Paraplegia needs attention. Yours and Ours.

In India, the people, especially women, do not give much priority to health and healthcare. Our country has around 200,000 individuals with spinal cord injuries and every year 10,000 new cases are added to the existing number. Many of these cases get neglected due to the high cost of rehabilitation.*

We are presenting here a few cases of paraplegia that were treated successfully across Narayana Hospitals.

Case 1: Paraplegia caused by severe bone destruction due to pus formation

This is the story of Sujain (name changed), a 31-year-old woman who came to the OPD with complaints of weakness in both legs along with numbness.

It all started 18 months ago when the patient started suffering from lower back pain. She visited an osteopath with whose help she was able to manage it. However, after a few months, she started having persistent pain when she got pregnant and attributed the same to her pregnancy. Because of this, she took no medication. After delivery, the patient got diagnosed with tuberculosis of the lower spine for which she was put on anti-tubercular drugs.

Four months ago, she suddenly became bed-ridden. She was not responding adequately to any treatment. The family sought treatment at various places but got the same response that she would have persistent weakness in both legs without much hope for recovery.

The patient visited us and after a thorough examination, we found that she had no movements or sensations from the waist below. MRI of the lower spine revealed severe bone destruction with pus extending to mid of the spine and compression of nerves by the pus. The patient underwent an operation, the pus was removed, the spine stabilized with the help of screws and anti-tubercular drugs were administered.

Immediately after surgery, she started moving her toes and the sensations improved drastically. Now, 2 months after surgery, the patient is walking without support and there is no pain at her back.

This case highlights the problem of inadequate healthcare access, emotional familial pressure, and inadequate and inappropriate treatment.

Case 2: Multi-level Spine Fracture

This is the story of a 24-year-old young man who fell down from a 30 feet height at work.

The patient, brought to the hospital’s emergency wing, was suffering from severe pain in the lower back, inability to move both legs, and loss of sensations after the fall. He could not even pass urine and stool on his own. The X-Ray and MRI suggested multiple level vertebral fracture and compression of the spinal cord.

Due to the complexity of the injury, we decided to perform the surgery in stages: first, we operated upon the lumber spine and then a few days later, we performed the sacral spine decompression and fixation.

A few days after the surgery, the patient improved significantly and at 6 weeks, he started walking and his bladder sensations improved significantly.

The purpose of the surgery was to prevent further neural injury and prevent pain and early rehabilitation.

Case 3: Paraplegia caused by tumor around the spine

This is the story is of a 35-year-old woman from Uzbekistan.

Five years ago, the patient was operated on for breast cancer. This time, she came with metastatic cancer at mid-back with back pain and no movement in both legs. MRI and X-Ray suggested compression over the spinal cord with the destruction of dorsal spine vertebra.

We operated on her, removed the tumor around the spinal cord and fixed her spine with the help of screws with decompression. Her recovery was slower, compared to the two patients in both the cases above. However, after two months, she was able to move her legs and could stand on her own.

Such complicated and neglected cases can be handled by an experienced team of spine surgeons who can deal with it carefully, with the help of well-equipped operation theatres, advanced cutting-edge instruments, and latest technologies like a modern microscope, 3-D C-arm with navigation, etc. This can consistently give complication-free best results. These facilities are available at all of Narayana Hospital branches at an affordable cost.

The writer, Dr. Rajesh Verma, is a Senior Consultant & Director of Orthopedics, Joint Replacement and Spine Surgery at Narayana Superspeciality Hospital, Gurugram

*Source: https://www.natureasia.com/en/nindia/article/10.1038/nindia.2007.25

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