The neurosurgery team at Meenakshi Hospital, Thanjavur, has successfully performed a highly complex spinal operation on a four-year-old child who had been left paralysed in all four limbs due to severe upper-neck instability.
The child had developed a condition known as atlanto-axial dislocation after a minor fall, in which the top two bones of the neck became misaligned. This caused compression of the cervical spinal cord, leading to quadriplegia, with complete loss of movement in both arms and both legs. Further evaluation at the hospital revealed that the child was also affected by spondyloepiphyseal dysplasia congenita, a rare genetic skeletal disorder that disrupts normal bone growth and development, significantly increasing surgical risk.
Following detailed CT and MRI scans and comprehensive clinical assessment, the medical team diagnosed both atlanto-axial dislocation and the underlying congenital disorder. The genetic condition, which occurs in approximately one in 100,000 births, had weakened the child’s bones and complicated surgical stabilisation of the spine.
The surgical team performed an occipito-cervical transfacetal screw fixation procedure, a technically demanding operation in which screws are placed into the bones of the skull and upper cervical spine to realign and stabilise the neck. The surgery was conducted using intraoperative neuromonitoring to ensure continuous protection of the spinal cord and nerves during the procedure.
The operation was led by neurosurgeons Dr Arun Kumar and Dr Kaveeze, with neuro-anaesthesia support from Dr Arimanikam and Dr Vinodha Devi. Post-operative care was provided by critical care specialists Dr Shobana Devi and Dr Siva Kumar, while paediatric support was led by Dr Abdul Rahman.
Hospital officials highlighted that the case highlights the importance of early diagnosis, advanced neuroimaging, specialised surgical techniques and coordinated multispecialty care in managing rare and complex paediatric spinal disorders.
