A six-month old male child underwent successful metal free spine fixation surgery with mother-bone graft at AIIMS Trauma Centre in June 2022 making him the youngest child to undergo such surgery in India. However, the child was on ventilatory support for almost 11 months since he was operated on and was discharged on May 10.
The child had sustained spinal cord and brachial plexus injury during normal vaginal delivery. At the time of presentation in AIIMS in May last year, the child had respiratory distress and minimal movement of all three limbs and no movement of the right upper limb (Erbs’palsy) was observed. The examination revealed injury to spinal cord and cervical spine dislocation (Cervical spondyloptosis), said the hospital.
AIIMS Doctor said that it was almost impossible to fix such young spines using metallic implants/cages due to the very small size of cartilaginous bones in such young infants. However, on being explained, the mother consented to give part of her iliac crest bone to the child. “Mother of child was subjected to general anaesthesia at the same time as child was undergoing 15 hr long surgery for his spine fixation in parallel operation theatre. Interestingly, mother was blood group B+ while Child was blood group A+ in this case. There was no rejection of bone graft and at one year follow-up, good bony fusion and spine stability has been achieved in child”, said the hospital.
“Looking at age of child and urgent need of surgery, we improvised and used mother iliac crest graft for fusion of child spine (cervical spine cord decompression and 360 degrees fusion) and fixed it with absorbable 2.5mm PLLA plates (front of spine) and special suture tapes (polystyrene polyethylene braided suture) for back of spine to allow for growth while maintain motion of neck”, said AIIMS Doctor. The child currently interacts well with parents, feeding well and has shown partial neurological recovery in his limb movements after surgery, said the hospital.
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