The big operative case of the day was a young lady named Priscilla who had idiopathic scoliosis. Priscilla is a nursing student in her final few months of nursing school. She has been trying for years to visit our mission and have surgery, but because of issues with timing, she has never had the opportunity to have her deformity corrected. This year, the stars aligned and we were able to see Priscilla and schedule her for surgery. This meant that she would have to take a leave of absence from school for several months, and although this would set her back a bit in the process of becoming a nurse, she did not want to let the chance slip away again. We spent the morning and early afternoon correcting her deformity and fusing her spine into a new, straighter position.
Our second patient was a young lady named Jolly who presented with back and leg pain. She was found to have fractures and erosion at L2-L3; the appearance was suggestive of an infectious process. Indeed, when we reached the area of the fracture, we found infectious material within the disc space. This was removed along with part of the eroded/fracture vertebral bodies and her spine was instrumented into a more normal alignment. We sent cultures of the infectious material and placed some antibiotic powder into the wound before closing.
During the day, Dr. St. Clair saw several new patients in the wards, one of whom was a man with a cervical spine injury in need of stabilization. The practice of carrying objects on one’s head has existed for centuries in Africa and other developing countries. Unfortunately, this patient was carrying a large load of firewood on his head when he tripped, applying a heavy flexion and axial compression force to his neck, which resulted in a fracture/dislocation at C4/C5. He lost function in his arms and legs almost immediately after the injury, and because the event occurred days before he reached us, his prognosis for recovery of limb function was poor, but he was in need of stabilization to prevent and further deformity or injury from occurring. We took the patient to the operating room after our second case, where we reduced the dislocation and removed some herniated disc material that was compressing his spinal cord at that level.
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