An advanced spinal surgery performed by a team of doctors from Fortis Hospital, Bannerghatta Road, Bengaluru, has given a new lease of life to a French woman affected by a progressive neurological condition called atypical Parkinson’s.
The surgery, called high cervical spinal cord stimulation, is not new but is the first of its kind in India, the doctors say. It offers a new hope in treating the condition which mimics the symptoms of Parkinson’s but is distinct from it.
Atypical Parkinson’s, also called the Parkinson’s plus syndrome, is a rapidly progressive condition that is caused by the degeneration of neurons in parts of the brain. Treating it is particularly challenging as the condition does not respond well to conventional Parkinson’s treatments such as deep brain stimulation, which are otherwise effective.
The surgery team was led by Dr Raghuram G, additional director of neurosurgery, and Dr Guruprasad Hosurkar, additional director, neurology.
The affected person, identified as Mary, 65, had tried several treatments in different countries but did not get any relief. Her movements were severely affected, confining her to a wheelchair. She had impaired speech, difficulty swallowing, depression and could not control her bladder.
After thoroughly examining her, the Fortis team of doctors diagnosed her condition as atypical Parkinsonism, specifically known as mild multiple system atrophy. It decided to perform the spinal stimulation procedure for relief. Before that the doctors performed a trial procedure to evaluate Mary’s response.
Promising results
Mary was discharged ten days after the surgery. With neurorehabilitation she improved remarkably, Dr Raghuram said. After about four months, she could walk with minimal support, her pain reduced, and she regained bladder control. The doctors say the surgery has given the woman a new lease of life.
Dr Raghuram told Happiest Health, “High cervical spine stimulation is not new. It is being used abroad for effective pain management. Several research papers have been published on its efficiency in improving the quality of life [of affected persons].”
A procedure with a difference
In the surgical procedure, the doctors placed thin electrodes along specific regions in the spine to stimulate the lost nerve action. The high cervical spinal cord stimulators acted as remote controls – sending tiny electrical impulses to neurons that were either not communicating or miscommunicating. The procedure helped reduce pain, tremors and muscle rigidity and improved movement in atypical Parkinson’s.
Spinal stimulation involves placing thin electrodes (wires) in the epidural – the space between the spinal cord and vertebral column. “Unlike deep brain stimulation, here, the electrode is placed within the space of the vertebrae and spinal cord rather than deep inside the brain tissue,” according to Dr Raghuram.
An external battery provides the electrical impulses through these wires. In this case, once the trial was successful, the thin wires were placed along the spinal cord and the battery was permanently placed under the skin.
Cervical spinal stimulation is used in other conditions to treat pain after an injury in the nerves, severe radicular pain, post-stroke or post-surgical pain and complex regional pain syndrome. However, “It still cannot be the first therapy for Parkinson’s. The first therapy would still be deep brain stimulation, and cervical spinal cord stimulation would still go as a secondary option, provided the person is eligible,” clarifies Dr Raghuram.
