Question 1

What complications are expected from trigeminal neuralgia surgery (microvascular decompression)?

Dr. Anil Kumar Kansal · Accepted Answer

There can be anaesthesia-related complications. On the surgical side, we can get a haematoma in the cerebellum, sometimes bleeding, sometimes infection, or damage to the nerves — though our infection rate is very low. One patient developed chemical meningitis leading to hydrocephalus and needed a shunt, but the rest did very well. Initially some patients complained of partial hearing loss from traction on the eighth nerve; now we use minimal traction, so results are good and complications are minimal.

Question 2

What is the recurrence rate of the tumours (in cases treated with microvascular decompression / related skull-base surgery)?

Dr. Anil Kumar Kansal · Accepted Answer

Only about 5%, not more than that. In our setup we have done more than 100 surgeries and have not had to redo any; some patients may have mild symptoms that can be managed with medicine or reassurance, but otherwise the results are good.

Question 3

Are there any recent advances in the management of paediatric congenital hydrocephalus?

Dr. Anil Kumar Kansal · Accepted Answer

We do endoscopic third ventriculostomy in paediatric congenital hydrocephalus, but success is slightly lower at a young age — around 70-80%. A programmable shunt has a 95% success rate, but shunt revision and infection are other factors to weigh; endoscopic third ventriculostomy is a better choice when it succeeds, since the chances of recurrence problems afterward are very low.

Question 4

What is the time needed for full recovery, and what are the complications, for trigeminal neuralgia treatment (microvascular decompression)?

Dr. Anil Kumar Kansal · Accepted Answer

We keep the patient for three or four days; the pain is usually gone right after surgery. We continue medication for one month afterward and then stop it. We mobilise the patient to walk from the next day, and they generally do very well. We do a post-operative CT scan to check for any bleeding or collection, but results are close to perfect.

Question 5

What is the success rate of the surgery, what are the financial implications, and are the screws inserted in robotic spine surgery absorbable or will they need to be removed post-op?

Dr. Anil Kumar Kansal · Accepted Answer

The screws used in spine surgery are not absorbable — they remain in place lifelong. Financially, robotic-assisted spine surgery costs about $1,000 to $2,000 extra on top of a normal spine surgery of around $7,000, but the advantage is that screw misplacement drops to less than 1%, which is significant because a single misplaced screw can undermine the whole surgery — so while it adds cost, it also adds real value to the outcome.

Question 6

What are the success rates of these surgical procedures generally, and what are the absolute contraindications to surgery?

Dr. Anil Kumar Kansal · Accepted Answer

Absolute contraindications include cardiac problems, any bleeding or coagulation disorders, or severe infection in the body. If a patient — for example with trigeminal neuralgia — is responding well to medication at a controllable dose, we will not operate; surgery is offered when the patient's pain is not relieved despite medical management.

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