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When Three year old baby girl Alisha (name changed) from Gulbarga was brought to Sakra World Hospital, she was suffering from severe neck pain & was unable to walk. The baby fell from the cot and sustained Atlanto-Axial Dislocation which led to impairment of neck rotation and difficulty in walking due to a damage on the spinal cord. The patient was initially checked by local doctors at Gulbarga and treated for neck pain. Finally, a neurosurgeon recognised the problem to be a fracture between the skull and the spinal cord and immediately referred the case to Department of Neurosurgery, Center of Excellence for Neurosciences at Sakra World Hospital, Bangalore for further treatment.
The Neurosurgical Team headed by Dr. Satish Rudrappa, Director – Neurosciences, Senior Consultant - Neuro and Spine Surgery performed a Neuro Navigation, Neuromonitoring and Intraoperative CT Scan Guided Procedure on the 3 year old, one of the youngest case in Karnataka. This procedure has been a great success in adults, but among children a different set of challenges are involved like bone being soft and cartilaginous as it is still in its developing stage. The joint involved is at the junction of cranium and spinal canal with high degree of mobility. Surgical procedure when done at this region in paediatric age group requires proper instrumentations which are seldom available which increases the risk of failure. In addition, surgery in paediatric patients requires least blood loss.
After extensive discussions with the parents, and counsellors, the neurosurgical team decided to proceed with the surgery.
The surgery lasted up to four hours where screws and plates were used to join the bones connecting the brain and the spinal cord. Special titanium based equipment’s were utilised instead of steel to avoid further complications and easier examination in the future as this case involved only a 3 year old baby.