Mumbai: Boy from shelter home undergoes 12-hour surgery for rare spinal defect

Boy from shelter underwent a 12-hour surgery at GT Hospital last month to correct a congenital spinal bone defect. (Representational)

A DECADE after he went missing and two years after the shelter home he lived in initiated efforts to get him treated, Rajesh Ganesh Shinde, now 16, underwent a 12-hour surgery at GT Hospital last month to correct a congenital spinal bone defect that had forced his spine to bend to 90 degrees.

Pratiksha Pratap, superintendent at the Children Shelter Home in Ulhasnagar, said she started looking for treatment options for Rajesh in 2015. “He could not sleep on his back as the spinal bone projected out. He had pain while sitting or getting up,” she said. The home officials first took Rajesh to hospitals in Thane, later to Nair hospital, and then to JJ hospital.

“The surgery was expensive. Several hospitals had no expertise to conduct the surgery, so we had to drop the plan,” Pratap said.

A student of Class X, Rajesh does not remember his parents’ names. “My father has passed away and I don’t know where my mother is,” he said. Records with shelter home show that police had found him injured in a train accident at Thane station and handed him to the child welfare committee. Rajesh was then shifted to the Ulhasnagar shelter home.

Rajesh said the pain worsened after the train accident. This year, following a donation of Rs 80,000 from a private organisation, the shelter home restarted its efforts to treat him.

Orthopaedic surgeon Dr Dheeraj Sonawane of GT Hospital said Rajesh suffers from a condition called kyphosis that could be hereditary, or formed during pregnancy. Doctors claimed such deformity can lead to paralysis if the spine, bent at 90 degrees, affects the nerve bundle running through it.

On October 8, Rajesh was admitted to GT hospital. He had to miss his half-yearly exams. “It used to pain a lot. I remember spending last several years in pain. So, there was no option but to skip exams,” he said.

“There were multiple challenges even during surgery. He could suffer paralysis if the nerves were affected during surgery, or there could be blood loss. We had a very small window to remove the clubbed vertebra in spine and we could not risk touching the cord,” Sonawane said.

A MRI, CT scan and 3D X-ray showed two vertebras in his lower back were fused and bent outward creating a ‘V’ shape in spine. For a straight posture, Rajesh had to force the rest of his spine to bend.

In a 12-hour surgery starting 9 am on October 26, the clubbed vertebra bone was removed. It was covered with a mesh cage and replaced in the spinal column. Before the surgery, doctors consulted US-based Dr Lawrence G Lenke and Singapore-based Dr Gabriel Liu to understand how to approach the spinal bone. The major challenge was to remove the bone without touching the spinal cord.

A neuro-monitor, usually used for brain surgeries, was used and a technician was specially called from Surat to assess whether there was any friction of spinal cord during surgery that could cause paralysis.

“He will be discharged in few days now,” Pratap said, adding that while initial cost of operation was beyond a lakh, the surgery became possible after Rajesh was enrolled in Mahatma Jyotiba Phule Jan Arogya Yojana, the state government’s health insurance scheme for the poor.