A state-of-the-art procedure performed by neurosurgeons at Fortis Hospital, Bannerghatta Road, Bengaluru, has offered a new lease of life to a bomb blast survivor from Yemen. The young man had lost his right leg and had been enduring phantom limb pain.
Phantom limbic pain occurs when the brain misreads signals, maintaining sensations from the amputated limb Dr Raghuram G, additional director of Neurosurgery at Fortis Hospital, Bannerghatta Road, explains that this creates an illusory sensation of the limb’s presence, leading to pain.
As the brain generates the illusion of causing pain it’s called phantom limbic pain, managing it proves challenging even with pain management methods.
Twenty-two-year-old Yasseer, 22, had survived a bomb blast and had been wheelchair-bound for the past two years. “The boy was in severe pain, unable to cope with his day-to-day activities; no pain medications or spinal injections helped ease the pain; he was out of options when he reached us,” Dr Raghuram told Happiest Health.
He added that the man was extremely sensitive even to a draught of air and would not let the doctors examine him initially.
Correcting the misread messages
When pain medications failed to numb the sensation, Dr Raghuram and his team adopted a technique called surgical neuromodulation. The main goal was to modify the brain’s misread signals from the brain and help the brain relearn that the limb no longer exists, explains Dr Raghuram.
In neuromodulation, the impulses of neurons are altered or modified by external electrical stimulation. Since the pain was localised to a particular region, the surgeons anatomically identified the nerves in the spinal cord that were causing the phantom pain, and electrically stimulated the nerves in the lumbar region of the spinal cord during the procedure.
A procedure that made the difference
The electrical stimulation was done with the help of a spinal cord stimulator, where thin electrodes (wires) were placed in specific regions identified for pain by neurosurgeons. The external stimulus from the battery (pacemaker) masked the pain signals from the brain. A trial surgery was first conducted to make sure of its effectiveness, followed by a permanent surgery within a week.
The procedure helped Yasseer overcome his touch sensitivity and gave him significant relief from pain. According to Dr Raghuram, the young man was so sensitive to touch that he would not let anyone touch the amputated limb; however, a week after the procedure, Yasseer’s condition significantly improved. He is now all set to get prosthetics for his lost limb and start a new chapter of his life.
