A fall from a ladder that caused a serious fracture in his spine could have left a 40-year-old man with a bent neck, if not for the efforts of a surgeon at Jaslok hospital, who not only saved him, but also straightened his neck.

The patient, Ramesh Ushire, who works in a bank and is a resident of Lohoner in Nashik, had undergone a surgery last year after being involved in a motorcycle accident. To complicate matters, he also had a condition called Ankylosing Spondylitis (AS), where the spine becomes stiff and fused over time, causing pain and limited movement. In Ushire’s case, parts of his spine were completely fused to a point that he had a ‘bamboo spine.’ Ushire was rushed in an ambulance from his village in Deola taluka to Pedder Road to the hospital after he fell on August 6. 

Dr Manish Kothari (right) with patient Ramesh Ushire

“If such patients have a fall, fractures are very common and they are extremely painful,” explained Dr Manish Kothari, a consultant spine surgeon at Jaslok, who operated on Ushire last year and also performed the life-saving surgery on August 7 this year. “After the motorcycle accident a year ago, his movement was almost nil,” recalled Ushire’s brother Arvinda. Back then, Aravinda said three surgeries cost the family Rs 12 lakh, but Ushire’s condition had improved and he could perform routine activities.

On August 6, when Ushire fell off a ladder, the family knew where he needed to be rushed. “They sent the reports in advance. He was brought here in an ambulance very carefully,” Dr Kothari said.

Very challenging injury

This time the injury was much more challenging than what Dr Kothari had witnessed. The fracture in this case was such that his spine (at the neck) was bent at almost 90 degrees. “The risk of paralysis was high. His condition was very critical so I asked a lot of my colleagues what they thought should be done. They advised me to just fix his spine as it was because that was the safer option. But that would have left him bent forward at the neck; he would have never been able to look straight,” Dr Kothari said.

The idea of his patient not being able to live a functional life left Dr Kothari uneasy. He decided to go ahead with a risky surgery. It took nine ward-boys and two hours to just delicately turn Ushire into a position where he could be operated on. “One wrong movement while just positioning the patient, even while he was going for the CT scan, could have left him completely paralysed,” Kothari said.

A delicate operation

Ushire was in surgery for four hours. “We used something called neuro-monitoring. It determines the health of the spinal cord live during the surgery. The broken spine had to be further broken to correct it. Then I inserted some implants and rods to support it. After that the rest was easy as they held the spine in the normal position,” said Dr Kothari.

Dr Kothari and Dr Ameet Pispati, director, orthopaedics performed the surgery. Ushire was discharged on August 12.

“His spine is straight. He is already walking around and not in much pain. He called me today to tell me his stitches were removed,” said Dr Kothari. The ordeal cost the family R5 lakh. Aravinda said the hospital provided them some concessions.

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