At Gleneagles Hospital, a 48-year-old woman who had a fall and was almost paralyzed had a complicated skull base-spine fixation procedure. After a relatively minor fall at home, the woman had remained bedridden. She was referred to Gleneagles Hospital when her condition did not improve after visiting other hospitals in the city. Doctors found a serious abnormality at the craniovertebral junction—where the skull and spine meet—after performing examinations and imaging tests. Because it contains important arteries and nerves, this area is especially sensitive. The MRI showed that the odontoid bone, which is located at the top of the cervical spine, was severely compressing the brainstem and spinal cord.
The woman was identified by the doctors as having an uncommon congenital disorder in which aberrant bone alignment resulted from a birth abnormality in bone production at the craniovertebral junction. Together with the pressure from the fall, this imbalance led to spinal cord compression, which ultimately resulted in paralysis.
Under the direction of Dr. Phani Kiran S, director of spine surgery, and Dr. Nigel Symss, head of the neurosurgery department, the medical staff at Gleneagles Hospital suggested surgery to realign the damaged bones and relieve the compression. The Distraction, Compression, Extension, and Reduction (DCER) approach was used by the surgical team. In order to relieve pressure on the spinal cord and return the skull and spine to their proper anatomical alignment, this technique entails meticulously realigning the misplaced bones.
By realigning the odontoid bone to its correct anatomical position, the surgical procedure relieved the spinal cord’s compression. The patient’s condition improved after the surgery, and the alignment was successfully restored.
Dr. Kiran clarified that the spinal cord compression that had been overlooked until the incident was caused by the congenital abnormality. Under normal circumstances, the fall might have been insignificant, but it worsened the disease and caused paralysis.
After the procedure, the patient was on the path to recovery, said to Dinesh Nayak, director of neurology at Gleneagles Hospital. In situations of spinal cord compression brought on by congenital defects, this example emphasizes the vital significance of prompt diagnosis and accurate surgical management, particularly when seemingly slight injuries might have serious repercussions.
SOURCE :
THE HINDU
