By Shauna Jemmott

The life of four-year-old Stefon Bradford has changed, and his Linden family is thankful to neurosurgeon Dr. Amarnauth Dukhi, who spearheaded a successful surgery to correct a congenital spinal disease termed Myelomeningocele.

Medical references have described Myelomeningocele to be a birth defect in which the backbone and spinal canal do not close before birth. It is caused when there is incomplete closure of the spine during the first month of pregnancy, a time during which the two sides of the spine (or backbone) join together to cover the spinal cord, spinal nerves and meninges (the tissues covering the spinal cord).

It is a neural tube defect in which the bones of the spine do not completely form, resulting in an incomplete spinal canal, causing the spinal cord and meninges to protrude (stick out of) from the child’s back. It is a rare disease and may affect one out of every 4000 infants, according to medical journals.

The child’s grandmother, Sandra Seymour, told the Guyana Chronicle that she was thankful to Dr. Dukhi and his team for successfully performing the life-changing surgery, something which her family has been hoping to accomplish for the past four years.

“He’s done a great job so far,” Seymour said as she waited with her grandson, while his mother Tonica DaSilva (who is also her daughter) travelled to Linden to take care of her other two children Monday.

She said the family, after seeking surgical help, was told four years ago that there was no neurosurgeon available here in Guyana and a search began online for a possible neurosurgeon overseas. However, Dr. Dukhi completed his studies and returned, which saved the family from a huge overseas bill.

Dr. Dukhi, a neurosurgeon at Georgetown Hospital for 17 months now, told the press at the Georgetown Hospital that Bradford was born with a neural tube defect, in which the spinal cord was exposed into the lower back, and was pending surgery for four years.

Such surgery overseas is “quite expensive as all neurosurgical procedures are very technical and it’s quite expensive to do them in any other part of the world.

“As you know the family was waiting here for four years to have this surgery done. We captured him in the neurosurgical clinic about six months ago and we needed (to fix) some final issues … and some microsurgical dissection kits,” the doctor pointed out.

He said the equipment was acquired and the surgery completed successfully on April 8. During the five hours that it lasted, a team of four doctors – including Drs. Asif Subhan, Jarrel Watson, and Yuli Permansingh – reconstructed the child’s spinal cord, closed the defects and ensured Braford’s lower back looked normal again.

“We were able to reconstruct the spinal cord, we were able to close the defects and we were able to give him a normal looking lower back now.

“When you open that Myelomeningocele – that defect – you would have the spinal cord, the actual nerve there exposed out, and that would have to be taken good care of so it’s not damaged during surgery, and for that reason we needed some special instruments to be able to perform such a case here,” the doctor explained.

He described it as a “very technical surgery” and explained that while part of the child’s spinal cord (nerves) was exposed, it had to be reconstructed or repaired by “creating a new spinal canal to fit those nerves in and then close and reconstruct the back”.

He said that though he had done similar surgeries before, what was unique about this particular one was that the child had already matured four years on. It is a surgery that is usually done in the first six months of a child’s life.

Dr. Dukhi explained that a VP shunt had to be placed into the child’s head towards his abdomen, preventing the accumulation of certain fluid in the brain, thus protecting it from injury.

“Most of the times when you repair these Myelomeningocele, almost 95 to 97 (percent of patients) develop something called a hydrocephalus, which is basically the accumulation of certain spinal fluid in the brain, so we had to put a system in place where we’re able to drain the fluid from the brain into the belly.

“So you have something that is called a VP shunt in place also, so that would avoid further complications. The spinal cord is attached to the brain, so if you’re going to repair a defect at the bottom, it’s gonna accumulate the fluids at the top, so that’s why a shunt is placed in the brain towards the abdomen, to help to release the pressure on the brain, and with that they live as per normal most of their lives,” he explained.

When the Guyana Chronicle was at the Paediatric ward, Stefon Bradford was doing fine. He looked studious holding a Tablet on his thigh as he sat on his bed with his grandmother by his side. He is expected to be discharged today.

“He is doing fine, he is actually walking, and we have no major neurosurgical deficits except that he cannot control his urine as yet. Hopefully we are looking for some improvements with that, but that would only be progressive with time,” Dr. Dukhi explained.

The child would need much follow-up care, which according to the doctor would include monitoring of the child for any signs of infection. Neurological deficits in terms of losing function of the lower limbs have not been observed post-surgery.

“He’s actually walking, he’s moving and hopefully that’s just the starting of him being able to control the other neurological deficits (as) he is not able to control his urine.”

With this new accomplishment, the Neurosurgical department of GPHC has come “a long way from when we just started” and though it still lacks some instruments and resources to get certain surgeries done, the doctors are hoping that they would soon be able to acquire some of those instruments to do similar surgeries.

“As long as the resources are there, definitely, we have the human resource capacity. We’re now waiting in terms of having the backup plan, in terms of instruments data and a few other stuff that we’re still working on,” Dr. Dukhi told the Guyana Chronicle.

Dr. Dukhi completed neurosurgical studies at Calixto García University Hospital in Havana, Cuba.