Ankita Panja was 2 years old when we first met her in the hallway of the Ramakrishna Mission Hospital. She was being carried in her mother’s arms because it was too painful for her to stand or walk. She had gradually lost the ability to walk and had begun to lose weight, had no appetite and was having fevers. There was a visible lump in the middle of her back.
We sent her for x-rays of the spine, which showed an abnormal alignment, a kyphosis of the spine at the junction of her thoracic and lumbar spine. Ankita was the youngest patient we have seen infected with tuberculosis of the spine. The tuberculosis infection had destroyed the 11th and 12th thoracic vertebrae and was putting pressure on her spinal cord, accounting for the pain and the difficulty with standing or walking. There was no question that she needed urgent anterior and posterior surgery to correct her spinal problem and to prevent further damage to her spinal cord.
The first stage of Ankita’s surgery consisted of stabilizing the spine with instrumentation spanning the diseased area of the spine. She was so small that we had to insert rods and screws normally used in the cervical spine to stabilize her spine from the back. The second stage of the surgery required us to perform a thoracotomy (an incision to open the chest cavity) so that the destroyed vertebra could be removed and the infection surrounding the spinal cord removed. One of her ribs was removed, cut into pieces, stacked side by side and bound with suture like a bundle of sticks to replace the defect where the vertebrae once were.
Ankita spent several days in the paediatric ICU after surgery. Her first days were stormy, as pain control is difficult due to very limited drug choices in the Kolkata hospital. Ultimately, she made very good progress and after several days she was fitted with a spinal brace and gradually allowed to get out of bed. Ankita made a full recovery and after receiving anti-TB drug therapy, was cured of her infection.
The following year we returned to Kolkata and one of the first patients we saw in clinic was Ankita with a big smile on her face, and literally running to greet us. Seeing this bright and active little girl, recovered from major surgery, reminds us why Operation Straight Spine and our volunteer team’s tireless efforts are so important to those we care for.