Neuro-navigation is a computer-assisted surgery that allows a surgeon
to ‘navigate’ within the spine with utmost precision–
Karnal, May 16, 2023: The Neurosurgery Team (Brain and Spine) at Fortis Hospital Mohali has successfully treated a 50-year-old woman suffering from Spinal Tuberculosis via the most advanced technique of Neuro-navigation, the technique is available at a select hospitals in North India, Fortis Hospital Mohali being one of them. Spine Tuberculosis affects the spine and causes infection in the disc and spinal bone. It is the most common form of extra-pulmonary tuberculosis.
Patient Bala Devi had been experiencing severe lower backache, limb weakness, difficulty in walking along with general malaise for about 5-6 months and had also consulted several doctors but her condition had failed to improve. She finally consulted Dr Harsimrat Bir Singh Sodhi, Senior Consultant, Neuro-Spine Surgery, Fortis Hospital Mohali, recently where subsequent medical examinations revealed that she had Spinal Tuberculosis.
The Patient’s MRI of the spine was re-evaluated and revealed two collapsed vertebral bodies, along with huge paravertebral collection (pus around the spinal cord), which was presumed to be because of Spinal Tuberculosis. Any delay in treatment would have caused severe neurological complications, spinal deformity and long-standing health implications for the patient. Dr Sodhi advised Neuro-Navigation Surgery as a viable option to treat the spine and drain the pus surrounding the spinal cord. Neuro-navigation is a computer-assisted, invasive surgery that allows a surgeon to ‘navigate’ within the spine with precision.The pus drainage is invasive and requires high amount of precision due to proximity to the kidneys and major blood vessels. Hence, Neuro-navigation assisted needle aspiration of pus was done to avoid any injury to the surrounding vascular structures.
The Patient was also administered anti-TB medicines on the same day and a biopsy was done to establish the diagnosis. The pus surrounding the spinal cord was drained out and she was advised complete bed rest. She was also put on lumbar belt to prevent any inadvertent damage to the spinal nerves. Post treatment, the Patient was pain-free within a month of the treatment. She has resumed her normal activities and is leading a normal life today.
Discussing the case, Dr Sodhi, said, “In Spinal Tuberculosis, the health implications of delayed or no treatment are quite significant as the patient may become paralytic and lose control in both his legs along with urinary incontinence. Also, the treatment plan for TB of other organs is 6 months whereas it is 18 months in case of spinal tuberculosis. Also, if patients tend to have irregular treatment or take treatment for a lesser span than required, their neurological status can worsen with long-standing implications.”
Stating that the treatment for spinal tuberculosis usually lasts for at least 2 years in most cases, while others might need it for more than 3 years depending on the complexity of the case, Dr Sodhi, added, “The medicines can be procured from a certified government hospital and has to be taken daily. Patients need close monitoring with regular clinical evaluation and repeated spinal MRI to examine the extent of the disease. Of all spinal TB patients, 10% have clinical worsening or progression of disease on MRI, despite being on medicines. Such patients might need surgery for decompressing the nerves or to provide stability to the spine.”