New Delhi: Rahul (name changed), a 4 year old boy underwent fusion and decompression surgery for treating a disability known as cranio-vertebral junction (CVJ). CVJ is a condition where the skull and the upper cervical spine fuse together.
“The boy was admitted in bed-ridden condition and his conditions had worsened. This was a complex case as he was too young for the surgery, but being the last resort, the surgery was performed with extreme care. The aim of the treatment was to stabilize and strengthen the unstable parts of his spine without damaging any nerve. Post surgery he was kept in ICU for a week, under strict observation and was discharged after his condition stabilized. Now after 6 months of his surgery, he has recovered completely and able to walk without any support. He is now living a normal life just as other children of his age.” Says Dr Satnam Singh Chhabra, Head Neuro and Spine department, Sir Gangaram Hospital
When he was diagnosed with CVJ, he was unable to move or lift his legs and often complained of stiffness in neck, heaviness of the head along with respiratory problems and the conditions worsened over time. The abnormality can prove to be fatal as the nerves inside the spinal cord leading to the brain gets damaged and squeezed.
CVJ disorders are very common in India and the most common form is congenital (by birth). This is a critical disorder as it affects and weakens the large opening at the bottom of the occipital bone where all important nerves like brain stem pass. The disorders lead to instability as the spinal bones become misaligned. As the lower brain stem and the spinal cord are flexible, they are prone to compression.
“ Patient with CVJ experience significant disability like progressive paralysis of limbs, neck pain and headache. In complex cases (as in case of Rahul) where the brain stem is affected, they have difficulty in sensing vibration, weak muscles, no coordination between hands and legs, impaired vision, feet numbness and dizziness. And hence immediate diagnosis and treatment is necessary to reverse the symptoms and prevent permanent disability” added Dr Chhabra
Though it is treatable with surgery, diagnosis on time is necessary which is based on physical examination and radiological tests like CT scan, MRI ad X-rays to confirm. The goal of the surgery is to ensure stability and prevent neurological injuries which are done through one of the surgeries – reduction of displaced bones, decompression of the affected nerve and fusion in the CVJ region.