A 56-Year-Old Woman with TB Leading to Bone and Spinal Cord Damage Successfully Treated at Wockhardt Hospitals, Mira Road

The patient’s TB had spread to the bone and spinal cord canal, damaging it and leading to pus. Not treating her at the right time could have led to a complete loss of movement in their hands and legs due to paralysis
Mumbai: A Team of Dr. Vinod Rambal, Consultant Neurosurgeon, Dr. Ashwin Borkar, Consultant Neurosurgeon, Dr Roopa Mepani, Consultant Anesthesiologist at Wockhardt Hospitals Mira Road effectively treated a Mira Road resident suffering from tuberculosis (TB) which had severely damaged her bones and resulted in pus formation and spinal cord compression & vertebral column instability. The patient, who experienced symptoms like neck swelling and difficulty walking, sitting, and standing, underwent two surgeries: 1) Transoral excision of destroyed C2 body and granulation encircling the spinal cord. 2)To stabilize the head and neck she was turned face facing down and a titanium implant was used to fix the back of the head and C3,4,5 vertebrae on either side. The patient has now regained stability & is able to walk by herself.

Mrs. Malti, a housewife had neck swelling & for which she sought medical treatment & was diagnosed with TB involving neck nodes. She was found to be retrovirus +ve. Two months down the line she responded to the treatment but suddenly found weak in her arms & legs & was unable to sit, stand & walk independently. She was started on medication, but in spite of treatment her health deteriorated, the pain became extremely unbearable, and neck movements became painful & restricted. On Investigation, she was found to have a lot of damage & disease extended in the vertebral column bones (C2) destroying the bone & extending into the spinal canal.

Dr Vinod Rambal, Consultant Neurosurgeon at Wockhardt Hospitals Mira Road said, “On arrival in 1st week of August, she came with chief complaints of neck pain, unable to walk, sit & stand. Her MRI revealed that tuberculosis (TB) reached the soft tissues of her neck and bones. TB not only affects the lungs, lymph nodes, brain, and kidneys but even the bones and spine. This condition occurs in 50% of TB Patients. Vertebra C2 was affected by the granulation tissues extended intraspinally resulting in compression of the Spinal Cord. The TB destroyed the bones and tissues and reached the spinal canal. It was compressing the spinal cord, which made her uncomfortable. As a result, she was unable to sit, stand, and walk weakness, she was reexamined and investigated. Her MRI showed destruction of the second vertebrae and going around the neck. She was already put on antituberculosis medication and scheduled for 2-stage surgeries on 5th August.

Dr Rambal added, “It was a big risk to operate on her as the large column of tissue was damaged, reached the spinal canal, and could have caused permanent loss of movement in hands and entire body leaving her paralyzed and bedridden for life. So, we operated her. First, we went from the mouth and opened that damaged area and the bone which was destroyed and full of pus and granulation tissue causing the pressure on the spine. However, the spine is unstable and will take a few months to recover. In the second stage, the junction between the head & vertebral column had to be stabilized as a single pillar by turning her upside-down making her sleep on her tummy. Post her surgery now she can walk and there is no instability in the spine. The surgery lasted for 4-5 hours. The patient was discharged after one week. The TB drugs will be continued for one-and-a-half years. She has been advised on Regular Medicines and cervical collar.”

“It is a stroke of good fortune that I was able to receive timely treatment at Wockhardt Hospitals. I extend my heartfelt thanks to the doctors who played a crucial role in aiding my recovery and enabling me to walk again. As I slowly recuperate, I eagerly anticipate the day when I can effortlessly resume my daily routine,” concluded the patient Mrs. Malti.

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