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The child was the youngest across the globe to have successfully undergone a corrective surgery for atlanto-axial dislocation (AAD) at Sagar Hospitals, Bangalore

November 13, 2018, Bangalore: While the nation marks Children’s Day on Wednesday, here is a story of a twenty-month-old baby that celebrates life with strength and resilience. Having born with an anomaly of ‘dislocated head over neck’, Tejas,a year back, went through a rare surgery when he was eight-months-old. A team of neurosurgery experts led by Dr Murali Mohan had conducted one of the rarest surgeries in the history of medical science, at Sagar Hospitals.

The baby who was under strict monitoring and observation, is today, a year later, hale and hearty and able to lead a normal life. With the baby in his arms, Dr Murali, Head of Neurosurgery, Sagar Brain and Spine Institute, Sagar Hospitals, who had conducted the surgery said, “We are happy that

the child not only withstood such a complex surgery at a tender age, but also that he came out victorious, post the surgery. We kept a tab on his health through the last one year and today, happy to inform that he has recuperated and leading a normal life. Having gone through such a challenging time at this age, I should say, this is the fastest post-surgery recovery I have seen in my life.”

What was the issue?

It all started when the child was diagnosed with an Atlanto-axial dislocation (AAD), a rare anomaly with a malformed base of skull and a widened foramen magnum (the opening in the skull through which the spinal cord enters the brain). As a result, the skull settled down to sit on the second spinal bone, as opposed to the first spinal bone which is normally the resting place of the I skull base. Apart from this, the skull had also slipped forwards over the neck bones.

“It was a miracle that the child had survived as long as he did, despite this deformity with such a severe compression to the brainstem-spinal cord junction, despite the lack of neck holding and muscular development. The only option for ensuring survival was a surgical remedy, which needed to address two issues. Firstly, the severe spinal cord compression and secondly, preventing further slippage”, said Dr Ann Agnes Mathew, Consultant Pediatric Neurologist, Sagar Hospitals.

The first spinal bone had to be taken out from within the skull. With no space for instruments, the buried part of the bone had to be drilled out of the spinal cord. Once decompression was achieved, the next challenge was to fix the head in such a way that it wouldn’t slip over the neck bones again. As the bones were not fully developed and hence couldn’t accept even regular pediatric size implants, the surgeon had to use innovative ideas to achieve stabilization. Titanium screws and plates were used to achieve this goal. Although this was a risky surgical affair, it was well accomplished by the team. This was the first time a surgical repair of AAD has been done on an Infant, across the globe!

“As a surgeon it takes immense courage to tackle unexpected surgical challenges that come in one’s way. A standard teaching in medical science is that, not all cases that we are going to treat are in our textbooks. It was a phenomenal challenge to tackle the situation, as surgery would be a major procedure requiring several hours. We are happy that the surgery was successful. But more than the grilling surgical process, seeing the child’s unprecedented progress makes my heart fill with joy and happiness, added Dr Murali.

“We’re so grateful to the doctors at Sagar, especially Or Mohan who gave us a new lease of life. We had lost all hopes and had no relief in sight. The doctors not only conducted the surgery but kept in touch with us and monitored our child’s progress throughout the last one year, “said Srinivas,Father of Tejas.

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(Tj vision media)

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