A 43-yr-old male arrived in emergency medicine of Columbia Asia Hospital, Hebbal with knife stuck to the nape of the neck. The surgery was challenging as the doctors had to operate in the position the patient arrived, without any upper body movements and neck manipulations due to spinal cord injury. Usually, anesthesia is administered in the supine position, however in this case it was administered in the same position as the patient arrived. After a 3-hour operation, the patient was shifted to the ICU for further observation and is now recovering at the hospital.
September 14th was like just another day for 43-year-old Rage Venkata Ram Prasad of Ananthapur. Little did he know that he will never be able to forget that fateful day ever in his life. At around 1 p.m. in the afternoon when Prasad was returning from court, near the coca cola godown, he was suddenly attacked by someone with a knife.
The attacker who himself was on a two-wheeler, attacked Prasad who was riding his motorbike on his way back home. The sharp knife hit Prasad’s nape, damaging the spinal cord with a splurge of blood. Till the time police reached at the crime scene, Prasad laid unconscious on the road covered in a pool of blood.
Police immediately rushed him to a nearby hospital, and later shifted him to Columbia Asia Hospital, Hebbal for multi-specialty care, where he underwent emergency surgery on the same night of the incident.
No neurosurgeon would have witnessed such a case where knife has entered to spinal cord spliting it into two in the neck.
“The patient was brought to the hospital with knife intact in his neck. The CT scan revealed that the knife had pierced into the spinal cord in the neck. In this situation, administrating anesthesia was difficult as patient had to be turned on to the supine position. We decided and went ahead giving anesthesia in the position which he arrived.” explained Dr. Prasanna, Consultant – anesthesiologist, Columbia Asia Hospital, Hebbal.
“Once the anesthesia was given, the next challenge was to position him for surgery, which needs manipulation of patient and his neck. We made sure that the complete surgery was done without any movements of the neck, and was done in the same position the patient arrived, without any upper body movements and neck manipulations due to spinal cord injury. He had also suffered left hand paralyses due to the injury,” said Dr. Avinash K M, Consultant – Neurosurgery, Columbia Asia Hospital, Hebbal.
“Patient is a miraculous man to have survived and able to walk with the nature of spinal cord injury,” added Dr Avinash KM
“Usual prognosis in such cases is not good. Most of the time patient will be paralytic. In this case because he underwent both anaesthesia and surgery without any manipulation of the neck he has recovered well and able to move his limbs,” he added.
“Patient is doing fine. He is extubated and breathing and talking well. He is moving hands and legs well.He is able to walk now. Prognosis is good,” said Dr Prasanna.