Dr. Raj Prasad, Apollo Hospital, Delhi, India, Spine Surgeon
Dr. Rajendra Prasad is a neuro and spine surgeon at Apollo Hospital in Delhi with in depth experience in various brain and spine surgeries. Dr. Prasad is UK board certified and spent many years in England.
I went to the British Isles in June 1979, to complete my post graduate training and specialize in Neurosurgery. I spent a year as a Senior House Office in Neurosurgery at the Cork Regional Hospital, Cork, Ireland. This is one of only two large Neurosurgical Centers in Ireland. I then spent two years in General Surgery to get the basic surgical training and this helped me in obtaining the F.R.C.S in May 1983.
Between September 1983 and February 1984 I worked as a registrar in Neurosurgery at the National Hospital for Nervous Diseases, Queen Square, London. This is one the oldest and most prestigious Neuroscience’s Center in the world. I worked under the supervision of Mr. R Hayward FRCS and Mr. N Grant FRCS, both of whom were also paediatric neurosurgeons at the Great Ormond Street Hospital for Sick Children
I completed my Neurosurgery training during the three years between February 1984 and 1987, as a Registrar in Neurosurgery at the University Hospital Nottingham, U. K. This is a very busy Neurosurgical Center, covering a population of over three million people. It is well equipped with CT scan, Digital Subtraction Angiography and MRI scans. In my first year there, I worked with Mr. J.A.G. Punt FRCS who is a paediatric neurosurgeon. Subsequently with Mr. D. T. Hope, who has a special interest in microvascular surgery and surgery of the spine.
As the most senior of the three registrars, I worked in the capacity of a Senior Registrar. I performed a large number of operations independently, both routine and emergency. At Nottingham University Hospital, I gained a wide experience of micro neurosurgery for vascular lesions (intracranial aneurysms) transphenoidal hypohysectomy, anterior cervical discectomy and microlumbar discectomy, as well as surgery for intracranial tumours (both intra extra axial) and spinal tumours. Nottingham University is also a very busy trauma centre and during my three years there I have dealt with a large number of head spinal injuries.
After completing my training in the UK, I returned to India in 1987. I took up a consultant appointment at two large hospitals in Delhi. St. Stephen’s Hospital is more that a hundred years old, was initially a meternity hospital, and is now a very busy general hospital. I was the only Neurosurgeon at this hospital, which has a very busy casualty department. I had two clinics and two operating sessions per week. The operating theatre has a modern operating microscope and all facilities for microneurosurgery. The hospital also has a large neonatal and paediatric department which provides a number of paediatric neurosurgical cases. I had performed 179 major neurosurgical cases in my years there. In addition I also had honorary attachment as a Senior Consultant with Tirath Ram Shah Hospital and Moolchand Hospital.
While in India, I received an offer to take up an appointment as Senior Registrar at Frenchay Hospital, Bristol, UK. I accepted the offer with a view to enhancing my training in spinal surgery. My duties at Bristol as Senior Registrar involved operating twice a week mostly independently on major cases. These included clipping of intracranial aneurysms, excision of intracranial and spinal tumours (both intra and extra axial), cervical and lumbar microdiscectomies. I performed spinal fusion’s independently using the latest implants, including the hartshill rectangle, interlaminar clamps, anterior cervical plates and transpedicular screw fixation systems. A large part of my practice was trauma, both spinal and cranial. I consider my year at Bristol invaluable in my training as a spine surgeon.
In addition to the above, I learnt the techniques of stereotactic surgery and Neuroendoscopy. I spent my weekly study at the Spinal Injury Centre, Odstock, in Salisbury, acquainting myself with the rehabilitation of the spinal injures patient. I also took part in the regular teaching sessions for nurses and junior doctors. This I did at the regular morning rounds and in weekly teaching sessions. I was an active participant at our clinical meetings and Neuroradiology conferences.
At the end of my Senior Registrar assignment, I took up appointment at the Social Insurance Hospital in Riaydh. This is a 250 bed hospital equipped with latest CT scan & MRI and very sophisticated operating suites for neurosurgery. The hospital is owned by the Ministry of Labour and covers all work related injuries to the large expatriate population of Saudi Arabia together with being a private hospital for the local people. I had one scheduled operating session a week and ten OPD’s a week in addition to being on call 7 days a week. Most of the emergency admissions were head and spinal injuries. My elective surgery was mainly for cervical and lumbar degenerative disease. The necessary spinal implants and halo vest were available at the hospital.
In 1995 I was appointed Spine Fellow at the Royal National Orthopaedic Hospital, Stanmore- London, U.K. The job included completing a 4 years research project looking at the fusion rate of artificial bone used in spinal fusion procedures. I was involved in a variety of surgeries for scoliosis, trauma of the spine, tumours and degenerative diseases of the spine. I trained with world renowned spine surgeons, Mr. T. Morley and Mr. A Ransford.
In August 1996, I joined the Apollo Hospital New Delhi, India as Senior Consultant Neurosurgeon with a special interest in Spine Surgery. This is a 700 bedded multispeciality hospital, the fourth largest corporate hospital in the world. The Neurosurgery department here is the best equipped in the country, comparable to any western facility and includes the X-Knife.
