Doctors at Fortis Hospital Shalimar Bagh recently performed an intensive surgery on a 22-year-old patient, removing the world’s largest recorded spinal ependymoma tumor (37.4 centimeters). The largest known spinal ependymoma tumor recorded till date has been of 28 centimeters, in this case however it was 9 centimeters larger. A team of doctors led By Dr Sonal Gupta, Neuro and Spine Surgery; Shalimar Bagh performed the complex, high-risk demanding surgery over 12 hours, successfully removing the tumor.

The patient presented with persistent back pain (which had been previously treated with medicines and physiotherapy) for more than one and half years. She had developed recent onset weakness in both legs (which was making it difficult for her to walk). MRI revealed an unpleasant surprise of a large spinal tumor, which was extending across 14 vertebral columns, from the center of the patients back to the end of her lower back.

Dr Sonal Gupta, Director, Neuro and Spine Surgery, Fortis Hospital, Shalimar Bagh, said, “It was a very high-risk case as it involved many segments. The surgery had to be done on the spinal cord which comprises many nerves, so there was a chance for the patient to be bed ridden for the rest of her life. Another challenge was that since the location was within the spinal canal. We had to remove the bone at 14 levels, which could have caused the patient to develop instability of the spine. Therefore, our approach involved opening the spine (open door laminoplasty) through drilling and fixing it back with plates. The bone pieces were fixed back with plates instead of nibbling of the bone. Had we done a fixation of 14 levels of spine, she would have developed a rigid back, making it difficult for her to bend forward for the rest of her life.”

She added, “During the surgery, we used an advanced form of electrophysiology monitoring, which meant that if we touched a nerve during surgery, the machine beeped. This helped us in removing the tumor gently without damaging the nerve tissues. We began the surgery at 8 am in the morning and it continued till 8 pm. On the 11th day after the surgery, the patient is walking with support and is under a vigorous neuro-rehabilitation programme.  She will require regular neuro rehabilitation and follow up imaging to keep an eye on recurrence of the tumor.  Such success has been possible due to a great team support of entire neurosurgery dept, Anesthesia dept., dedicated neuro ICU critical care team and most important neuro rehabilitation team.

Mr Mahipal Bhanot, Zonal Director, Fortis Hospital, Shalimar Bagh, said, “Fortis Hospital Shalimar Bagh approaches every case in a manner which is beneficial for the patient. Our doctors remain committed to treating every patient despite complications.  This case involved high risks and therefore, needed to be approached in a manner of precision, I am glad that this was done successfully. I congratulate the team of doctors for their commitment to world class patient care and treatment.”