Wednesday, July 12, 2017

Turning The Tables On Bad Backs

Thanks to the Allen Table, spinal surgeries at a hospital in Kerala have become so much more easier

Photos:  Dr. C. Anu Thomas, senior consultant neuro-surgeon (extreme left) with his team; the Allen Advance Table 

By Shevlin Sebastian

K. Balan lies on a table in the operating theatre of the Indo-American Hospital at Chemmanakary (25 kms from Kochi). Dr. C. Anu Thomas, senior consultant neuro-surgeon, prepares to release a compressed nerve in the fifth vertebrae. For several weeks, the 38-year-old Balan had been bed-ridden, because of the pain. He had tried Allopathy as well as Ayurveda treatment, before he came to the hospital, in a state of desperation.

“This is a routine minimally invasive surgery,” says Thomas. But there is one difference. Balan is lying on the Allen Advance Table. This table has been imported from the USA at a cost of over Rs 1 crore.

The advantage of this table is that, at the press of a button, it can turn 360 degrees, with the patient strapped in. “Before we got this table, when we had to do a back surgery, six people had to physically lift the patient, move him to another bed, and turn him over,” says Thomas. “When a person has a fracture of the spine, any minor movement can be harmful. So, you have to be very careful. But, on the Allen Table, this problem does not arise at all. Patient safety is 100 per cent.”

There are other advantages, too. Since the equipment is made of carbon, when an image of the spine is taken, with the C-Arm, a radiological tool, only the image of the spine can be seen. “In the case of an ordinary table, because it is made of steel and other materials, it will appear as markings on the image,” says Dr. Jain George P, the chief of neurosurgery. “So the visuals lack clarity. Without clear visuals, it is difficult to operate accurately.”

Interestingly, the time taken for a surgery has been reduced. “In complex surgical cases, we save between 30 minutes and an hour, because we don't need to move the patient,” says Dr. Jaser Mohammed Iqbal, consultant anaesthesiologist. “Most surgeries take anywhere between three to nine hours.” These include operations for disc hernia, tumours, spinal deformity, and bone fractures on the spinal column – cranio-cervical, thoracic and lumbosacral.

Interestingly, the cost for patients have not been increased. “That is because most of our clientele come from middle and lower-middle class families,” says Dr. Thomas. “So we do not want to place an undue burden on them.”

Asked why the Allen Table is not yet being used in India, by other hospitals, Jain says that the prohibitive cost is the major deterrent. “Also, there is a lack of awareness about it among medical professionals,” he says. “I came to know about it only when I went to do fellowships in Detroit and Tampa, USA. Maybe, the company could do some aggressive marketing in India.”

Meanwhile, Balan, a truck driver, is recuperating steadily, following the surgery. “I don't feel any pain at all,” he says. But he has ensured that he takes the tablets daily, as prescribed by the doctor. For a long time, Balan had been extremely worried, because he is the sole bread-winner for his family, which consists of his wife, two children and parents. “In the end, everything has worked out well,” he says, with a smile. 

(Sunday Magazine, The New Indian Express, South India and Delhi) 

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