BEYOND THE IMPOSSIBLE: SKIMS Neurosurgery Department's 11-Hour Odyssey Through The Spine. Akram Sidiqui

BEYOND THE IMPOSSIBLE: 

SKIMS’ Neurosurgery Department's 11-Hour Odyssey Through The Spine.

At SKIMS, the Department of Neurosurgery has turned perseverance into precision, transforming a Valley institute into one of India’s rarest frontiers of neurosurgical excellence.”

Akram Sidiqui

Sidiquirayan@gmail.com 

It is said that when love commanded, Farhad split mountains; with sheer will alone, he carved a canal through stone for his Shirin. Such is the power of human resolve, to turn the impossible into the inevitable.

The same indomitable spirit defines the neurosurgery wizards at the Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Soura, Srinagar. Conquering impossible crusades and cutting through every layer of redundancy, they have time and again established remarkable neurosurgical milestones , making the people of this land stand tall with pride.

There are mornings when a hospital corridor seems less like concrete and fluorescent light and more like a threshold ,a thin, trembling membrane between the ordinary and the astonishing. On one such morning in Srinagar, within the quiet, resolute heart of SKIMS, a door opened into that realm of the extraordinary.

An eighteen-year-old girl was wheeled into the operating theatre for a surgery so rare that even textbooks whisper of it in footnotes, and global neurosurgeons recall it only in scattered case reports, an eleven-hour resection of a holocord intramedullary spinal cord tumour, approached through a seventeen-level laminoplasty, performed free of cost in a government institute of the Valley.

Holocord tumours, lesions that unfurl across nearly the entire length of the spinal cord, are extraordinary even in the world’s largest neurosurgical centres. To attempt their resection is to walk a knife’s edge of precision, demanding not only supreme technical finesse but the serenity to work within the spinal cord itself, where every millimetre carries the weight of a lifetime’s movement, sensation, and autonomy.

At the Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Soura, this formidable challenge was embraced by the team led by Dr. Abrar Ahad Wani, Professor and Head of Unit, Neurosurgery, with steadfast neuro-anaesthesia support from Dr. Zulfikar Ali. They entered this delicate realm not with haste, but with the calm conviction born of long apprenticeship and quiet faith in science and skill.

Eleven hours later, they emerged from the theatre having achieved what will be retold for years, the tumour excised, the spinal cord preserved, and the young woman awakened to a dawn that once seemed unreachable.

India-wide rarest neurosurgical feats and the niche SKIMS has attained.

To grasp where this operation stands, one must first step back and view the panorama of India’s most exceptional neurosurgical triumphs ,those rare frontiers where science, skill, and spirit converge. In the last decade, only a select few procedures have so boldly redefined the borders of surgical possibility.

Foremost among these are the separation of craniopagus twins, twins joined at the skull, a marathon of medicine demanding months of planning, staged vascular division, 3D neuro-reconstruction, and a flawless choreography between neurosurgeons, anaesthesiologists, and reconstructive experts. India has achieved such miracles only a handful of times, each recorded in global journals as a triumph equal parts daring and devotion.

Standing beside them are the delicate brainstem cavernoma excisions, the monumental giant skull-base reconstructions, and the breathtaking cerebrovascular bypasses that shimmer in medical literature like rare constellations in an immense sky.

And now, woven into that constellation, shines the name of Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Soura, a beacon of neurosurgical excellence from the Valley. Over the years, SKIMS has quietly amassed a lineage of landmark achievements: successful resections of complex skull-base tumours, meticulous spinal deformity corrections, advanced endoscopic pituitary surgeries, and lifesaving trauma interventions that have drawn national recognition. Each milestone has built a staircase to this moment, the rarest of them all.

For holocord intramedullary tumours belong to a class almost mythical in neurosurgery. They surface in journals as solitary case reports, their resolution recorded precisely because so few are ever attempted. The SKIMS team’s recent feat now joins this elite circle, its depth, duration, and flawless functional recovery securing it a place at the summit of India’s most demanding neurosurgical endeavors.

SKIMS’ Growing Legacy Of Rare Neurosurgical Successes (2020–2025)

What strengthens this achievement further is that SKIMS did not arrive here suddenly. Over the last few years, the Department of Neurosurgery has quietly, and repeatedly, demonstrated a capacity to manage cases that most centres may see once in a decade, if ever.

