Doctor Nguyen Van Trung examines a patient – Photo: D.LIEU
This is also the first time endoscopic surgery to treat cervical spine fractures has been performed in Vietnam.
Challenging Case
The Department of Orthopedics and Spine Trauma, Bach Mai Hospital has just received a 25-year-old man who had a traffic accident and suffered a cervical spine injury.
The patient, Mr. PVT (from Thai Binh), had an accident due to falling off his motorbike, hitting his head on a hard surface, leading to severe neck pain.
After examination and X-rays, doctors determined that he had a fracture of the odontoid process - an important structure in cervical spine movement.
According to Dr. Nguyen Van Trung - Deputy Head of Orthopedic and Spinal Trauma Department of Bach Mai Hospital - odontoid fracture is a dangerous injury, easily leading to displacement, non-union of the bone and high risk of spinal cord paralysis, leaving serious sequelae. Conservative treatment methods often have a failure rate of up to 85%.
Previously, open surgery often rigidly fixed the C1-C2 vertebrae, limiting natural neck movement and easily leading to adjacent joint degeneration.
Endoscopic surgery not only overcomes these limitations but also maintains the rotational mobility of the neck, which is especially suitable for young patients.
“To perform this endoscopic surgery, the doctors had previously performed many open surgeries to treat cervical spine fractures. Along with that, they were proficient in performing endoscopic surgery for other injuries.
Therefore, after careful consideration and preparation, the doctors decided to perform laparoscopic surgery with many advantages.
Among them, the outstanding advantage of advanced techniques helps preserve the natural movement of the C1-C2 joint (this joint is responsible for 50% of the neck's rotation ability), while reducing the risk of infection, less blood loss and shortening recovery time," said Dr. Trung.
Image of endoscopic surgical tube being inserted through a 1cm incision – Photo: BVCC
The surgery requires a highly skilled medical team and good coordination because the neck area contains many large blood vessels and important organs.
“During the consultation and surgery, the doctors also considered all possible options. If the endoscopic surgery was not successful, they would switch to open surgery to ensure the patient’s safety. Fortunately, the endoscopic surgery was successful. This is the first successful endoscopic surgery to directly screw the odontoid process in Vietnam,” said Dr. Trung.
Immediate recovery after surgery
Sitting on the hospital bed, Mr. T. has recovered after the surgery. Mr. T. shared that after only one day of surgery, he was able to sit up, walk and eat normally without feeling any discomfort or limited movement in his neck.
“In particular, the small incision of only about 1cm left almost no trace. I did not feel any screws in my neck. All activities were the same as before the accident,” Mr. T. shared, saying he felt very lucky to know that he was the first patient to have successful surgery using this method.
Doctor Hoang Gia Du, head of the Department of Orthopedics and Spine at Bach Mai Hospital, added that endoscopic surgery with direct screw placement on the odontoid process is a major step forward, bringing high efficiency with a success rate of 90-95%.
“This technique is not only an achievement of the medical team but also opens up opportunities for safe, advanced treatment for many patients in Vietnam. This is a major step forward in the field of spinal trauma and orthopedic surgery, bringing new hope to patients,” said Dr. Du.
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