16-year-old Amritsar girl safely treated for complex spinal cord disorder at Paras Hospitals, Gurgaon

·        The girl was born with Kyphoscoliosis (hunch back) and her spinal cord was split in two halves causing pulling of the spinal cord and spinal nerves that led to pains and weakness in her limbs

·      Doctors at Paras Hospitals, Gurgaon perform complex microscopic surgery to safely treat the sensitive disorder

Gurgaon: 16-year-old Shefali (not her original name) was diagnosed with a defect of the spinal cord when her spine started developing an uncharacteristic bent. A congenital deformity that made her back bone split into two halves, it left the young girl with an ill-formed curvature besides causing pain in her limbs and making her susceptible to injuries.

Kyphoscoliosis, as the deformity is called, also caused a weak urinary function as well as weakness in her legs, and necessitated immediate medical intervention to prevent further aggravating of her condition. This is when the doctors at Paras Hospitals, Gurgaon, decided to make a sensitive but critical surgical intervention to correct the disorder.

However, there were complications and risks associated with the complex surgery that had to be taken into account. If attempt is made to correct just the curvature of the spine without operating on the internal problem of the spinal cord, this can lead to a sudden onset of paralysis. Therefore, the doctors led by Chief of Spine Surgeries, Dr Arun Bhanot, decided that the approach in this case would be more than one surgical intervention in a phased manner.

It had to be secured that the spinal cord does not develop a new risk of paralysis when the spinal alignment is corrected.

The procedure was therefore carried in two phases. First, the correction of the internal spine formation; and second the correction of the curvature.

“The first set involved major twin surgeries in one day - to release the low lying spinal cord and to release the bony division which was dividing the spinal cord into 2 halves in the middle of the spine. Only when this was safely done, the 2nd stage correction of the spine could be proceeded ahead with,” says Dr Bhanot, talking about the complex case.

The first set of surgeries were performed on 30th june, 2014 by a team of spine and neurosurgeons. There was none of the anticipated risks or complications that could happen in such a complex case. She started experiencing relief in her limb pains and started walking within a couple of days of the first surgery.

Kyphoscoliosis is a progressive form of scoliosis at birth, which throws more problems with age. The girl was already suffering from a weak urinary function, had pain in her arms and legs due to the continuous tug experienced at the lower half of the spine and also weakness in the legs. She had also developed a slightly sideways curvature of the spine.

“If left untreated, there was a probability that due to the curvature becoming more pronounced, She would also have looked grotesquely malformed which can lead to imbalance and can have severe psychological consequences on the affected person. However, this being a complex case, we could not embark on immediate spine alignment correction. Rather, we first had to deal with the malformed spinal cord to minimize the risk,” adds Dr Bhanot.

Even correcting Kyphoscoliosis in a normal spine does carry small amount of risk, that is why these kind of surgeries are conducted in very few centers in the country.

The first set of surgeries done and the internal deformity of the spine addressed successfully, the patient is now ready to start the procedure to correct her abnormal curvature and body posture. A 2-3 week window period is given to allow the patient to recover from first surgery and spine to get adapted to the new anatomy. In this period, the girl can walk and do her daily activities by herself.

The spine alignment correction procedure which starts after this window period will also improve her posture and balance and protect her from long term consequences of a bad spinal alignment at the same time giving her a chance of big psychological boost by giving her a near normal physical appearance. “This was a very complex procedure as it entailed multiple risks and complications. However, we are glad that the girl is already showing significant improvement in terms of the arm pain and leg weakness after the first round of surgeries. The first set of surgeries has assured that we do not develop a new spinal cord problem as well as try to get some lost function. We are now ready to start the second phase of our treatment which will correct the girl’s spinal imbalance,” says Dr Bhanot.

Coming from an economically weaker family, the girl could not afford such high quality and complex treatment procedure. This is where a UK based NGO offered to help through their local coordinators. The NGO was instrumental in helping the girl receive the best of treatment.


No comments