14-year-old girl gets new lease of life after successful spine surgery

ST CORRESPONDENT
Friday, 28 September 2018

The girl’s problems began when she was five and her parents noticed a slight change in her spine, with a small protrusion.

PUNE: An eight-hour surgery by city doctors helped a 14-year-old girl overcome a deformity which made her walk with a one-sided tilt and humped back.

The girl’s problems began when she was five and her parents noticed a slight change in her spine, with a small protrusion. Over time, it slowly grew prominent and became a constant source of worry. With the deformity being visible, her self-esteem took a hit and she had to tilt her head to talk to people. She was suffering from a rare birth defect known as congenital scoliosis. However after the surgery at Ruby Hall Clinic at Wanawadi, she was finally able to walk out with her head held high. 

Congenital scoliosis is a medical condition in which a person’s spine has a sideways curve, which is usually “S”- or “C”-shaped, caused by vertebrae that are not properly formed. This occurs very early in development, in the first six weeks of embryonic formation.

In some cases, the degree of curve is stable, while in others, it increases over time. Symptoms of scoliosis include a curved upper back, back pain, leg length discrepancy, an abnormal gait, and uneven hips. Other symptoms may include having one shoulder higher than the other, a ‘prominent’ shoulder blade and rib cage when bending forward, and visible curving of the spine to one side. This condition occurs 1 in every 1,000 births, it is the least common of all types of scoliosis and its treatment has limited options. What made this case an exception was the fact that it had to be surgically corrected due to its severity.

Discussing the case, Dr Bhushan Khedkar, Consultant Spine Surgeon at the hospital said the backbone helps hold the body upright and without the spine’s gentle curve down the back, we wouldn’t be able to balance, walk, or move properly.

“With scoliosis, children whose curve gets to be 45 or 50 degrees are usually surgical candidates. However, in this case curve was already 75 degrees, and her short torso made it exceedingly uncomfortable for her. As such, surgical correction was the only option,” said Dr Khedkar. He said the surgery consisted of a hemivertebra excision along with the deformity correction.

“The goal was to straighten and balance the spine and secure it in place with rods and screws to stop the curve progression while skeletal maturity is reached. However, there is always a big risk of impending spinal cord injury with such surgeries along with the possibility of loss of power in lower limbs and loss of bladder and bowel control. For this purpose, neuro-monitoring was used throughout the procedure thereby reducing the incidence of spinal cord injury,” said Dr Khedkar.

The patient was able to walk just three days after the surgery and was discharged a week later. Led by Dr Bhushan Khedkar, the team of doctors included anaesthetists Dr Amit Dixit and Dr Amol Ramekar, ICU specialist Dr Shilpa Kulkarni, General Surgeon Dr Harshvardhan Chaukulkar, Spine Surgeon Dr Hrushikesh Mehata as well as a team of physiotherapists.

WHAT IS CONGENITAL SCOLIOSIS?
- Congenital scoliosis is a medical condition in which a person’s spine has a sideways curve, which is usually ‘S’- or ‘C’-shaped, caused by vertebrae that are not properly formed.
- This occurs very early in development, in the first six weeks of embryonic formation. In some cases, the degree of curve is stable, while in others, it increases over time.

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