Narayana Health SRCC Children’s Hospital, Mumbai, successfully performed a complex surgical procedure to treat a rare case of Tethered Cord Syndrome in a 10-year-old child from Niger. The patient was initially evaluated in Niger but had to travel to Mumbai as the advanced technology required for this intricate procedure was unavailable in their home country.
The long-standing presence of this condition significantly increased the surgical complexity. The operation was skillfully led by Dr. Saurav K Samantray, a renowned Pediatric Neurosurgeon, at Narayana Health SRCC Hospital in Mumbai.
The 10-year-old Niger girl was born with a congenital disorder called spinal lipoma with Tethered cord syndrome and should ideally have undergone surgery at around six months of age. However, a delay in diagnosis and treatment resulted in paralysis of the lower limbs, loss of urinary and bowel control, progressive spinal deformity, and hip subluxation.
After a medical evaluation at Narayana Health SRCC Children’s Hospital, Mumbai, the doctors decided on a multidisciplinary team approach where a pediatric neurosurgeon performed the spinal cord surgery, and a pediatric orthopedic surgeon treated the hip and feet problems. The bladder, bowel, and kidney problems were addressed by a urologist, while physiotherapy, orthoses, etc., were managed by the rehabilitation team. The comprehensive treatment was taken care of under one roof, at Narayana Health SRCC Children’s Hospital.
The surgery was performed using a neurosurgical microscope under intraoperative neuromonitoring, following the standard protocol for such complex procedures. The chronic nature of the disorder significantly increased the complexity of the operation, but the surgery was completed successfully and without complications. Lasting five hours, the procedure was carried out with meticulous precision to ensure the patient’s safety.
Post-surgery, the patient was closely monitored in the ward and made an excellent recovery with minimal post-operative pain, effectively managed with medication. Her surgical wound healed well, and on the fourth post-operative day, the pediatric urology team removed her urinary catheter. They also trained her mother in clean intermittent catheterization (CIC), a technique using a clean rubber catheter every 4-5 hours to drain the bladder, aimed at preventing urinary infections and long-term kidney damage.
From the sixth post-operative day, the rehabilitation and physiotherapy team-initiated therapy sessions. A customized hip-knee-foot orthosis (HFKO) was designed to support her in standing and walking. For the first time in her life, the young girl was able to stand and walk with assistance, marking a life-changing milestone.
Dr. Saurav K. Samantray, Senior Consultant, Pediatric Neurosurgeon, Narayana Health SRCC Children’s Hospital, Mumbai, said, “Seeing this young girl stand and walk – with support – for the first time in her life, was a truly rewarding moment for all of us. The surgery was exceptionally challenging due to the chronic nature of the condition. It lasted a grueling five hours, but the collective expertise of our team along with advanced technology, helped achieve a very successful outcome. In the end, the smile on the face of the child was all that mattered. This case exemplifies the importance of timely diagnosis and multidisciplinary care in treating complex congenital disorders.”
This successful treatment not only restored the patient’s mobility but also offered hope to many children with complex conditions, demonstrating the impact of collaborative, multidisciplinary care in pediatric healthcare.