Cervical Spine Injury - Recovery : Surgeons - Dr Anuj Bhide / Dr Ajit Mishra / Dr Nandan Marathe скачать в хорошем качестве

Cervical Spine Injury - Recovery : Surgeons - Dr Anuj Bhide / Dr Ajit Mishra / Dr Nandan Marathe

Sharing a success story filled with determination, grit & inspiration. On the night of 23/1/22 this patient was brought to Cardinal Gracious Memorial Hospital, Vasai (Casualty) after a high velocity road traffic accident in critical condition. The patient was immediately evaluated and emergency management started by the casualty medical officers Dr Pranita, Dr Merchant and their team. Dr Joel Tuscano & his surgical team further evaluated the patient and with his keen diagnostic skills he found that the patient was not moving his limbs (hands and legs), even though the patient was not fully conscious, which makes such an evaluation very difficult. Patient was placed on routine Cervical spine ATLS protocol collar for immobilisation and after primary stabilisation was advised admission. Through our ‘Video Conferencing Portal’ at CGMH (in which immediate speciality reference is taken from doctors at various other hospitals in Mumbai), the case was discussed and evaluated by Dr Anuj Bhide & Dr Ajit Mishra (Brain & Spine Surgeons). It was decided that along with head injury leading to the unconscious state the patient also need to be evaluated for ‘Spine Injury’. An immediate CT Scan of the Brain & an MRI of the Spine was performed on emergency basis at the hospital. It was found that the patient has severe cervical spine fractures and spinal cord injury along with the head trauma. Patient was advised surgery by the Neurosurgical team for the spine injury. In such cases operating immediately is the key as every minute can be crucial for the patients improvement. Also, travelling to any other centre is potentially very risky because of the jerks that may aggravate the spinal injury during travel in an ambulance. Patient was shifted to the Intensive Care Unit under the Surgical Department where Dr. Joel and his team (Dr. Chetna, Dr. Meena, Dr. Leslie, Dr. Savitri, Dr. Sandeep, Dr. Mayuresh & Dr. Ram) with their team of trained staff stabilised the patient and all necessary pre operative fitness was done. Relatives were taken into confidence and assured that whatever best is possible for the patient will be done. The patient was operated early next morning. In cervical spine injury the Anesthesia is very tricky as intubation(general anesthesia)& positioning is very difficult. Dr Payal Coutinho performed the task expertly and the patient was turned in the prone (lying on the belly) position with the help of the trained operating room staff. The surgery was performed by Dr Anuj Bhide & Dr Ajit Mishra (MCh, Neurosurgery) and the spinal cord compression was reduced and the spine was fixed with the help of screws and rods. The surgery was performed with the help of the latest ‘Operating Microscope’ which adds to the safety of the surgery & aids complete decompression of the spinal cord. In view of partial paralysis of even the patients respiratory muscles it was anticipated that the patient will require prolonged ICU and Ventilatory support. Therefore a ‘Tracheostomy’ (tube directly into the neck) was performed immediately after the surgery and the patient was shifted to the ICU. On the next morning after surgery it was seen that the patients legs were moving more freely, although he could not lift them above the bed level. That gave a very positive hope to the surgical team & all ICU doctors. Thereafter, patient slowly regained consciousness & with the support of the Intensivists under the guidance of Dr. Poonam Wankhede (MD) & Dr. Joel, & physiotherapists Dr. Abby Matthew, Dr. Justy Babu & Dr. Delissa the patient showed a remarkable recovery. The patients relatives play a very important role and also the fighting spirit of the patient needs to be appreciated. Gradually, day by day the patient showed improvement in the power of his hands and legs and he was weaned off from the ventilator. After two weeks in the ICU, the patient was shifted out from the ICU. Eventually his tracheostomy was removed and the patient was gradually mobilised on the wheelchair. Finally, on the day of discharge after 4 weeks in the hospital, the patient was able to sit up on his own, and when he was told by Dr Bhide, that I assure you that you will walk in a few weeks, the patient replied, “I will run, not walk doctor”. CGMH provided all the facilities to this patient starting from casualty stabilisation investigations & surgical care within 12 hours time followed by dedicated ICU management & rehab. Ultimately, what any doctor & hospital can do it provide the correct treatment at the correct time. Beyond that, it is prayers & efforts of the family and above all the healing hands of the Supreme power that make such miracles possible. Surgical Team: Dr Anuj Bhide / Dr Ajit Mishra / Dr Nandan Marathe. Anesthesiologist: Dr Payal Coutinho. Hospital: Cardinal Gracious Memorial Hospital, Vasai(West) (Patient Identity & Images with permission)