Guyana leading the way in Vault C spinal implant surgery

DPI, Guyana, Thursday, March 1, 2018

Guyana has become the first country in South America to perform a Vault C Anterior Cervical Discectomy and Fusion System (ACDF) implant surgery successfully, twice.  The surgeries which were performed by Guyana’s leading Neurosurgeon Dr. Amarnauth Dukhi at two separate private institutions gave two patients the ability to utilise their motor skill are being partially and fully paralyzed.

Post ACDF with double implants on the 51-year-old patient.

According to Carlo Koren, President of Innovation Medical Technologies Incorporated, Guyana is the only country in the South American continent to perform the procedure. Innovation Medical Technologies is the South American distributor of the titanium plate, which is manufactured by Precision Spine, a US-based company that was used in the surgery,

Speaking with the Department of Public Information (DPI), Dr. Dukhi explained that both patients ages 51 and 65 suffered from spinal injuries due to separate motor vehicular accidents which left them bedridden and paralyzed.

Dr. Dukhi said, in the case of the 51-year-old male a double implant was performed and prior to the surgery the patient experienced severe weakness in the upper and lower limbs, difficulty walking and limited or no function of the arms. While, in the case of the 61-year-old male, the patient suffered a motor vehicular accident in December 2017 in the interior which left him completely paralyzed.

However, post-ACDF implant, he was able to recover movement of the upper limbs and is currently under rehabilitation of the lower limbs. His surgery was done five days after the incident.

In explaining the technical procedure, the Surgeon said, “a small incision is done on the neck, where you have to go from the anterior approach through the skin, then you separate the trachea, the oesophagus to one side and then all the vessels and the nerves to the other side. You go through all those structures through the neck to the spine. When you get to the spine then you have to prepare it; after preparation – the traumatic disc that has migrated and compressing the cord will be removed.”

Dr. Dukhi continued, “So you decompress the cord by removing that disc and now [in] that space that is left empty, the implants are placed. It is fixated into that spacing so you reconstruct and realign the spine using implants, then it is fixed by utilising the screws.”

Head of Neurosurgery of GPHC, Dr. Amarnauth Dukhi.

He noted that surgery of this nature is a very complex procedure that has a limited timeline in order to yield successful results.

“This type of surgery depends on how quickly you get the patient. This surgery will not change the prognosis in patients who are paralysed for a prolonged period and surgeries delayed for long periods. If there is hope, the correct thing to do is immediate surgery. If the spinal cord is damaged, there is also no point for surgery. Timing is critical,” he stressed.

Dr. Dukhi also revealed that in a move to further enhance Neurosurgery in Guyana; four doctors are presently being trained in Neurology at the Georgetown Public Hospital Corporation (GPHC). He is also collaborating with Professor Ivor Crandon from Jamaica to design a “University of Guyana/University of the West Indies” programme to train local doctors at a post-graduate level. Dr. Dukhi is optimistic it will be ready in less than a year

According to the surgeon, Guyana has much to look forward to as neurosurgery advances.

“Vascular neurosurgical procedures is the peak of neurosurgery, it takes a lot of technology, instruments, human resource capacity to develop that and that by itself is very costly, so we would have to have the political willpower, build our own human resource capacity in terms of training more doctors in neurosurgery, so we can facilitate these type of surgery in the future and I have no doubt we would get there. We are working towards that, we are now almost into the minimally invasive neurosurgical procedure. We were able to source through the government a neuroendoscope and tower, where sooner or later we would be able to start up procedures so that babies do not have to have open shunting surgeries for hydrocephalus.”

However, he opined that Guyana still has a way to go but with the support of government and other stakeholders, the country can be a leader for medical treatment in the future.

Immediately after surgery. The picture illustrates post-ACDF spinal implant on the 51-year-old patient done in Guyana.

“Prior to 2015, there was nothing neurosurgical in Guyana. Neurosurgical capacity was nil. I think we would have gone a long way to where we are now in building a Department of Neurosurgery at the Georgetown Public Hospital Corporation, where we are now able to offer surgeries for brain tumours among others, where persons previously would have had to go overseas.”

One of the patients who benefitted from the breakthrough surgery told this publication, he is thankful and proud that the surgery was done right here in Guyana.

The 51-year-old, father of four who hails from Foulis, East Coast Demerara was the second person to undergo the surgery on February 3, 2018.

“I had about three accidents with the last one in the US in December last year and I used to feel numbness in various parts of my body with severe pain which caused me to walk with a limp and due to the pain, I went to get local massage which made it worse. When I went to the doctor, I was told to get an MRI. I was later told my case was rare but there was hope.  After agreeing to have it done locally I realized it was the best thing I ever did because I can now walk and do all the things that were not possible before surgery. I still have physical therapy, but I am very thankful to Dr. Dukhi.”

Dr. Amarnauth Dukhi has been transforming Neurosurgical procedures in Guyana since 2015 and has successfully completed over 450 surgeries, giving patients a second chance at a normal life.

 

By: Nafeeza Yahya

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