Rohit Shishodia

A 32-year-old man got a new lease of life at a local hospital in Delhi where he was treated for Basilar invagination, a rare condition in which the top of the spine pushes into the base of the skull causing pinching and pressing on the brain stem which is the thick bundle of nerves connecting the brain to the spinal cord.

This rare condition can cause an opening in the skull where the spinal cord passes through to the brain to close, and its prevalence in the general population is estimated to be 1%.

This patient underwent a challenging surgery which is called Distraction, Compression, Extension, and Reduction (DCER).

The two-hour complex surgery was done to realign and treat basilar invagination.

The patient visited the hospital with complaints of severe occipital headache and neck pain.

He was also not able to walk properly and progressively his hand grip was becoming weak and was evaluated with a CT scan and MRI where it was found to be a case of basilar invagination.

According to the hospital statement, to increase the volume of the skull base, the process of compression and extraction was conducted by removing the base of the skull and decompressing the spinal cord.

A spacer/cage was inserted between the C1 and the C2 joint (first and second section) of the spine.

The hospital claimed that after the surgery, the patient was able to walk independently right on the first day and the numbness and tightness of the hand also improved.

It added that any complication would have made the patient ventilator-dependent and caused internal bleeding.

The CT scan after six months of the surgery revealed satisfactory decompression of the spinal cord and correction in the basilar invagination.

“We are extremely delighted to see the quick recovery of the patient and he was able to be discharged on the third-day post-operation. This case was extremely tricky and required an experienced hand and we were only able to save him because of the skill and proficiency displayed by us as a team,” HOD and Consultant of Spine Surgery of Manipal Hospitals, Dr. Saurabh Verma said.