A CHALLENGING SPINE SURGERY

A 49 year old gentleman from Sundarban was presented in Ruby General Hospital post an alleged slip and fall on road while carrying a heavy weight of sack from home to the farming field. He had come with quadriplegia (Partial or total loss of sensory function in both arms and legs), complete cord translation injury and complete loss of sensation from below his collar bone. He was admitted under the care of Dr. Biplav Singh (Consultant Neuro Surgeon) and after relevant investigations, the CT Scan and MRI of neck revealed C6 – C7 anterior listhesis (A type of spinal instability where an upper vertebra slips forward over the vertebra below it). He suffered from spinal shock and with fluctuation of heart rate and blood pressure. He was initially aggressively managed in the critical care with uro anaesthesia and temporary pacemaker. After discussion with the family and with written and informed consent the gentleman had been immediately posted for surgery. He had locked facets which had been unlocked with a challenging C7 Corpectomy (A major spinal surgery that involves removing all or part of a vertebral body to relieve severe pressure on the spinal cord) with cage fixation (A major and highly complex surgical procedure used to stabilize the neck and promote bone fusion) and C6 – T1 laminectomy (A major surgical procedure that removes a portion of a vertebra called the lamina, which is the roof of the spinal canal), facetectomy (A major surgical procedure that removes all or part of the facet joints) and lateral mass screw fixation. Complete reduction and stabilization was achieved intraoperatively. Postoperative period is uneventful and the gentleman is recovering well and remains stable with no added neurological deficits. He is raising his hands as well as regaining power in his upper limbs and sensation in the lower limbs.

Complex spine trauma care is never an individual effort — it is always a team achievement.