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HCG Cancer Centre Borivali Successfully initiates D Wave Spinal Neuro-Monitoring technique

Patient with a rare Nasal Tumor

Mumbai

Harshali (name changed),18 years was brought to HCG Cancer Centre, Borivali with difficulty in walking. She was bed-ridden for almost a month and half and without proper intervention her future was bound to be on a wheelchair. After consulting multiple hospitals, she was referred to Dr. Mohinish Bhatjiwale, a renowned and one of the best neurological surgeons in the country by a family friend. Under his supervision a thorough examination of the patient was done and an MRI scan revealed the young girl had been suffering from a spinal cord tumour.

After lot of proper investigation, decision to surgically remove the tumour, was made. It should be noted that the middle portion of spinal cord is the most sensitive part and could be easily damaged during surgery. In Harshali’ s case, the tumor was occupying almost 90% of the spinal cord. There was just 10 % of spinal cord remaining. This posed a serious challenge as any small mistake during the surgery could make her immobile and handicapped for life which is a known complication in such surgeries. Dr. Bhatjiwale and team decided to get Harshali operated while all the time monitoring the signals in the spinal cord using a special electrode, the D wave monitoring technique. In this the signals are recorded directly from the spinal cord and detect any deviation in the surgery thereby guiding the surgeon and avoiding damage to normal spinal cord structures.

While intraoperative neuro-monitoring is generally done during surgeries, Dr. Mohinish Bhatjiwale, Consultant Neurological and Spine Surgeon, HCG Cancer Centre Borivali opines that, “The method of directly recording waves with an electrode placed over the spinal cord, for spine surgery is done for the first time in Mumbai. Any interruption created by surgery is immediately picked up by the electrode thus warning the surgeon to stop operating in that direction. Signals help the surgeon avoid touching sensitive nerves during the surgery. This approach, used for the first time for a spine surgery in Mumbai, was taken keeping in mind the sensitivity involved as well as the patient’s condition.”

From a possible wheelchair bound future, Harshali is currently responding well to the treatment. With successful D wave monitoring, the patient’s lower limb power and bowel bladder function were saved, and a significant handicap was averted. The young girl, Harshali is recovering well and speedily from the weakness that afflicted her lower limbs and is on the road to normalcy. She is now able to walk, after nearly a month and a half of being bedridden.

Speaking about her pre and post treatment conditions, Harshali’ s Father said, “From a hopelessly crippling situation a few days ago our daughter is now on the road to recovery. She has been suffering from this ailment for a long time. If not for this surgery, she wouldn’t have been able to walk again. I express my sincere gratitude to Dr. Bhatjiwale and all the doctors and staff who treated our daughter at HCG Hospital, following all the protocols during the pandemic. They made the stay safe inspite of the covid situation. Their efforts have given a new lease of life for our entire family and we are happy to see our daughter on the road to leading a normal life.”

A multidisciplinary team of specialists consisting of medical oncologists, surgical oncologist, pathologists, radiologists, and anesthetists provided optimal and supportive care to the patient. In this tough Covid times, the limitation of logistic & manpower could not affect the team morale at HCG Cancer Centre Borivali.