Pioneering surgery gets Irene walking

16 August 2007 - Just three weeks ago, Irene Godier was doubled over in excruciating pain and faced almost certain paralysis or even death because of the crippling damage to her spine.

Yet today the 79-year-old is able to walk in her garden with a smile, thanks to a Norfolk surgeon whom she describes as “a quite extraordinary man”.

Consultant orthopaedic surgeon Am Rai used a pioneering technique that he had gradually developed with his team at the Norfolk and Norwich University Hospital and rebuilt her spine using an expanding titanium cage.

The four-hour operation, which he believes is not undertaken anywhere else in the country, was Mrs Godier's only hope after a scan in May revealed that a vertebra in the small of her back had shattered and crumbled away due to the brittleness caused by osteoporosis.

The future looked bleak, with shards of broken bone pushing dangerously close to her spinal nerves and likely to lead to paralysis in her legs, problems with her bladder and bowel and ultimately death - but, instead, Mrs Godier was able to get back on her feet within two days of surgery.

“The x-rays showed she had broken her vertebra in the lumbar region - this is common in elderly people because the bone is very soft and weak so occasionally sneezing or coughing or a minor fall can cause a fracture,” said Mr Rai.

“She had a scan which showed that the broken fragments of bone were causing a pressure on the spinal nerves.

“This is quite a dangerous situation - the risk of paralysis is great and walking with crutches would damage the vertebrae further by walking about and pushing the bone in to the space which the spinal nerves would occupy.”

Usually, the major surgery would be more invasive, take 10 hours and involve months in hospital, but Mrs Godier had a comparatively rapid recovery.

“This sort of operation would normally mean making two incisions, one from the back and one in to the abdomen, but people are in hospital for months afterwards where as Mrs Godier had the operation and was mobile within 48 hours,” he said.

“This procedure can also help people with cancer of the spine and infection of the spine, and it's slowly been developed over a period of four years.

“It's a very expensive piece of metal but it has helped her discharge within 10 days and let her carry on with her life.”

Mr Rai said he will write a series about the technique, which he believes will be taken up at other hospitals.

“Surgery is getting more and more complex but we can offer a lot more and get the patient up and about and out of hospital much quicker.

“If you go back 10 years this patient would have been in hospital for months.”

Mrs Godier is now recuperating at home in Norwich and hopes to one day be rid of her crutches and visit her daughter in Antigua next year with her husband, Alec.

“I was a very active woman and knew I would never be the same again, whereas now I am walking around and feel a damn sight better than I was before the operation because I was screaming out in pain whenever I took a step,” she said.

“I think Mr Rai is quite an extraordinary man; to me I think that he's God brought down to earth.

“Obviously I'm extremely grateful to him, he has given me a new lease of life and as soon as I am able I will take him a big bottle of champagne.”

THE OPERATION

Mr Rai and his team fixed screws to healthy vertebrae, which were connected by rods above and below the fracture in Mrs Godier's spine.

They then took out the broken vertebra through an incision in her back and, using this same opening, placed the expanding titanium cage in the gap to support her weight.

“We put the cage in to the front of the vertebra through a very small space that's probably about two centimetres across, without touching or damaging the nerves,” said Mr Rai. “If you do, the patient is going to be paralysed.”

Source: http://new.edp24.co.uk/content/news/story.aspx?brand=EDPOnline&category=News&tBrand=edponline&tCategory=news&itemid=NOED16%20Aug%202007%2008%3A12%3A35%3A470