CMRI Kolkata recently set a benchmark in advanced medical care by successfully managing a complex case of spinal tuberculosis in a pregnant woman. This groundbreaking achievement underscores the hospital’s commitment to innovation, patient-centered care and excellence in handling high-risk cases.
A 25-year-old woman in her second trimester had progressive numbness from the waist down, which progressed to a loss of mobility and control over bladder and bowel functions. Gradually she became bed-bound and suffered from excruciating pain in her back.
An MRI scan was done under general anesthesia as the patient was finding it difficult to lie on her back due to severe pain. MRI revealed that she had Spinal Tuberculosis ( Spine TB), and her 5th and 6th dorsal spinal vertebrae had completely collapsed and was severely compressing her spinal cord threatening to permanently render her paraplegic.
This case was more challenging due to her ongoing pregnancy with an otherwise healthy baby. It presented significant risks, including the need to minimize blood loss and x-ray exposure to protect both mother and child, limitation of analgesia options etc. There were multiple challenges in every step of her operation and also the subsequent treatment. The multi-disciplinary team, led by Neurosurgeon Dr. Rathijit Mitra, used the latest techniques to ensure success of the surgery. She was positioned on her left and a thoracotomy was done on her right side to gain access to the diseased part of the spine through her chest cavity retracting her right lung. To minimize the blood loss a special tool called the bone scalpel (an advanced device which uses ultrasound to cut bone) was used instead of a normal drill to remove the diseased part of the spine. An implant was then placed to fill the gap and fixed with screws. Special techniques were used to stabilize the patient during the procedure, reflecting meticulous planning and execution.
The well-being of the baby was checked multiple times by the Obstetrics team before and after the procedure.
Samples sent for histopathology and Microbiology confirmed that it was spine TB and she was put on anti-TB medications which were monitored by the medical specialists.
The next challenge was to control her pain given the fact that she was 5 months pregnant and pain management needed special attention. This was taken care of by our Anesthetist and pain management expert Dr Manish De. Within a few days the patient started showing signs of improvement and slowly her bladder and bowel control came back along with sensation in both her legs.
The patient started walking on her own in the next few days and both she and her unborn child were found to be in excellent health. This case exemplifies CMRI’s leadership in navigating complex medical scenarios through a combination of advanced technology, expertise and multidisciplinary collaboration.
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