UAE: Cancer is a serious condition but fortunately rare in human being. 5-30% of patients with cancer will have spinal involvement and only 10% of these patients will develop abnormal signs like back pain or spinal cord and nerve damage, says Dr Seyed Mohsen Mahmoodi, Consultant Orthopedic Surgeon and Medical Director of Thumbay Hospital, Dubai.
A 58 years male who was absolutely healthy, with no past history of significant diseases developed low back pain on second May 2015 without any history of trauma to his back or heavy weight lifting.
He was seen by doctors and medicines were given to control his pain. After three weeks he experienced very severe pain in his back with numbness in both lower limbs. After about two weeks the numbness increased and due to the weakness developed in his legs, he stopped walking.
The patient was admitted to a private hospital and MRI and CT scan were done. He was diagnosed as having metastatic spine tumor with spinal cord compression. Based on the recommendation of his treating physician, the patient was shifted to Thumbay hospital on 12.06.2015 for continuation of care. Because of this rareness, close relation of the disease to the spinal cord and main body nerves, and difficult access to the affected site; the care of such patients requires expertise and experience to be dealt with at referral centers, says Dr. Mahmoodi.
Lower back MRI with contrast showed mass lesion of size 4.7 x 2.9 cm at vertebra L1 causing compression fracture of vertebral body and extension to the back side of the vertebra on the right side. There was extension into spinal canal with displacement of spinal cord to the back side and to the left. MRI upper spine showed two more vertebra developed tumor (T6 and T8). He was operated on 14 June 2015 for removing the affected vertebra L1 along with removing the cancer tissues from inside the spinal canal to release pressure on the spinal cord. The vertebra was replaced by vertebra replacement device. Plate and screws were used to fix spine above and below the affected level, and artificial bone graft was used to help for bone healing.
The patient was kept under care of a multispecialty team consisting of specialists from anesthesia, cardiology, ICU, internal medicine, urology, and physiotherapy before and post surgery care.
We were delighted to see that the same day after operation severe pain in the legs had decreased dramatically and the legs’ movements improved in the following days until he was able to walk with the help of a walker after one week. He was referred to oncologist to treat his cancer disease, added Dr. Mahmoodi.
Dr Seyed Mohsen Mahmoodi is Orthopedic Surgeon, Educator and former Vice Chancellor of National University, Tehran, Iran. He has fellowship of International College of Surgeons (FICS, USA) Orthopedic Surgery board certification from Iran, and has Master of Science in Medical Education from WHO collaboration center and European expert in ozone therapy diploma, from Germany. He has 10 fellowships, advisories and workshops in Australia, Bahrain, Cyprus, Egypt, Germany, Syria, Tunisia, UAE and WHO. Dr. Mahmoodi worked as consultant orthopedic surgeon at Iranian Hospital, Dubai, and later with Dubai Health Authority, before joining as the Medical Director of Thumbay Hospital in Dubai earlier this year.