From fear of quadriplegia to journey of revival at Sun Hospital

Spinal intramedullary tumors at the C5/C6 level are rare. If not treated promptly, the patient may develop neurological complications, causing urinary and bowel disorders, or even permanent disability. This highly difficult surgery, requiring skills and modern equipment, has just been successfully performed at the Sun Hospital.

Mr. T. (46 years old) was admitted to the hospital with prolonged numbness in both arms, progressive weakness in both legs, decreased sensation from the chest down, and bowel disorders. After examination, doctors at Mat Troi Hospital diagnosed and determined that Mr. T. had an intramedullary tumor compressing the spinal cord, which progressed rapidly and severely despite medical treatment for many months prior.

Mr. T. said that at first, the symptoms were just like normal neck-shoulder-nape fatigue. He had been examined and had X-rays in many places since last year but the disease was not detected. When the numbness became worse, he went to the Sun Hospital because he knew that the modern MRI and CT-Scan systems here were all the latest generation equipment. Luckily, the imaging doctors here helped him accurately detect the intramedullary tumor, so that he could have a definitive treatment direction.

Diagnostic images via MRI at Sun Hospital.

According to data published in the journal Neurosurgery Clinics of North America, spinal intramedullary tumors account for only 5–10% of spinal tumors, the most complex group of tumors, and are a rare disease. The disease often progresses silently with vague symptoms such as back pain, neck and shoulder pain, and numbness in the limbs, so it is easily overlooked or misdiagnosed. When the tumor grows large and compresses the spinal cord, the patient may face the risk of quadriplegia, urinary and bowel disorders, and even permanent disability.

Interdisciplinary consultation, chaired by Dr. Nguyen Quang Thang (Director of Mat Troi Hospital), with the participation of the Medical Advisory Council, especially the direct participation in the surgery of Associate Professor, Dr. Ngo Manh Hung, member of the Advisory Council.

“This is a very difficult case, with many potential serious risks such as quadriplegia, respiratory failure requiring prolonged mechanical ventilation or other severe neurological complications. The success of the surgery depends on the close and precise coordination between the surgical team, anesthesiologists and operating room nurses. Mat Troi Hospital will mobilize maximum resources and perform the surgery with the support of the most modern equipment system,” emphasized Dr. Nguyen Quang Thang.

On August 22, the team unanimously decided to perform surgery to open the posterior arch, decompress and remove the tumor. Two major experts in the medical industry directly performed the surgery: Associate Professor, Dr. Ngo Manh Hung - neurosurgeon, former Deputy Director of the Neurosurgery Center of Viet Duc Hospital; Head of the Department of Neurosurgery of the National University of Medicine and Pharmacy Hospital, and Professor, Dr. Nguyen Quoc Kinh - President of the Vietnam Association of Anesthesia and Resuscitation, former Director of the Center for Anesthesia and Surgical Resuscitation of Viet Duc Hospital.

Intramedullary tumor surgery is one of the greatest challenges of modern neurosurgery, requiring absolutely precise microsurgical techniques with state-of-the-art supporting equipment, because the tumor is located right in the spinal cord, the center of motor and sensory control. The surgeon must open the posterior spinal arch, incise the spinal cord at the correct anatomical layer, microsurgically dissect each part of the tumor in a safe plane and absolutely stop microvascular bleeding. Even a small mistake can cause permanent paralysis.

Modern microsurgical systems are used for surgery.

The most modern Zeiss Kinevo 900 microsurgical microscope at the Sun Hospital has been effective, magnifying sharp surgical images, supporting experts in each precise operation in the narrow space of the spinal canal, allowing flexible navigation. The IONM intraoperative nerve monitoring system continuously monitors motor-sensory transmission, warning of the risk of nerve damage during the invasive process, for timely adjustment. The Zeiss Qevo microprobe has an integrated camera, allowing for checking hidden areas, assessing the extent of tumor removal without the need for an additional independent endoscopy system, thereby optimizing the process, shortening the surgical time.

After more than 4 hours, the tumor was maximally dissected. The pathological results determined it was a low-grade Astrocytoma - a type of glioma that grows slowly and has a lower malignancy than other types of tumors.

Associate Professor, Dr. Ngo Manh Hung and his team during surgery for spinal intramedullary tumor.

After recovering from major surgery, Mr. T. is awake, his limbs' movement has improved significantly, he feels well recovered, his numbness in his hands has significantly reduced, and he has started to practice standing and walking with the support of a team of rehabilitation technicians.

“When I knew exactly what my illness was, instead of being confused, I felt relieved because I had finally found the right cause. I was lucky to have discovered it in time, when there was still a chance for surgery and effective treatment. I just want to tell everyone: don't be subjective with unusual symptoms, even the smallest ones, go to the doctor early and choose a reputable hospital and doctor to have the right treatment direction,” Mr. T. shared.

The success of this complex intramedullary tumor surgery not only brings a clear opportunity for recovery for the patient but also affirms the strength of the General Surgery Department - Sun Hospital - where a team of experienced surgeons gathers, along with the support of leading experts from prestigious surgical centers at end-line hospitals such as Viet Duc, Bach Mai, National Children's Hospital, Hanoi Heart Institute... The more complex the surgery, the more opportunities there are to promote the strengths of modern surgical equipment and anesthesia and resuscitation and international standard operating rooms.

Mr. T. practices rehabilitation at the Sun Hospital.

Also a medical unit that currently masters complex cranial neurosurgical techniques, Sun Hospital is gradually affirming itself as a prestigious medical address, converging intelligence, technology and compassion, bringing patients better health, spirit and quality of life. Not only providing patients with the opportunity to be treated with advanced methods, the hospital also focuses on comprehensive mental care, accompanying patients and their families throughout the recovery journey.

Source: https://cand.com.vn/y-te/tu-noi-lo-liet-tu-chi-den-hanh-trinh-hoi-sinh-tai-benh-vien-mat-troi-i780566/