An 8-year-old boy from Kolkata who had lost his ability to walk owing to a severe 74-degree spinal deformity (kyphosis), loss of two vertebrae, and progressive paralysis (paraparesis). This complex case of advanced spinal tuberculosis (Pott’s spine) was treated successfully by a team of expert neurologists at KIMS Hospitals (Krishna Institute of Medical Sciences), Mahadevapura, after being turned away by multiple hospitals.
The treatment including surgery was led by Dr. Sharad S. Rajamani, Director & Senior Consultant - Neurosurgery, Skull Base & Vascular, Endoscopic Cranial & Spinal Surgery and Dr. Ajay Jhajharia, Dr. Manjunath, Dr. Gurudutt (Paediatric & ICU) and Dr Divya Joshi (Inf. Diseases). The child had been experiencing progressive spinal curvature that prevented him from standing or walking. He simultaneously had developed an abscess in the ankle region. Diagnosis of spinal TB led to the bending of his back in four months. The child's health status worsened so drastically that he could not walk for nearly one month. This case had several medical challenges, especially spinal instability, correction of deformity, neurologic preservation, and a family history of tuberculosis, which complicated the case further.
Scans showed the presence of an abscess pressing on the spinal cord, as well as collapse of the vertebrae, making this disease very serious. Tuberculosis was also found to have spread to the ankle with abscesses.
Due to the high risk of paralysis (paraplegia) associated with the surgery, the child was reportedly refused treatment at three different hospitals across Bengaluru and Kolkata.
“When the child had come to us, the situation was dire. With increasing spinal deformity and neurological compromise, urgent surgical intervention was the only viable option. The risk of paraplegia was extremely high. However, without surgery, the child could have faced permanent disability. It was challenging but imperative that we act fast and aggressively. Despite the risks and complications, the team decided to proceed with a complex spinal reconstruction surgery. “The child was investigated and prepared for surgery over 2 weeks before the surgery. Following surgery, the child was able to walk within a week,” said Dr. Sharad S. Rajamani, Director & Senior Consultant - Neurosurgery, Skull Base & Vascular, Endoscopic Cranial & Spinal Surgery, KIMS Hospitals (Krishna Institute of Medical Sciences), Mahadevapura, Bengaluru.
The surgery of 6 hours involved the removal of collapsed vertebral segments, drainage of infection and abscess, decompression of the spinal cord and stabilisation using metal rods and screws with navigation technology.
The transformation has been life-changing for the 8-year-old. After months of being unable to move his legs, the child showed immediate improvement following surgery. Within just two weeks, he has progressed from being bedridden to sitting up and is now walking around independently. The patient has been discharged and advised to attend regular medication and follow-up.
Dr. Nitish Shetty, Managing Director, KIMS Hospitals (Krishna Institute of Medical Sciences), Bengaluru, said, “Timely detection and treatment of tuberculosis infections, particularly those affecting other body parts, for instance, spinal tuberculosis, are extremely important in order to avoid serious problems and disabilities. With skilled doctors and advanced neurological care, we could deliver and provide the right treatment and care to the patient.” At KIMS Hospitals, Bengaluru, we are committed to delivering timely, personalised and advanced medical care to our patients.
