Surgery for tumors of the spinal cord in the cervical-occipital region

Wednesday,  20  Апрель  2022

In March of this year, 35-year-old patient Vladimir from Almaty began to suffer from weakness and numbness in his right upper and lower extremities. The man at the place of residence received treatment from a neurologist, but his health did not improve. Soon the man was sent for an MRI scan of the cervical spine. Based on the results of the MRI images, the man was diagnosed with an intramedullary vascular tumor at the level of C1-C4. The tumor was located inside the spinal cord, passing into the brain at the base of the skull. The location of the tumor was in an extremely inaccessible place and required the fine work of neurosurgeons, modern equipment and technology. By the way, such a complex operation was possible only at the Center for Neurosurgery.

According to the patient, before contacting the Center for Neurosurgery, he sent several requests for treatment to foreign clinics in Korea and Germany. “Many of my friends advised me to go abroad for treatment. In Korea, for the same operation that was performed at the Neurosurgery Center, I was asked for 29,000 euros. At the same time, Korean doctors did not give a guarantee of a successful operation or a guarantee that after the operation I would not become disabled. Also, having made a request to Germany, I managed to talk with German doctors. They asked why I did not apply to the National Center for Neurosurgery in Kazakhstan (Nur-Sultan)? German doctors spoke of the Center for Neurosurgery in Nur-Sultan as a modern clinic, which is no worse than foreign ones, which uses modern methods and technologies in treatment and has all the necessary equipment and instruments, qualified specialists and performs successful operations.” - shared the patient Vladimir. The man admits that he did not know about the existence of such a clinic in our country. After that, he collected the necessary information and documentation and applied for medical help to JSC "National Center for Neurosurgery", where he was consulted by the head of the department, Doctor of Medical Sciences, Professor Talgat Kerimbayev.

Doctors of the Department of Spinal Neurosurgery, Pathology of the Peripheral Nervous System performed a 4-hour operation to remove the tumor of the craniovertebral junction with compression of the spinal cord and trunk. Before the operation, a 3-Tesla MRI study with tractography was performed, with the help of which the doctors were able to clearly see the localization of the tumor, which facilitated the work of neurosurgeons in choosing the tactics of surgical treatment. Also during the operation, intraoperative neuromonitoring was used, which allows you to control surgical manipulations on the structures of the spinal cord in order to avoid neurological complications.

The operation was performed by the head of the Department of Spinal Neurosurgery, Pathology of the Peripheral Nervous System - Prof. Talgat Kerimbayev, who has a practical work experience of about 30 years, and a neurosurgeon - Dr. Zhandos Tuigunov.

According to Dr. Kerimbayev, the primary task during the operation was to successfully reach the tumor along the anatomical grooves and, without damaging the pathways and centers of the spinal cord, remove it. “The area of ​​the craniovertebral junction is a very dangerous localization for tumors. There is a brain stem, there is a vertebral artery, respiratory vessels, motor centers. In case of damage to these vital centers, the patient can be paralyzed, and even turn into a fatal outcome. In this case, an approach that was technically difficult to implement, but safe for the patient, was chosen, allowing the tumor to be completely removed, while maintaining the function of the vital structures of the body. We encounter such complex operations quite often. - shared Dr. Kerimbayev.

The operation was successful and the tumor was completely removed. On day 2, the patient was activated. The operation was performed for free as for a citizen of Kazakhstan. At the time of hospitalization, the patient had hemiparesis of the right side, weakness, numbness in the right half of the body. The man could hardly take care of himself, could not take objects in his right hand, fine motor skills of the hands were impaired, muscle strength was reduced. Now the patient feels well, numbness of the right side of the body has regressed, muscle strength and fine motor skills of the hands are in dynamics with a pronounced improvement almost to the normal state. On the control MRI, the tumor was completely removed. Today, the patient is preparing for discharge on the 7th day after the operation.

“I had a complex operation, the tumor was located in a hard-to-reach place. Today a week has passed after the operation, I walk, move, I feel great, every day I am on the mend, I recover quickly. I am very grateful to all the medical staff for my recovery. The doctors here are the best, I am proud that we have such centers in Kazakhstan - a modern Center for Neurosurgery, Cardiac Surgery, an Oncology Center. There is no need to travel abroad and spend huge sums of money, we have all this in our country.” - shared the patient Vladimir.

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