In addition to Spinal Instrumentation, I am involved with Stereotactic Radiosurgery, Neuroendoscopy, and image guided and stereotactic surgery. I have used extensively cervical, thoracic and lumbar implants both anterior and posterior. The common ones being the cervical locking plate, moss cage, lateral mass cervical plate, screws and rod system both trandspedicular and antero-laterlly to the thoracic and lumbar spine .The aim being to instrument early for spinal trauma to help early mobilization and discharge from the hospital. I have also designed an MRI compatible Halo Vest made locally, at a fraction of the cost of the imported systems. The other common spinal surgeries have been microdiscectomies for cervical and lumbar disc disease. Thoraco-lumbar injuries I have acutely dealt with through a transthoracic route for decompression and instrumentation. I have performed 240 spinal instrumentations to date at the Apollo Hospital. New Delhi.
I am involved in the treatment planning with the medical physicist and the radiation oncologist of patients taken up for stereotactic radiosurgery (SRS) and stereotactic radiotherapy (SRT). We have the first dedicated linac X-knife installed outside USA; we have treated over 250 cases so far.
I have been trained in Neuroendoscopy, having attended a workshop in Mainz, West Germany. I routinely perform endoscopic transnasal pituitary tumour excisions, a technique which we have modified .This is in addition to endoscopy for hydrocephalus and thoracic spine surgery. Endoscopically operated pituitary tumour patients have gone home after 48 hrs with no stitches involved.
In addition to the above I have operated on brain and spinal tumours both intra and extra-axial, these include several gliomas, acoustic tumours and giant meningiomas.
I have performed more than 1100 major brain & spine operations at the Apollo Hospital, New Delhi in the last 8 years. I have extensively traveled throughout India in these last 8 years, lecturing and conducting workshops on spine surgery.
Spine surgery: including microdiscectomy for cervical and lumbar discs and instrumentation for spinal injuries.
Microsurgery and stereotactic surgery for brain tumours.
Endoscopy for pituitary tumours.
X-Knife treatment of brain tumours and vascular malformations.
Neuro-rehabilitation for head and spine injuries.
- Registrar in Neurosurgery at the National Hospital for Nervous Diseases, London 1983.
- Registrar in Neurosurgery at Nottingham University, Queens Medical Centre, Nottingham. U. K. 3 years – 1984 to 1987.
- Senior Consultant Neurosurgeon- Stephen’s Hospital, Tirath Ram Hospital & Moolchand Hospital, New Delhi – 1988 to 1991
- Senior Registrar in Neurosurgery at Frenchay Hospital, Bristol. U.K. 1991-1992.
- Senior Consultant Neurosurgeon Social Insurance Hospital, Riyadh 1993-1994.
- Zimmer Spine Fellow: Royal National Orthopaedic Hospital, Stanmore. London, U.K. 1995 – 1996.
Papers Published / Presented:
- “Advantages of MRI in planning surgical strategy in Paediatric Intracranial Tumours”, Annual Conference Neurosurgical Society of India, 1986.
- “Stereotactic radiotherapy for brain tumours”, Annual meeting of Association of Neuroanaesthetist of Eastern India- Cuttack 1998.
- “Instrumentation in spinal injuries”, National Neurotrauma Conference- Nagpur, 1998
- “Spinal Instrumentation: Experience at Apollo Hospital” – Annual Conference, Neurosurgical Society of India, Jaipur. December 1999.
- “Morbidity & complications of spinal instrumentation”: Assessment of 100 cases- Annual Conference Neurosurgical Society of India, Mumbai. December 2001.
- “Spinal instrumentation”, Annual meeting of Association of Neuroscientists of Eastern India. Guwahati Assam 2001
- “Endoscopic trans-nasal pituitary tumour surgery- assessments of results”, Annual Conference Neurosurgical Society of India – Cochin, Kerala 2002.
- “Newer surgical options in the treatment of diseases of the Thoraco lumbar spine”, AO workshop, Kanpur India
- “Trans-oral decompression of the upper cervical spine” at Coimbatore in August 2003.
- “Cervical spine injury- when to operate?”, Spine Congress-September 2003 at Apollo Hospital, New Delhi-India.
- “Anterior cervical plating after anterior cervical discectomy & fusion” at the NSI National Conference at Chandigarh December -2003
- “Microsurgical Laminotomy without Laminectomy for Lumbar Canal Stenosis: Review of 70 consecutive cases” at the annual meeting of Association of Spine Surgeons of India at Pune Jan. 2004
- “Anterior cervical plating after anterior cervical discectomy” at the 4th Armed Forces Neurosciences Update, February 2004
- “Other techniques of Atlanto Axial Fixation” at International Spine & Spinal Injuries Conference, March 2004 New Delhi
- “Use of Halo Vest & Traction” at 2nd Instructional Course in Spine Surgery, Spine Society of Europe & Association of Spine Surgeons of India, October 2004
- “Anterior Cervical Vertebral Resection & Stabilization Techniques”, Annual ASSI Meeting January 2005 at Bangalore, India
- “Surgery for Cervical Disc Prolapse: Results of Cervical Fusion & Plating”, Annual ASSI Meeting January 2005 at Bangalore, India
- “Spinal Instrumentation Evaluation of Morbidity related to 240 consecutive cases”, WFNS World Congress 2005. Morocco.
- Life Member Neurological Society of India
- Life Member Association of Spine Surgeons of India
- Founder Member & Vice President Delhi Spine Society