Case Study: Cure after 25 years of Suffering-Microsurgical procedure on the spine

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Mr. Anandan, 50 year old man, sustained a crush belt injury in 1988 while he was working in the Gulf. He was diagnosed with complete Brachial Plexus Avulsion injury. He was operated in 1990 on his arm with no improvement in function. Pain in the whole of the right upper limb has been steadily increasing since then. In the last 10 years, he has severe right-hand pain which is stabbing, electric shock-like and burning, which occurs daily. It is the worst kind of pain anyone could have. He had consulted several doctors in the last 15 years and had all possible allopathic and nature treatment with no improvement. After meeting Dr. G. Balamurali at Kauvery Spine Centre, Kauvery Hospital, he was operated on 3rd of August. There are several hundreds of patients with such injuries without a proper cure to offer. Most common causes of such injury are road accidents and fall from heights. 25% of patients with this injury develop severe pain in the whole limb. The pain is typically burning, stabbing, pricking, electric shock like, sharp and continuous. The pain can get worse as times goes on and some patients commit suicide not able to cope with pain. Pain can be aggravated just by talking, movement of body, breeze from the fan, noise from the surroundings and water during bath. They cannot talk to anyone, don’t go out and cannot lead a normal family life. Some patients are house bound for like 15-20 years and have serious psychological issues. They lose their job and get isolated from their family, children, and friends. This is one of the worst conditions to have. That’s why the rate of suicide is as high as 75%. Medical treatment includes high doses of sedative and neuropathic drugs but this makes them drowsy and sleepy, day and night and the medications are very expensive too. Many patients discontinue medicines due to severe side effects. Mr. Anandhan was on a lot of drugs with no relief from pain since 1989. He had a very poor quality of life and has contemplated suicide several times. The support from his family was the only thing that kept him alive.

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On the 3rd of August, Mr. Anandhan underwent a DREZ (Dorsal Root Entry Zone) Rhizotomy procedure. This is a microsurgical procedure on the spinal cord that involves mapping the spinal cord with intraoperative neuromonitoring and identifying the areas where there is nerve damage in the spinal cord and making multiple lesions at a very specific area to remove the pain source. This is a technically demanding surgery. Serious side effects like paralysis is possible if the procedure is not done by adequately trained persons. A team comprising an Anaesthetist, Neurologist and Neurosurgeons performed this procedure for about 8 to 10 hours.

Following surgery, Mr. Anandhan is now 100% pain-free. This is the first time he has slept without pain after 25 years of severe suffering. He and his family are overjoyed about the outcome. He wants to spend time with his children, which he has missed all these years. He has a lot of ambitions to fulfil which he never thought he could do in his life.

Dr. G Balamurali, an internationally trained Neuro-Spine surgeon, performs surgical procedures in the spinal cord. These surgeries are performed by only a few surgeons in India and by no one else in Chennai. He has treated about 13 patients in the last 5 years with more than 90% success in relieving pain.

Conditions like spinal cord injury, cancer pain, and cerebral palsy can all be treated in a similar manner. Kauvery hospital is fully equipped to perform such procedures with the help of the latest technology.

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Case study by Dr. G. Balamurali, MBBS, MRCS(Ed), MD(UK), FRCS (Neurosurgery)
Lead Consultant Spine & Neurosurgeon
Kauvery Hospital