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Interview with Neurosurgeon Dr.S.N.Manikandan

dr manikandan

Dr. S.N. Manikandan is a consultant neurosurgeon at Fortis Hospital, New Delhi. He graduated from some of the top medical teaching institutions in India; MBBS from Stanley Medical College and MCh (neurosurgery) from Christian Medical College, Vellore. His special interests in neurosurgery include skull base, cerebrovascular and spine neurosurgery. Below is a general interview with him.

1) What are the common reasons other than trauma, for which people seek neurosurgeon's opinion directly?
There are multiple reasons.
1. Neurooncological problems: Brain tumors like gliomas, meningiomas, skull base tumors.
2. Infections like brain abscess, tuberculomas and cysticercosis
3.Vascular diseases like aneurysm, arteriovenous malformations of brain and arteriovenous fistulas
4.Spine problems like backache, cervical and lumbar disc prolapse, spine tumors
5. Neurological problems like Parkinsons disease, tremors and dystonia can be treated by deep brain stimulation

2) What are the significant advances that has happened in the field of neurosurgery in the past decade?
1. Microneurosurgical principles: Help minimizing the morbidities associated with brain surgeries.
2.Neuronavigation: You can approach the lesions with minimal invasive techniques via neuronavigation
3. Neuroendoscopy  has a vital role in intraventricular tumors
4.Deep brain stimulation helps in parkinsons disease, chronic pain and in psychiatric disorders.

3) Most people are concerned when they undergo surgery. Their anxiousness is maximal when their own brain is being operated. There are concerns about the outcomes of the neurosurgery. How has the post neurosurgery morbidity and mortality improved over the past decade?
The significant advances as I mentioned in question no 2 has brought down the morbidity in neurosurgery to a significant level. It is as safe as other surgeries.

4) Low backpain seems to a significant problem in the general population. For certain indications surgery is considered as an option. Since neurosurgeons perform spinal sugery, what is your perspective on spinal surgery for low back pain?
Yes. You need to consult only neurospine surgeons. The good neurological examinations will tell us where is the problems and what and why there is a problem. I would say spine surgery has to be done only by neurosurgeons because the backache problems cannot be solved only by putting some screws and plates. There are several causes of chronic bachache including extradural causes like bone, ligaments, facetal arthropathies, metabolic causes like high uric acid levels etc.

5) Use of technology has improved outcomes in neurosurgery. With better microscopes and imaging, microbrain surgery has decreased the post op morbidity. What are the future technological advancements that is likely to improve the specialty?
Endovascular interventions to solve vascular pathologies. Advances in medical oncology and stereotactic radiotherapy can help us to improve the quality of neurooncological procedures.

 6) Though India has world class hospitals and doctors, neurosurgey is a technology intensive field and years of training is required to become proficient. There might be limited neurosurgeons trained in certain procedures. Are all the advanced neurosurgical procedures done in India or do patients need to visit foreign countries for some procedures?
In fact the patients from other foreign countries have started coming to India for neurosurgical problems. We are much better than most of the countries and we have facilities on par with the best in the world.

7) As a personal question,why did you choose neurosurgey after finishing medical college?
As you know all of us get into this field to save life. I felt my personality is very much fitting with the qualification to be a neurosurgeon.

8) Neurosurgery residency is supposed to be tough with long working hours and steep learning curve. This obviously has deterred many medical students from choosing neurosurgery as their career. What are your advice for medical students aspiring to become neurosurgeons?
I would suggest to work as resident doctor  for 1 year with neurosurgeons in a good voluminous center and have a feel of neurosurgery. It would be clear by the end of the year if you like neurosurgery and if you are fit enough to pursue a career in neurosurgery. Many like neurosurgery but many not be able to tolerate the demands of neurosurgery training and quit within one or two years. So you should see for yourselves if you are capable of pursuing a career in this field.  

Contact Information
Dr. S.N. Manikandan
Ph: 08860064145

Monday, October 13, 2014