Fortis Hospital doctors treat pregnant woman suffering from spinal TB, paralysis

New Delhi: In what can be termed as a medical miracle, Fortis Shalimar Bagh reported a significant medical achievement with the treatment of a 28-year-old pregnant woman suffering from spinal tuberculosis and paralysis for seven months. 

This was a very challenging and rare case. The patient was pregnant and was suffering from pain in her back for four months. Initially, the patient thought it to be pregnancy related pain, thus did not give much importance to it, but later that is the 6th month of her pregnancy, the patient developed weakness in both her legs and within 20 days both her legs were completely paralysed and she was bed-ridden.

The patient was also unable to pass urine, necessitating a catheter. This is when the patient came to Fortis Hospital Shalimar Bagh and was diagnosed as spinal tuberculosis on MRI.

Urgent surgery was required to alleviate the pressure and stabilize her spine. The surgical procedure was complex due to her pregnancy, the doctors had to make her lie down in such a way that no pressure was exerted on the abdomen/foetus. Unable to use traditional spinal fixation methods, as the doctors could not put screws to fix the unstable spine, due to pregnancy-related X-ray restrictions, mandatory for inserting screws (intervertebral titanium cage), surgeons opted for a temporary wire fixation. Additionally, the anaesthesia was carefully managed to be safe for both mother and baby.

Despite her condition, the patient remained hopeful and bed-ridden until the delivery of a healthy baby via C-section. Post-delivery, after 15 days, an MRI revealed severe spinal cord swelling, unstable collapsed spine with spinal cord compression. To address this, another surgery was conducted through the side of her lung to remove tuberculosis tissue and stabilize the spine, involving the placement of a cage and screws to bridge the vertebral gap.

Three months after her surgery, the patient showed no leg movement, prompting a repeat MRI that revealed ongoing spinal cord swelling. Despite the challenging prognosis, she and her husband remained optimistic. They persisted with regular physiotherapy and continued tuberculosis treatment. This perseverance paid off, as her condition improved over a period of time. 9 months into her TB treatment, she started walking, and after completing an 18-month course of treatment, she fully regained her mobility.

Giving details of the case, Dr. Sonal Gupta, Director & HOD Neurosurgery, Fortis Hospital Shalimar Bagh said “This is rarest of rare case in medical history, where a patient suffering from paralysis could be cured even after 7 months of zero movement in legs. TB spine in pregnancy is not very rare, but to become completely paraplegic and remain paraplegic for 7 months and then make 100% recovery is what is rare and that is what is miraculous.”

Dr Sonal added “Survival of the baby was a challenge because of severe abdominal spasms due to spinal cord compression. Additionally, the surgery could not be completed in one go as there was radiation risk to the foetus.

However, with a never give up attitude, supportive family and correct medical intervention, the patient is now free of tuberculosis and is leading a normal life. The prognosis for spinal tuberculosis is improved by early diagnosis and rapid intervention. If the patient was not treated on time, she would have been remained bed-ridden and wheel chair bound for rest of her life.”

Deepak Narang, Facility Director, Fortis Hospital Shalimar Bagh said, “This is a case of medical excellence which allowed for a successful outcome in the patient’s condition where recovery is usually not possible. This case required a multi-disciplinary and well-curated approach, considering the critical condition of the patient. Despite all the odds, correct assessment and line of treatment by a multi-discrepancy team of doctors- Dr Sonal Gupta, Director & HOD Neurosurgery, Dr. Sunita Varma, Director Obstetrics & Gynaecology,

Dr Pradeep Kumar Jain, Principal Director & HOD - LAP GI, GI ONCO, Bariatric & MIS Surgery and Dr Umesh Deshmukh, Director & HOD Anaesthesiology could not only save the patient, but also helped her deliver a healthy baby. Clinical expertise to handle such critical cases with best-in-class emergency care are the hallmarks of Fortis Hospital Shalimar Bagh, and we continuously endeavour to provide highest level of care to save lives and get improved outcomes.”