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When Spine Stands Between You and Your Final Wish


Imagine a life where the fright of getting paralyzed impedes you from playing with your grandchild.  A 70-year-old man stepped onto the premises of RGCIRC with neck pain owing to metastasis from lung cancer.  Imaging revealed a C4 vertebral pathological compression fracture with complete collapse and a posterior bulge indenting the cord with signal changes inside it.

Figure 1: (a) and (b) Sagittal and axial views showing the C4 vertebral body collapse and cord indentation. (c) Axial CT showing the osteolytic lesion involving the C4 vertebral body.

Such instability of the cervical spine could have led to quadriplegia following trivial trauma. With the other modalities of palliative therapies not being able to address the issue, the onus was on the neuro-oncosurgery team to come up with an acceptable solution. So the goal of the surgical intervention was to approach the target site through a very narrow anatomic corridor in between the vital structures like carotid artery, jugular vein, trachea, and esophagus, excise the diseased vertebral component, decompress the cord and stabilize the spinal segment. Accordingly, C4 corpectomy, followed by mesh cage and anterior plating was done.  A conscious attempt was made to hide the skin incision in one of the skin creases.

Figure 2: (a) healed scar of surgery. (b) lateral X-ray showing position of mesh cage and anterior plating

The intraoperative and postoperative periods were uneventful. Being pain-free he could ambulate on the first postoperative day. A week later he turned up in the neurosurgery OPD with his grandson, walking fearlessly and more importantly ready to restart the systemic therapy for the primary disease.

A heartfelt message penned down by the patient’s son is a testimony to this true story.

“… father had a C4 collapse and we were worried that it might paralyze him one day. The neurosurgery team was quick to plan an optimal surgical approach and meticulously addressed all our worries. The surgery went fine and our family is happy that he is back to what he was 1 month back, especially playing with his grandson….”

Having a metastatic disease is like a death sentence, but it’s the right of every patient to live whatever life he has, to the best of his functional abilities and with utmost dignity. The Brain and spine oncosurgery team at RGCIRC is dedicated to providing such patients with a ray of hope in the twilight phase of their lives.

Dr. (Prof.) I. C. Premsagar
Sr. Consultant & Chief of Neuro & Spine Oncology Services

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Rajiv Gandhi Cancer Institute and Research Center or RGCIRC is the largest tertiary healthcare centre in Asia. Since our inception in 1996 in New Delhi, India, we have helped patients from across the sub-continent, SAARC countries and other places for diagnosis and treatment of all types of cancers. We bring cutting-edge technology while offering super specialised care in Medical. Surgical and Robotic oncology. Our alliances with internationally renowned institutes have helped us become pioneers in new approaches to treating cancer.

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