Increasing Need for Tertiary Care Brain & Spine Interventions in Mumbai Dr Jayesh Sardhara, Senior Consultant-Brain & Spine Surgery, Fortis Hospital Kalyan

Increasing Need for Tertiary Care Brain & Spine Interventions in Mumbai 

Dr Jayesh Sardhara, Senior Consultant-Brain & Spine Surgery, Fortis Hospital Kalyan 

 With Mumbai's growing population, tertiary care has become essential for managing complex neurological and spinal disorders. Understanding the need for tertiary care is crucial for the health of Mumbai's population. 

 The prevalence of neurological and spine diseases has increased in Mumbai due to population growth and demographic aging. As people age, degenerative diseases such as Alzheimer’s, Parkinson’s, and various forms of spinal degeneration become more common. The incidence of brain strokes and hemorrhages has also risen, particularly among the younger generation over the past two decades, which is a concerning trend. These conditions typically require prompt surgical intervention to prevent severe disability and improve quality of life. 

 Additionally, the adoption of an urban lifestyle has contributed to the rise in brain and spine disorders. The fast-paced city life in Mumbai is associated with high stress, sedentary habits, and unhealthy eating, leading to increased incidences of strokes and chronic backache. Factors such as long working hours, inactivity, poor exercise levels, herniated discs, and spinal stenosis necessitate immediate diagnosis and treatment. 

 Tertiary care centres in Mumbai have more advanced diagnostic instruments and modern surgical techniques to enable increased accuracy of diagnostics and efficiency of treatment methods. By using advanced microscopes and special dyes, neurosurgeons can now get very detailed pictures of the brain's complex structures. This big improvement helps surgeons target even the smallest parts of the brain accurately. Additionally, these advancements have led to less invasive procedures and faster recovery times for patients. 

Advancements in endoscopes, microscopes, neuronavigation, and neuromonitoring have significantly improved brain surgery outcomes. Minimally invasive surgeries for conditions like brain tumors, Trigeminal Neuralgia, Hydrocephalus, Sciatica, and Aneurysms can now be performed through keyhole endoscopy, requiring only a small skin incision and a tiny hole in the skull or via the nose. These procedures carry minimal risk, with reduced chances of infection, post-surgery pain, and neurological deficits. Patients can typically be discharged within 3 to 4 days. Additionally, keyhole spine endoscopy now offers safe and effective treatment for back and leg pain due to disc problems, often with a recovery time of just a day or two. 

 Complementing these advancements is the integration of neuro-navigation technology, which assists surgeons in mapping the brain's anatomy in real time. This ensures surgical precision and reduces the risk of errors, ultimately leading to improved patient outcomes. Minimally invasive endoscopic approaches are revolutionizing brain tumor surgery. Techniques such as keyhole brain endoscopy enable surgeons to reach and remove tumors through small openings (less than the size of a one-rupee coin), minimizing tissue damage and expediting recovery, especially for deep-seated tumors where traditional surgery poses greater risks. 

 During surgery, advanced tools like the Cavitron Ultrasonic Surgical Aspirator (CUSA) with neuromonitoring allow for the precise removal of tumors while protecting vital brain tissue. These tools use vibrations to break down tumors, reducing damage to healthy tissue and improving surgical accuracy. Additionally, emerging therapies like targeted therapy and immunotherapy offer promising alternatives for patients who do not respond well to standard treatments for brain tumors. Many brain tumors can now also be treated very safely via endoscopy through the nose, resulting in sutureless surgery. 

 Mumbai's existing tertiary care facilities should be strategically improved, and new state-of-the-art centers of excellence should be established to meet the growing demand for specialized neurology and spine care services. By focusing on enhancing tertiary neuroscience and spine care capabilities, healthcare professionals, government bodies, and the community must collaborate to build a robust healthcare system that will ensure Mumbai's health for the future.