Surgery for a congenital anomaly of the cervical-occipital region, which was the cause of paralysis of the legs and neck

monday,  10  Октябрь  2022

The parents of a 6-year-old girl from the Almaty region turned to the National Center for Neurosurgery for medical help. A little patient complained of weakness of the arms and legs, limitation of movements and forced position of the neck.

On the MRI picture, the doctors found a congenital anomaly in the development of the vertebrae of the cervical-occipital region. A consultation was held by the doctors of the Center for Neurosurgery. On which further tactics and method of treatment were determined.

The complexity of the situation was that the girl was missing several vertebral bodies, which led to a complete displacement of the head in front.

According to Prof. Talgat Kerimbaev, Head of the Department of Spinal Neurosurgery, Pathology of the Peripheral Nervous System, due to the high complexity and risks, such operations are performed only in leading specialized clinics and quite rarely. “We performed a super-complicated operation on a child. The girl had multiple congenital malformations of the vertebrae of the cervical-occipital region, as a result of which the spinal cord and brain stem were compressed. Because of this, by the age of 6, the child could not walk independently, move freely, dress, lie on his back. Taking into account the neurological symptoms and the results of the MRI study, by the decision of the team of neurosurgeons, an operation was performed to reconstruct the vertebrae of the cervical-occipital region with the restoration of normal anatomical ratios of the head and neck, followed by transarticular, transpedicular, transcortical fixation of C1, C2, C3, C4, C5, C6" - explained Prof. Talgat Kerimbaev.

According to the girl's mother, until the age of five, her daughter could not fully walk, she walked on her toes like a ballerina. By the age of six, when her daughter began to grow sharply, she stopped walking on her toes and was only in bed rest. “We previously applied to this Center when we learned about the congenital pathology of our child, but then the operation was postponed for us, the doctors said we need to wait for the bones to strengthen a little. We have now arrived at the center for the operation. Special preparations for the operation took place here. A week ago, my child underwent surgery, it is still too early to walk, but now I see that there is no spasticity in the child's legs. The feet are relaxed, not stretched, as it was before. Now we are looking forward to when my daughter can take her first steps.” - shared the mother of patient.

According to Dr. Saparbek Seitbekov, a neurosurgeon at the Department of Pediatric Neurosurgery, the primary task during the operation was to successfully free the spinal cord, create physiological lordosis and fix the cervical spine. “During the operation, an anomaly of the vertebrae led to technical difficulties for access. There was a very high risk of damage to the brain stem and spinal cord and blood vessels. In case of damage to these vital centers, the patient can be paralyzed, and even turn into a fatal outcome. Fortunately, the operation was successful, the child was activated, and now there is a trend in the form of a regression of spasticity and an increase in the strength of the muscles of the lower extremities.” - shared Dr. Saparbek Seitbekov.

The operation  lasted 4 hours. The operation was performed by Academician of the National Academy of Natural Sciences of the Republic of Kazakhstan Prof. Talgat Kerimbaev, with practical experience of more than 30 years, neurosurgeon, PhD Dr. Viktor Aleinikov and neurosurgeon of the Department of Pediatric Neurosurgery Dr. Saparbek Seitbekov.

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