Groundbreaking spinal surgery performed

The world’s top spine surgeons recently performed groundbreaking spinal surgery on a 14-year-old girl with a rare case of congenital scoliosis at the Asian Medical Center.

Dr. Rolando Puno, orthopedic spine surgeon and professor at the University of Louisville in Kentucky, USA, headed the team, along with Drs. Noriaki Kawakami and Taichi Tsuji of Meijo Hospital in Nagoya, Japan; Filipino surgeons Dr. Jose Paiso of Asian Hospital and Medical Center; and Drs. Jose Ignacio and Eric Legaspi of the University of the Philippines-Philippine General Hospital.

The patient, Maria Eliniesa Lucas or Cayen, was born with congenital scoliosis, a condition that is painful and leads to progressive severe spinal deformity, in turn causing her to have only 40 percent lung function. She had to stop her schooling because of her physical difficulties.

While her spinal curvature of 126 degrees was alarmingly bad, her case was more unique and complicated due to the fact that her spinal cord protruded outside the confines of the spinal column into the chest cavity, medically known as "anterior myelomeningocoele."

Being one of six children whose parents are both deceased, Cayen had no financial resources to obtain treatment. When Puno presented her case to major spine symposia in the United States, he also found out that no other doctor had dealt with a similar case, except for Kawakami, who had done one such case in Nagoya, Japan.

Because of the rarity and severity of her condition, Puno initially tried to bring Cayen to the US to have her operation. But he was unable to find a sponsoring organization for a non-US citizen. After nearly a year, the attempts to find resources both here and abroad began to yield results.

Medtronic Corp. agreed to provide the spinal implants, the spinal cord monitoring equipment and the personnel needed to do the surgery. Brain Lab Corp. agreed to provide the intra-operative navigation system.

Kawakami and his assistant, Tsuji, agreed to travel to Manila to help with the surgery. Finally, Asian Hospital and Medical Center, in conjunction with the Asian Hospital Charities Inc., provided funding for Cayen’s entire hospitalization.

Cayen was admitted to the Asian Hospital six weeks before the scheduled date of surgery, for traction and intensive physical and pulmonary therapy. The attention given to her by the medical, nursing, physical therapy and other ancillary staff of the Asian Hospital helped in greatly improving her chances for a safe and successful operation.

The extremely delicate 12-hour surgery required two operations: one at the front and one at the back portion of the spine. Two metallic rods were implanted to correct, stabilize and fuse her spine without harming her ability to move.

Thanks to the collaboration of the international and local team of surgeons, anesthesiologists, operating room staff, pulmonologists, radiologists, intensive care specialists and physiatrists, Cayen recovered quickly after her surgery and was discharged after only one week from the Asian Hospital.

"The operation was very successful and her deformity is now down 82 degrees. Her recovery is also very impressive and we will monitor her progress so her spine fuses in six months," said Paiso, her attending physician and the section head of Spinal Surgery at the Asian Hospital.

"I can now breathe without any difficulty. I can feel that my head is now centered and balanced. My doctors told me that through continuous therapy like walking on a treadmill, riding a stationary bike, or plain 30-minute walking, this could help me improve my condition more," said Cayen.

Cayen’s surgeons are confident that she may return to school next year and to start life anew. "We are very happy to be able to help this young girl achieve a normal life again. We are also proud to be the first to successfully perform this procedure in the country, and we’re hoping to help more people survive and restore their quality of life," Puno said.