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Consultant Neurosurgeon Hussien El-Maghraby

Current position:
Consultant Neurosurgeon and Spinal Surgeon at the Woodland Hospital ( Ramsay Healthcare), Kettering, Northants

Consultant Neurosurgeon and Spinal Surgeon at the University Hospitals Coventry and Warwickshire NHS Trust

Consultant Neurosurgeon and Spinal Surgeon at St Cross Hospital, Rugby

Consultant Neurosurgeon and Spinal Surgeon at the Meriden Hospital (BMI), Coventry

Consultant Neurosurgeon and Spinal Surgeon at the Nuffield Health Warwickshire Hospital,

The Chase, Warwick Consultant Neurosurgeon and Spinal Surgeon at the Droitwich Spa Hospital (BMI), Worcestershire

Neurosurgical training:
Senior Registrar - National Hospital for Neurology and Neurosurgery, London
Senior Registrar - The Royal Free Hospital, Hampstead, London
Senior Registrar - The Royal London Hospital and The Barts, London
Registrar - Great Ormond Street, The Children’s Hospital, London
Registrar - Charing Cross Hospital, Hammersmith, London
Registrar - The Radcliffe Infirmary, Oxford
Research Fellow - Kings College Hospital, London

Achievements
Since December 2009, I established the new service of Minimal invasive spinal surgery for acute spinal fractures. I was trained on the new technique of Key Hole surgery to fix acute spinal fractures. Some of the spinal fractures will be suitable for this technique.

This Key hole surgery allows minimal accesses surgery and minimal blood loss. Most importantly it allows rapid and quick patients mobilization, less post-surgery nursing care, minimal in-hospital stay and quick recovery.

To date I operated on 14 cases of acute spinal fractures using key hole technique for insertion of rods and screws with cement. This allowed IMMEDIATE patients’ mobilization quick hospital discharges. On average most patients were discharged earlier compared to other patients who had the traditional big open surgery to fix their fractures. With regards to these 14 patients, the hospital saved on average 90 inpatients days of hospitalization with significant savings in nursing care.

To date I operated on 14 cases of acute spinal fractures using key hole technique for insertion of rods and screws with cement. This allowed IMMEDIATE patients’ mobilization quick hospital discharges. On average most patients were discharged earlier compared to other patients who had the traditional big open surgery to fix their fractures. With regards to these 14 patients, the hospital saved on average 90 inpatients days of hospitalization with significant savings in nursing care.

This service received huge Trust publicity locally, nationally and internationally with numerous newspapers and television interviews. There had been interviews in the newspapers with the emphasis on the pioneering surgery being available at the UHCW. Also the procedure and patient’s interview came out in Television news as BBC and ITV central news. In July 2010, I established the service of AWAKE CRANIOTOMIES FOR TUMOUR SURGERY. I have done the First 3 cases in UHCW with my colleague Mr Joshi Consultant Neurosurgeon.

This advances the service of brain cancer treatment in the Trust, by allowing maximal resection of tumours with least neurological complications. Such procedures also can be done in patients with significant co-morbidies sparing then m to have general anaesthetics and post-operative complications. These cases received significant public interest both locally and nationally in newspapers and BBC radio interviews with the patients and surgeons. In September 2010 with the co-operative joint care between myself (Neurosurgery) and Mr Gary Walton (Head & Neck Department), we advanced the service of resection of difficult skull base tumours with the use of telescopes rather than the use of the traditional major surgery. This case received significant public interest both locally and nationally in newspapers and BBC radio interviews with the patients and surgeons.

In March 2010 with the co-operative joint care with Mr Darius Rejali, ENT surgeon, we introduced the different surgical procedure for skull base tumours (Vestibular Schwannoma). The procedure of Trans-labyrinthine approach is well known and is used in a number of centres in UK. Together we introduced to University Hospitals Coventry & Warwickshire NHS Trust.

Teaching:
Intercollegiate Neurosurgical curriculum programme trainer.

Actively involved in the teaching and examining of medical undergraduates at Medical School, Warwick University.

Faculty member for training courses in neurosurgery.

Broad range of sub-speciality interests:

Minimally invasive (keyhole) and general spinal surgery Trained in minimally invasive techniques at several centres in the USA and Europe. Interests in bone cement injections in osteoporotic and tumour related spine fractures for pain relief and immediate mobilization. Also interested in (keyhole) percutanous procedures for spinal surgery to facilitate rapid recovery and early return to normal daily functions by reducing post-operative pain. Involved in artificial disc replacement in spinal surgery to maintain motion and minimize adjacent discs degeneration.

