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It wasn’t just her condition, but also her phobia for hospitals which was holding Mahek back from having a relatively normal life. But with empathetic and skilled medical care, doctors were able to transform her life.

Bending life back into shape How this childs staggering spine deformity was corrected
Tuesday, January 28, 2020 - 13:40

When 13-year-old Mahek was brought in on a wheelchair to meet Dr Muralidharan Venkatesan, Senior Spine Surgeon at Apollo Hospital (OMR, Chennai), she weighed just about 20 kg, and was scared of hospitals. She had been a wheelchair user for almost two months then, and the rare and challenging nature of her spine deformity had not only deteriorated her physical health, but also her mental state.

Mahek was a syndromic child – she had anomalies in several organs. Among the many medical challenges she faced was an uncommon but severely debilitating condition called ‘congenital kyphosis’ – an anomaly of the spine. The spine of the child born with this condition is abnormally curved forward, giving a child a rounded or “humpback” appearance.

Mahek’s case was particularly saddening because she was also born with an atrial septal defect – a hole in the wall between the left and right atria of the heart – and had undergone a surgery for it when she was just a year old. After the heart surgery, she needed permanent tracheostomy to assist her breathing, and therefore she could not speak very well. She also had a few other developmental disorders. She has been in and out of hospitals for as far as she could remember, and that had instilled in her a fear of hospitals.

“She has been using a wheelchair because of severe progressive kyphotic spine and spinal cord compression,” explains Dr Muralidharan, and adds, “Her parents consulted several units across the country and almost lost hope of their daughter walking again. Even some renowned hospitals turned them down saying it was not worth risking surgery.”

It was certainly not an easy case. Doctors had to face some of the most basic challenges in treating her. “When she came to us about a month ago, our challenges started from evaluation – just doing the most basic tests were difficult. She needed continuous care for her other conditions too,” Dr Muralidharan says. For two weeks, she had to be given at hand care due to her phobia of hospitals.

But in those two weeks, her life has changed. “We did the surgery, and she is now mobile on her feet without assistance,” exclaims Dr Muralidharan. “It was an uneventful surgery and she is now back to her hometown,” he says with a proud smile, adding, “This is also another example of how a multi-disciplinary approach makes patients’ hospital journey safe.”

Fusion surgery to the rescue

The seven-hour marathon surgery performed on Mahek had two parts: deformity correction, and fusion surgery. The first part was to bring the spine back to its correct posture through screws and rods. The fusion surgery was to ensure that her bones would eventually take control of the spine in its correct posture, and give it support the right way. This is done through bone grafting.

“Mahek had an excessive forward bend in the spine, so there was a lot of pressure on the spinal cord. It was tensioning the spinal cord, so she could not walk. First thing we did was to correct the bend by realigning the spine,” the doctor explains.

The next step was decompression of the spine – removing bones and releasing tissue to reduce the pressure on the spinal cord. “After this, a bone graft was laid on the corrected area so that the bones fuse together and eventually support the spine in its new posture,” he says.

But such a complicated case cannot be met with success unless there is a multi-disciplinary, talented team which works together, the doctor says. “From the nurses in the general ward who kept her comfortable for two weeks, to the senior doctors from cardiology, neurology, paediatrics and anaesthetics, it was a team effort. In such cases, the team at the operating theatre plays a major role. It is also important to have good post-op care, including physiotherapy.”

Mahek’s father, Ajay, says that he is extremely thankful to Dr Muralidharan. “It wasn’t just about the surgery, but also about the empathetic and personalised medical care provided by Dr Muralidharan and his team because of which we were completely satisfied,” says Ajay. Mahek is now back to her usual routine and goes to school regularly.

This article was produced by TNM Brand Studio in association with Apollo Hospitals.