Highly complex spinal reconstructive surgery was recently successfully completed in Cape Town on an 18-month-old toddler with severe congenital scoliosis, a spinal deformity caused by vertebrae that are not properly formed, which causes the spine to curve sideways.
Mckenna Atson of Cape Town was born with three malformed vertebrae growing on the right but not the left, causing a progressive deformity as she got older. Orthopaedic spine surgeon, Professor Robert Dunn, who performed the surgery at UCT Private Academic Hospital, says that, at 18 months and just 9kg, Mckenna was extremely young and small to undergo the necessary spinal surgery to correct the deformity.
"It had, however, become imperative that we operate before she suffered irreversibly damaging complications from her condition. Left untreated, the spinal deformity would have continued to develop as she was growing, causing her severe structural imbalance, respiratory dysfunction, probable spinal cord compression and even possible paralysis," adds Prof Dunn, who is widely considered to be one of South Africa's foremost spine surgeons.
"The surgery required was highly intricate, certainly one of the more complex surgeries I have ever had to perform on such a young child, but we are pleased to have successfully completed it with the assistance of anaesthetists, Dr George Hartwig and Dr Piet Roux, at UCT Private Academic Hospital's recently commissioned paediatric surgical unit.
"We were able to correct and straighten her spine, and we expect Mckenna to have no further problems and to grow normally now. It was most gratifying to see this brave young girl walk herself out of the hospital just three days after having had the operation."
Mckenna's mother, Lee-Anne Atson, affirms that her little toddler has made an excellent recovery and is now able to stand up completely straight, whereas her gait had been increasingly skewed to the left prior to the operation.
"She has always been a highly active child, but we were rather astonished when she asked to walk on the second day after the operation," relates Atson. "My husband and I are delighted with the outcome of Mckenna's procedure and are so thankful to everyone who made it possible. Mckenna has just had a check-up and her doctors are pleased with her progress. She is an absolute bundle of energy and joy at home."
In the same week that Mckenna's operation was completed, Prof Dunn performed surgery on a 13-year-old girl from Mauritius with adolescent idiopathic scoliosis at the new paediatric surgical unit, achieving a dramatic correction of her spinal deformity. In another recent case, a child from Durban was treated at the new centre for a type of spina bifida.
Thanks to the new paediatric surgical facility, the clinical expertise of the specialists practising at UCT Private Academic Hospital, and the dedicated nursing care, we are able to offer a world class service for the management of all types of childhood scoliosis as well as perform the most intricate of paediatric orthopaedic procedures on the most difficult of cases right here in Cape Town. The centre is already attracting national and international patients and we fully expect it to become a Southern African treatment facility of choice on the sub-continent for children who are suffering from such potentially debilitating conditions," says Lieselle Shield, general manager of UCT Private Academic Hospital.
Prof Dunn explains that congenital scoliosis is a sideways curvature of the spine that is caused by a defect in the spine that is present from birth. Another type of scoliosis begins in adolescence and is more common. He says congenital scoliosis is relatively rare, occurring in 1 in 10 000 newborns, but points out that this nevertheless constitutes a significant number of children.
"Greater awareness needs to be raised on the subcontinent of this debilitating medical condition, particularly as many of these children often require early management and treatment. Because scoliosis tends to cause progressive twist in the spine as the child grows, it may cause a number of related complications such as respiratory, cardiac and neurological problems."
Parents should be on the look out for an uneven rib cage, one shoulder that is higher than the other and/or a twisting of the spine to one side. A hump on one side of the spine may also be visible when the child bends over. Prof Dunn suggests where parents are concerned about their child's spine or gait, the youngster should be investigated by a doctor. He points out that the condition is manageable in most cases and sometimes so mild that it requires no treatment.
Lee-Anne Atson says that Mckenna's condition was detected before her birth. "We were advised by our paediatrician to take her for further medical assessment once she started walking. At 18 months we took her to orthopaedic surgeon Dr James Watt who conferred with Professor Dunn, and they advised us that it was time for Mckenna to have an operation to correct her spine."
"I was overwhelmed at the top class treatment we received at UCT Private Academic Hospital. The doctors and nursing sisters were incredibly supportive throughout Mckenna's stay. Professor Dunn carefully explained the treatment plan from the outset and made every effort to inform us of the progress of the operation. We are so happy to have had our chatty Mckenna's problem taken care of so well. It is clear that Mckenna thinks it was her hand that was operated on due to the intravenous drips, not her back," adds Atson.
Shield, says: "The new paediatric surgical unit considerably enhances the care we are able to offer our young patients and brings new hope to scoliosis sufferers and other children with other conditions needing specialised surgery."
Editor's Note
UCT Private Academic Hospital (UCTPAH) in Cape Town has not only become one of the best known centres for medical care, but is also a training centre for South African healthcare practitioners. It is a joint venture between Netcare and the University of Cape Town's Medical School, Groote Schuur Hospital and Red Cross Children's Hospital. The partnership has allowed the UCT Medical School's students and registrars to benefit greatly from the hospital's training facilities.
It also ensures a cross-pollination of ideas between the different institutions, which contributes to the advancement of medicine in South Africa. Amongst others, it houses the OrthoUCT practice, which is an association of Orthopaedic Surgeons covering all the disciplines of the speciality.
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Issued by: Martina Nicholson Associates (MNA) for UCTPAH
Contact : Martina Nicholson, Graeme Swinney, Meggan Saville or Pieter Rossouw
Telephone: (011) 469 3016
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