Minimally invasive and endoscopic cranial surgery

Intraoperative neuro-navigation, awake craniotomies and endoscopic cranial surgery. Multidisciplinary approaches for tumours, pain, and spinal pathologies Work in close collaboration with neuro-oncologist, pain anaesthetists and interventional neuroradiologists with regards to surgical management of these conditions. Low back and neck pain, surgical management and spinal rehabilitation.

Nerve Entrapments

Leadership and Key team player

Skull base Service with ENT, Head & Neck, Oncologist and Neuro-radiologist
Neuro-vascular Service with Interventional Neuro-radiologists
Minimal Invasive Cranial Surgery with ENT, Head & Neck surgeons
Minimal Invasive Spinal Surgery with Interventional Neuro-radiologists
Minimal invasive cranial Awake surgery for Brain tumours

Research and interests:

I completed a number of research projects and awarded M.D. in Neurosurgery and M.Sc., in General Surgery.

“3D simulation (Dextroscope) for virtual clipping of intracranial aneurysms”
This was presented in 152nd meeting of the SBNS and published in the proceeding of British Journal of Neurosurgery.

“3D simulation (Dextroscope) for virtual reality for planning for skull base surgery”
This was presented in number of international neurosurgical conferences including the World Federation of Neurological Surgeons and European Skull Base Society Conferences

“Cerebrospinal fluid leak and/or pseudomeningocele formation after transmeatal retrosigmoid excision of vestibular schwannoma”
This was presented in 152nd meeting of the SBNS and published in the proceeding of British Journal of Neurosurgery.

Awake craniotomy with intraoperative brain mapping and image-guided neuronavigation for maximal resection of eloquent-related brain lesions. Technical report and experience in 8 cases.

Awake craniotomy with intraoperative brain mapping ensures maximal resection of eloquent brain lesions with no or minimal morbidity. Image-guided neuronavigation improves intraoperative topographical orientation. The accuracy of neuronavigation necessitates rigid head fixation using Mayfield clamp to maintain no movement between the cranial reference arc and the target area, which would not be tolerable with awake craniotomy. We present our experience of fixing the dynamic reference arc to the patients’ head under local anaesthetic, to facilitate combined awake craniotomy and accurate neuronavigation.

“CSF dynamic studies for adult Chiari I related Syringomyelia" for award of M.D. (Doctor of Medicine) in Neurosurgery”
The aim of this study was to evaluate the outcome of the most widely performed techniques of craniovertebral decompression in the treatment of adult Chiari related syringomyelia. Also to assess CSF flow studies across the craniovertebral junction using cardiac-gated phase-contrast MRI both preoperatively and postoperatively and its relation to the clinical outcome of various techniques of craniovertebral decompression.

“Surgical Stabilization of 12 Cases with Lower Cervical Spinal Injuries" submitted as partial fulfilment of the MS in General Surgery.”
During the year 1993/1994, 12 cases with lower cervical spinal injuries were enrolled. 3 cases of flexion teardrop fractures, 5 cases of unilateral facet dislocation, 3 cases of bilateral locked facet dislocation and 1 case of compression burst fracture. Clinical and radiological evaluation of spinal cord injuries were discussed. Immediate spine stabilisation and controversies of anterior versus posterior fusion were reviewed.

Qualifications:
  • MB BS
  • Medical degree

  • M.Sc.
  • Master of Science in General Surgery

  • FRCS (Ed)
  • Fellow of the Royal College of Surgeons (General Surgery)

  • M.D. (Neurosurgery)
  • Doctor of Medicine (degree) in Neurosurgery

  • FRCS (Surgical Neurology)
  • Fellow of the Royal College of Surgical Neurology
  • CCT (Neurosurgery)
  • Certificate of completion of training in neurosurgery
  • GMC
  • Specialist Register in Neurosurgery, UK
Professional memberships:
  • Society of British Neurological Surgeons

  • International Society of Minimal Invasive Spinal Surgery

  • Royal College of Surgeons of Edinburgh

  • British Medical Association

  • Medical Defence Union
Innovations

I introduced new surgucal produres and services to the UHCW. This to ensure that UHCW is and remains a leadership in Neurosurgery, Spine Suirgery and Trauma service. These techniques help to save many being minimal invasive, less hospital stay, rapid patients recovery and less nursing care. These innovations received significat public intersets in all media at local and national levels in newspapers, TV and Radio interviews. This rasied the feeling of achivement at all staff in UHCW.

Examples of Innovations
  • Minimal Invasive Spine surgery for acute spinal fractures
  • Minimal invasive Awake craniotomiews for brain tumours
  • Minimal invasive telescopic surgery for skul Base tumours
  • Introducing new surgical producers for vestibular schwannomas
  • Minimal invasive cervical spine prodecures (Stand-Alone Cages)

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