1: Suprasellar Dermoid Cyst Infected With Salmonella Typhi (2024).

In 2024, SKIMS surgeons encountered a pathology so unusual it merited publication in international literature: a 17-year-old girl with a suprasellar dermoid cyst whose contents grew Salmonella enterica serovar Typhi, an organism almost never associated with intracranial infections. The neurosurgical team not only diagnosed and excised the lesion but navigated a postoperative course complicated by its rarity. Such infections are nearly unheard of in neurosurgery, making this an extraordinary case in both pathology and management.

2. Paediatric Pineal Region Tumour Of Rare Subtype (2023–24).

SKIMS faculty also contributed to reports of papillary tumour of the pineal region (PTPR), a rare paediatric neuro-oncological entity scarcely documented worldwide. Managing deep-seated pineal lesions in children demands high-precision microsurgery and intensive postoperative vigilance, underscoring the department’s growing expertise in complex paediatric cranial pathology.

3. Complex Spinal And Cranial Surgeries In High-volume Practice (2020 onwards).

With nearly 2,000 neurosurgical admissions a year and multiple major surgeries performed weekly, SKIMS has, since 2020, handled an array of rare and demanding cases, from intradural spinal tumours to intricate skull-base lesions. While not all reach the news, each adds to the institutional muscle that makes monumental feats like the holocord resection possible.

These cases are the stepping stones that build institutional courage. They suggest a department not only capable of rare surgery but increasingly accustomed to it, a place where complexity does not intimidate but instructs.

What Made The 2025 Holocord Resection Singular.

Amid all these accomplishments, the 11-hour holocord tumour resection stands apart with an undeniable, luminous distinction.

The exposure: A 17-level laminoplasty, vast in length, delicate in architecture, granting entry without compromising future spinal stability.

The terrain: An intramedullary tumour spanning most of the spinal cord, requiring the surgeon to dissect within the nervous tissue for a distance few in the world have dared to attempt.

The endurance: Eleven hours under a surgical microscope, where precision cannot tremble, and every micro-decision must favour preservation. The patient awakened with preserved neurological function and signs of early improvement, a result far rarer than the surgery itself. It happened not in a corporate super-specialty corridor, but in a Valley where geography often isolates patients from high-end care, and it was done free of cost.

For the girl who lay on the operating table, the surgery restored not just function but possibility. For her family, the outcome was an answered prayer held through nights of fear. For the institute, it was a moment that crystallized decades of training, quiet perseverance, and a belief that excellence need not be imported, it can be built, nurtured, and performed here.

Hailing the entire neurosurgery team in general and Prof Abrar and his team in particular ,Prof. M. Ashraf Ganie, the Director and EOSG of SKIMS, described the operation as proof of the institute’s core values: compassion, accessibility, and advanced scientific care for the people of Jammu & Kashmir.

The Wider Meaning: A Shift In The Indian Neurosurgical Map.

The SKIMS operation nudges the map of India’s neurosurgical excellence outward, away from a few urban clusters and toward a more democratized geography of high-end care.

It signals to the country that institutions like SKIMS are no longer only recipients of referred cases but creators of new surgical benchmarks.

JiIt tells young Kashmiri doctors in training that they need not leave the Valley to witness rare feats; the Valley itself now produces them.

It assures families that their most complex medical needs do not demand the burden of travel and debt, but can be met at home, among their own people.

When sun of lassitude was warming the shivering dawn over Srinagar the morning after the surgery, the city was unaware that within SKIMS, a battle against one of the body’s most intricate enemies had been fought, and won.

A young woman slept in recovery while new sensations blooming in her limbs. A family exhaled for the first time in months that too air of thanksgiving. A surgical team walked out of the theatre in quiet satisfaction, knowing they had touched the boundary of what is medically possible and stepped beyond it.

An institution, the Valley’s own, added a shining entry to the book of India’s rarest neurosurgical triumphs.

And in a place where winters have already started camping for four long months a ray of hope bedazzled the chill of long nights hearlding the unique message that SKIMS proved what light looks like when it is made by human hands, human skill, and human resolve.