular features in the brain of the baby, which indicate spina bifida. An expert can easily assess the severity of the ailment using ultrasound.
Amniocentesis
If the prenatal ultrasound confirms the diagnosis of spina bifida, your doctor might request amniocentesis. During this process, your doctor removes a sample of fluid from the amniotic sac surrounding the baby using a needle. The purpose of this examination is to rule out genetic diseases, even though spina bifida is rarely associated with genetic diseases.
Treatment options for Spina Bifida
The treatment for spina bifida may vary as it always depends on the severity of the condition. While spina bifida occulta won’t require any treatment, other types do.
Surgery before birth
Nerve function in babies who have spina bifida can get worse after birth, if spina bifida isn’t treated. Prenatal surgery to treat spina bifida takes place before the 26th week of pregnancy. In this procedure, surgeons expose the uterus in the pregnant mother surgically open the uterus and repair the baby’s spinal cord. In some patients, this procedure can be performed even less invasively with a fetoscope through ports in the uterus.
According to research, children with spina bifida who goes through fetal surgery have reduced disability and are less likely to require crutches or any such walking devices. Fetal surgery can reduce the risk of hydrocephalus as well. Consult with your doctor whether this procedure is appropriate for you. Talk regarding the potential benefits and risks such as possible premature delivery as well as other such complications.
It is also quite important to have a comprehensive evaluation to determine whether fetal surgery is feasible. This specialized surgery should only be done at a proper health-care facility that has experienced doctors in fetal surgery. A multispeciality team approach and neonatal intensive care are also important. The team typically includes a fetal surgeon, a pediatric neurosurgeon, a maternal-fetal medicine specialist, a fetal cardiologist as well as a neonatologist.
Cesarean birth
Most babies who have myelomeningocele are usually in a feet-first position. If your baby is in this position or the doctor has detected a large crys or sac then cesarean birth might be the safer way to deliver your baby.
Surgery after birth
Surgery is required for babies with myelomeningocele, and the earlier it is performed, the earlier the risk of infections will be minimized. It will also help in protecting the spinal cord from being exposed to further trauma.
During this procedure, the neurosurgeon will place the spinal cord along with the exposed tissue inside the baby’s body, after which he will cover them with muscle and skin. At the same time, the neurosurgeon might place a shunt in the baby’s brain for controlling hydrocephalus.
Treatment for complications
For babies having myelomeningocele, there has been already irreparable nerve damage and usually a multispeciality team of surgeons, physicians and therapists might be required. Babies having this ailment might need even more surgery to treat a variety of complications. Some of these complications might include weak legs, bladder and bowel problems or hydrocephalus, which usually begins soon after birth.
Depending on the severity of spina bifida and the complications, the treatment options can include:
- Walking and mobility aid- Some babies can start exercises to prepare their legs for walking with the aid of braces of crutches as they get older. Some children might need walkers or wheelchairs. Mobility aids combined with regular physical therapy can help a child in becoming independent. Even children who require wheelchairs can learn to function quite well and become self-sufficient.
- Bowel and bladder management- Routine evaluation of bowel and bladder evaluations as well as management plans can help in the reduction of the risk of organ damage and illness. Evaluations can include X-rays, kidney scans, blood tests, ultrasounds and bladder function studies. These evaluations will have to be done frequently in the first few years of life but it can become lesser, as the child continues to grow.
- Surgery for hydrocephalus- Most babies who have myelomeningocele, will require a surgically placed tube which can allow fluid in the brain to drain into the abdomen. This tube might be placed just after the baby is born, during the surgery to close the sac located on the lower back or later as the fluid accumulates. A less invasive option is also available which is called endoscopic third ventriculostomy. However, candidates are chosen very carefully for this and they need to meet certain criteria. During this procedure, the surgeon will use a small video camera to see inside the brain. He makes a hole in the bottom of between the ventricles so cerebrospinal fluid may flow out of the brain.
- Treatment and Management of other complications- Special equipment which includes bath chairs, commode chairs as well as standing frames might help with daily activities. Whatever the issue, orthopedic complications or tethered spinal cord, most of them can be treated or managed to help improve the child’s quality of life.
Prevention of Spina Bifida
Taking folic acid in supplement form at least one month before one’s conception and continuing through the first trimester of the pregnancy can greatly reduce the risk of spina bifida and other neural tube defects. Having plenty of folic acid in the system by the early weeks of pregnancy is important if you want to prevent spina bifida. Since many women don’t realize that they are pregnant till this time, it is recommended by experts that women who are of childbearing age, should take at least a daily supplement of 400 micrograms of folic acid. Food such as rice, pasta, enriched bread and some breakfast cereals are rich in folic acid.
Women who are planning or expecting pregnancy should also remember to consume at least 400 to 800 mcg of folic acid per day. The human body doesn’t absorb folate as easily as it can absorb synthetic folic acid and therefore it is important that you take vitamin supplements as well. It is also quite possible that folic acid will help to reduce the risk of other birth defects, including cleft lip, cleft palate as well as some congenital heart defects.
It is quite a good idea to eat a healthy diet, including foods that are rich in folate or enriched with folic acid. It is seen to be present naturally in several foods, such as egg yolks, milk, beans, peas, citrus fruits, juices, avocados, dark green vegetables, etc.