It all started in September 2021 when a man fell on his back and injured his spine. He had severe pains in the cervical and thoracic spine. A day later, he called an ambulance and was hospitalized in a local hospital. Four weeks after treatment, his condition improved, the intensity and frequency of the pain decreased.
However, three months later after physical exertion (carrying weight on the shoulders), the patient experienced acute pain radiating throughout the back and encircling numbness from the armpits to the groin. He did not seek medical help but applied anti-inflammatory ointments.
“Somewhere in early January 2022, I developed numbness and weakness in my right leg. I went to see a local physician. After the prescribed treatment, my condition only worsened – numbness appeared in the second leg, weakness increased and there appeared spasms on the right side. I even had to use a cane to walk,” the patient recalls.
Conservative therapy was attempted unsuccessfully, and after several months the weakness in the legs increased. After a cervical MRI in March 2022, the patient was hospitalized at the Syktyvkar City Hospital where he was treated for two months. Doctors performed the only possible surgery under these conditions – they installed the spinal stabilizing system (a metal structure), and the dislocation of the 7th cervical vertebra was reduced. This was not enough, since cervical spinal stenosis persisted with spinal cord compression. Then the doctors at the Syktyvkar hospital turned to their colleagues in St. Petersburg for help. Having assessed the situation, the doctors at Almazov Centre requested an urgent transfer for the patient to Polenov Neurosurgical Institute and the patient was taken to St. Petersburg by air ambulance.
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| MRI before surgery | CT before surgery |
“The patient was admitted with complaints of limited mobility in the lower extremities, reduced sensitivity below the level of the armpit. He experienced periodic interscapular pain and was practically unable to move on his own,” recalls Prof. Konstantin Samochernykh, Director of Polenov Neurosurgical Institute.
At Almazov Centre, the patient was diagnosed with an old complicated bilateral locked dislocation of the C7 vertebra with spinal fusion in the malunion. The surgical team (Head of Neurosurgery Department Alexander Nazarov and neurosurgeon Andrey Kudziev) performed a complex three-stage surgery, which made it possible to restore the integrity of the spinal column while maintaining all functions of the spinal cord. The surgery involved multiplanar repositioning of the C7 vertebra and axial correction of the spine in the sagittal and frontal planes. Combined single-stage circular spondylosynthesis of c5-c6-th2-th3 vertebrae.
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| MRI after surgery | CT after surgery |
“A special feature of the surgical treatment was that we had to perform three stages in one single surgical procedure. During the first stage, the old metal structure was removed, then the patient was turned over to a prone position and decompression, reduction of the dislocation and stabilization were performed from behind. At the end, the patient was turned back to supine and the anterior sections of the spinal column were stabilized via anterior approach,” comments Alexander Nazarov.
Thanks to the professionalism of doctors at Polenov Neurosurgical Institute, the patient was able to get out of bed the very next day after surgery. Currently, he can walk on his own and is getting better every day.