New Delhi: HCMCT Manipal Hospital, Dwarka- a multi-specialty facility- successfully performed surgery on a 32-year-old male patient suffering from Basilar invagination, which is caused by a congenital anomaly (birth defect). The patient was presented to us 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. He was evaluated with a CT scan and MRI where it was found to be a case of Basilar invagination. It is a condition in which the vertebrae migrate upwards resulting in the folding of the base of the skull.

In order to realign and treat Basilar invagination, a technique called DCER (Distraction, Compression, Extension, and Reduction) was used. 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.

After the 2 hours of surgery, the patient was able to walk independently right on the first day and the numbness and tightness of the hand also improved. This case was considered to be a very challenging and rare as any complication would have made the patient ventilator dependent and caused internal bleeding. The CT scan after 6 months of the surgery revealed satisfactory decompression of the spinal cord and correction in the Basilar Invagination.

Basilar invagination is 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 condition usually occurs at a later stage in the middle age group population and can be a result of an injury or diseases (congenital anomalies in this case.) The symptoms of this condition can be as common as neck pain which is generally overlooked leading to fatal consequences.

Adding to this Dr. Saurabh Verma, HOD and Consultant of Spine Surgery said, “We are extremely delighted to see the quick recovery of the patient and he was able to be discharged on the 3rd 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.”

While talking about the case, Dr. Hamza Shaikh, Associate Consultant in Spine Surgery said, “We are happy to have successfully given another patient a new lease of life. Congratulations to the team for successfully dealing with this rare case.  Armed with the correct knowledge, expertise, technology, and infrastructure we can make way for medical breakthroughs.”