Doctors at Fortis Hospital Noida successfully treated a 72-year-old man from Aligarh (Uttar Pradesh) who had met with a major road accident and sustained severe injuries in the Spine Cervical. As the cervical junction of the spine is a critical and sensitive region, any delay in treatment would have led to permanent paralysis of the entire body. Since facilities of advanced surgery in the complex region of spine is not available at most of the hospitals in Eastern UP and Noida, the patient was immediately shifted from Aligarh to Fortis Noida.
The patient was presented with severe neck pain, stiffness and weakness in all the four limbs, he was also unable to sit, stand or move his neck. CT Scan and MRI revealed a severe fracture in the cervical region with compression. He required immediate immobilization of the neck with a hard-cervical collar and surgical procedure after fitness for surgery. Detailed investigation including the patient’s history revealed that he was suffering from co-morbidities such as diabetes, hypertension, coronary artery disease and also had Ankylosing Spondylitis (A condition where different bones of the spine fuse with each other like a bamboo shoot and the body becomes extremely stiff). The Neurosurgery team led by Dr Rahul Gupta, Director-Neurosurgery, Fortis Hospital Noida, performed this complex surgery after optimization by the neuro anaesthesia team.
Giving details of the surgery, Dr Rahul Gupta, Director-Neurosurgery, Fortis Hospital, Noida said, “The surgery lasted for 5 hours and there were a lot of challenges in positioning the patient during surgery due to Ankylosing Spondylitis and fracture in a delicate region. However, we have special gadgets and a modern operating table in the operation theatre which made this complex surgery possible. The patient’s cervical decompression and fixation of the fractured spine were performed using multiple screws and rods under the guidance of intraoperative imaging. The patient was constantly and intensively monitored by the Neuro Anaesthesia team. Post-surgery, the patient was extubated carefully and shifted to Neuro ICU for constant monitoring. The initial 24 hours after the surgery are very crucial as there is a possibility of the patient having breathing difficulty or fall in blood pressure. The next day, the patient was able to move all the four limbs with better power than before. His breathing and blood pressure were also normal. He was observed in the ICU for a day and then shifted to his room.”
“The patient made rapid recovery and with the help of physiotherapists, he was able to walk within 48 hours. During the perioperative period, his antiplatelet medications were stopped. The upper part of the cervical spine also called as Cranio vertebral junction is a difficult area to operate due to its complex anatomy and the presence of various neurovascular structures. This region is most important for head stability over the neck and movement of the head. Any injury to the spinal cord during surgery can lead to complete paralysis or even death. Apart from the location of the injury, his age, chronic illnesses, and Ankylosing Spondylitis made the treatment challenging,” Dr Gupta added.
Mohit Singh, Zonal Director, Fortis Hospital, Noida said, “It was a complex and challenging case and despite all odds, the team of doctors successfully treated the patient. I applaud the medical team led by Dr Rahul Gupta, Director-Neurosurgery for its continued commitment towards quality patient care. I am proud to say that the neurosurgery team of Fortis Hospital Noida is well-equipped to handle complicated cases with precision and intricacy with best clinical outcomes.”
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