Mr Amar Saxena

AREAS OF INTEREST:  1.With his vast experience of managing a wide spectrum of neurosurgical conditions, Mr Amar Saxena is  available to provide ‘Second Opinion’ on any of the areas  described below.

2. Mr Amar Saxena provides consultations and management (including surgical management) of subspecialty areas described below.

1. SPINE: A. CERVICAL SPINE:  Mr Saxena is an established complex cervical spine surgeon in the region. He is offers consultation for patients suffering from neck pain, arm pain/ weakness/numbness of arms or legs or those presenting with difficulty in walking/unsteadiness as a result of cervical spine pathology.

A i) Cervical spine degenerative disease: Mr Saxena has an extensive experience in managing degenerative spinal disease in cervical spine both in the NHS and private sector with excellent results. He was special one of the first two persons in the region West Midlands to perform Total cervical disc replacements in patients with degenerative cervical disc disease.

The first cervical disc replacement that Mr Saxena performed was covered on BBC West Midland News on the 12 June 2007. He has performed approximately over 200 disc replacements (including NHS) since then with good outcome. All cervical spine surgery is under operating microscope. His results for anterior cervical discectomy with fusion are excellent.

He has written a Book Chapter: Ronan Dardis, Amar Saxena et al: ‘Techniques of Cervical and Lumbar Arthroplasty'. Book chapter in Schmidek and Sweet: ‘Operative Neurosurgical Techniques 2-Volume Set, 6th Edition - Indications, Methods and Results’.

A iii) Rheumatoid spine (particularly cervical). Mr Saxena has good experience of managing patients with C1-C2 instability secondary to rheumatoid disease of cervical spine successfully.  A iv) Cervical trauma: Mr Saxena has extensive experience in dealing with cervical spine trauma (mainly in NHS) including anterior lag screw fixation for C2 fractures, C1-C2 lateral mass screw fixation for atlanto-occipital subluxation, cervico-thoracic fractures.

He has published a) Research Article: A Saxena. ‘Cranio-Cervical Trauma: Epidemiology, Classification, Diagnosis And Management’ J Spine Neurosurg. October 2017, Volume 6, Issue 5, 1-15. He has given lectures on ‘management of cranio-cervical injuries’ on international forums as described under his profile.

A iv) Cervical spine tumours:  Mr Saxena offers consultation and management (including surgery) on spinal intradural / extramedullary tumours like meningiomas, neurofibromas or schwannomas. He does not operate on intramedullary tumours like giomas/ependymomas of cervical spinal cord or on metastatic spinal disease.

A v) Whiplash injuries: Mr Saxena has extensive experience in managing whiplash injuries suffered as a result of road traffic accidents or injuries at work. He also provides expert opinion for medico-legal reports.

B. LUMBAR SPINE: B i) Lumbar spine degenerative disease: Mr Saxena has extensive experience of managing lumbar degenerative disc disease and spinal stenosis both in the NHS and private sector with excellent results. He offers consultation for patients suffering from lower back pain, leg pain/ weakness/ numbness of legs or those presenting with symptoms of neurogenic claudication i.e. reduced walking distance due to leg symptoms. as a result of lumbar disc disease or spinal stenosis.  I perform all lumbar spine surgery using “Interlaminar approach- under microscope” preserving bone as much as possible. It has the advantage of retaining muscle support, and protecting underlying nerve roots in the long run. The recovery is amazing. He avoids doing a laminectomy for the above reasons unless essential.

B ii) Lumbar spondylolisthesis: Mr Saxena offers consultation for lumbar spondylotic spondylolisthesis as a result of pars interarticualris defect.  B iii) Lumbar spine tumours: I offer management (including surgery if appropriate) on intradural / extramedullary tumours like meningiomas, neurofibromas or schwannomas. Mr Saxena does not operate on intramedullary tumours like giomas/ependymomas of the conus or on metastatic spine. B iv) Whiplash injury to lumbar spine (lower back pain): Mr A Saxena offers consultation for patients with whiplash injuries suffered as a result of road traffic accidents or injuries at work. He also provides expert opinion for medico-legal report.

C. THORACIC SPINE:  C i) Thoracic intradural extramedullary tumours: Mr Saxena offers consultation to patients suffering from difficulty in walking due to benign intradural extramedullary tumours (meningiomas, neurofibromas) of thoracic spine. He does not deal with intrameduallry tumours or metatstatic tumours. C ii) Thoracic spinal stenosis:  He offers consultation for patients with thoracic spinal stenosis. Mr Saxena does not manage thoracic disc disease.

2. NEUROVASCULAR:  Mr Saxena sub-specialises in neurovascular surgery and he was the departmental Neurovascular lead. . He has now passed on the lead role to a colleague. Decisions about what the best method of treating aneurysms, AVMs (neurointervention by coiling or surgical clipping) are taken in the neurovascular MDT. In the present scenario, majority of aneurysms are coiled.

Mr Saxena performs and provides support to his junior consultant colleagues in performing approximately 7-10 aneurysms in a year. As neurovascular lead Mr Saxena developed neurovascular referral pathways for regional hospitals and departmental Protocols for pre and post treatment management of patients with aSAH.

3. CRANIAL TUMOURS: 3 i) Benign intracranial tumours/Cysts: Mr Saxena manages and operates on benign tumours i.e., meningiomas (cranial and spinal except posterior skull base tumours) and other supratentorial or posterior fossa tumours/cysts i.e., Choroid plexus papillomas, Arachnoid cysts and Posterior fossa ependymomas (if indicated).

3 ii) Third Ventricular Colloid Cysts: Mr Saxena has special interest and experience in the surgical management excision of third Ventricular Colloid cyst using ‘Transcallosal approach’ with excellent results.

3iii) Mr Saxena has extensive experience of performing surgery on intra-axial cranial tumours (gliomas) and benign tumours like Pituitary tumours & cranial Meningiomas over the years. However, to encourage sub-specialisation within the department, he has given up operating on gliomas (including brain stem gliomas) and Pituitary tumours (passed on to another colleague as part of succession planning).

He does not operate on CP angle tumours (acoustic neuromas), spinal metastasis or paediatric tumours. Mr Saxena does offer consultation and opinion for management on any of the tumours mentioned above.

4. TRIGEMINAL NEURLAGIA AND HEMIFACIAL SPASM: Mr Saxena has special interest in the surgical treatment of craniofacial syndromes like Trigeminal Neuralgia and Hemifacial spasm. He has carried out a good number of Micro-vascular decompressions for these conditions (when indicated) with good results. He does offer consultation an management of these conditions.

5. CHIARY MALFORMATION: Mr Saxena offers consultation and management for Chiari Malformation including surgery i.e., cranio-cervical decompression.

6. ADULT HYDROCEPHALUS: Mr Saxena offers consultation for adult hydrocephalus. He has a particular interest in neuro-endoscopy and he performs Endoscopic Third Ventriculostomy for hydrocephalus in suitable patients. It has the advantage in avoiding insertion of a VP shunt. However, he also offer VP shunt surgery if ETV is not possible.